tag:blogger.com,1999:blog-9551150.post3789826550560186610..comments2024-03-28T01:27:23.408-04:00Comments on Health Care Renewal: Did Toxic Effects of an EHR Kill Rory Staunton?Roy M. Poses MDhttp://www.blogger.com/profile/00497209843184497847noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-9551150.post-61778390294190315502013-02-05T15:37:04.440-05:002013-02-05T15:37:04.440-05:00If this hospital is really was using the system ca...If this hospital is really was using the system called Epic as mentioned in the article, then I can tell you from personal experience, that there is no requirement or "hard stop" that forces you to check or sign off on labs or vital signs...It would be very easy to send someone home and then have VS or labs come back after the person has been discharged... Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-49885348731722900822012-07-21T20:43:38.598-04:002012-07-21T20:43:38.598-04:00I believe in the comments the writer of the articl...I believe in the comments the writer of the article references written nurses and doctor notes.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-14412827089140225422012-07-21T09:03:27.793-04:002012-07-21T09:03:27.793-04:00You ask: "Did Toxic Effects of an EHR Kill Ro...You ask: "Did Toxic Effects of an EHR Kill Rory Staunton?'<br /><br />Yes, until proven otherwise by the NYU leadership providing evidence to support their denial.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-47435951608304024672012-07-19T12:15:52.907-04:002012-07-19T12:15:52.907-04:00Anonymous July 18, 2012 7:52:00 PM EDT wrote:
Was...Anonymous July 18, 2012 7:52:00 PM EDT wrote:<br /><br /><i>Was there mayhem in that ER due to a crash of the EHR and/or other electronic and digital medical care infrastructure?</i><br /><br />That is indeed another consideration that should be investigated. See for instance "<a href="http://hcrenewal.blogspot.com/2011/05/twelve-hour-health-it-glitch-at.html" rel="nofollow">Twelve Hour InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-39413231706745162862012-07-18T19:52:47.627-04:002012-07-18T19:52:47.627-04:00Was there mayhem in that ER due to a crash of the ...Was there mayhem in that ER due to a crash of the EHR and/or other electronic and digital medical care infrastructure? Just wondering how otherwise competent doctors would have not acted on the constellation of data had they seen (or was it lurking in an electronic silo?) it and connected the dots. Hmmm.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-85961138514206624092012-07-16T09:54:33.865-04:002012-07-16T09:54:33.865-04:00"Keith" anonymous wrote:
Seems to me th..."Keith" anonymous wrote:<br /><br /><i>Seems to me that this is more an issue of process where the medical personel locked themselves into a presumed diagnosis and did not wait to confirm the test results against their presumption before releasing the patient</i><br /><br />Whatever happened was surely multi-factorial (that is, the dreaded "alignment of the holes in the cheese"InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-16125071426137976242012-07-16T09:53:20.037-04:002012-07-16T09:53:20.037-04:00Steve Lucas wrote:
We also have to wonder about t...Steve Lucas wrote:<br /><br /><i>We also have to wonder about the often placed gag orders covering the release of negative information regarding IT projects.</i><br /><br />The industry is spoiled. Through decades of misinformation and influence it has been given <b>unprecedented special regulatory accommodation</b> compared to other healthcare sectors, and to other risk-prone industries such asInformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-70775027202188453532012-07-15T11:19:43.707-04:002012-07-15T11:19:43.707-04:00One issue often pointed out is the world wide natu...One issue often pointed out is the world wide nature of this problem. Ontario, Canada is behind schedule and over budget on an ehealth project, but we find:<br /><br />“Mitchell said the registry is now in testing with CGI Consultants Inc., the vendor that won the contract to build the registry in August 2010, and that any questions about why it was delayed or when it would be complete should be Steve Lucashttps://www.blogger.com/profile/02457363632413213801noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-9680958123384047432012-07-15T10:01:37.552-04:002012-07-15T10:01:37.552-04:00Seems hard to blame the EMR in this awful event wi...Seems hard to blame the EMR in this awful event without more details. Most EMRs I have used require the doctor who ordered the test to lectronically sign off on the result. How this works in an emergenccy room where docs may be working shifts and and a doctor releasing a patient may not be the doctor that ordered the test may pose a problem.<br /><br />Compare to the old method of paper reslts Keithnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-13741677634522952342012-07-14T19:31:18.567-04:002012-07-14T19:31:18.567-04:00Machines take vital signs and send them to the EHR...Machines take vital signs and send them to the EHR. If a person is involved, such is an aid who puts them in the EHR. Nurses spend hours charting while the patients lie suffering.<br /><br />The doctors will be blamed but the likely facilitator is the EHR that did not indicate new data had arrived and that served as an impediment to the workflow that would have otherwise raised the sepsis Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-53269513318870386392012-07-14T16:54:23.957-04:002012-07-14T16:54:23.957-04:00dmillho1 said...
While the EHR may have contribut...dmillho1 said...<br /><br /><i>While the EHR may have contributed to this sad event, the person who took the last vital signs is culpable as well.</i><br /><br />The vital signs are arguable; the labs, I do not believe, are. Of course, there are multiple possible levels of responsibility possible - clinicians themselves, and corporate (if the IT contributed to a dangerous environment).<br /><br InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-11123879997190715062012-07-14T11:01:32.717-04:002012-07-14T11:01:32.717-04:00While the EHR may have contributed to this sad eve...While the EHR may have contributed to this sad event, the person who took the last vital signs is culpable as well. Regardless of the discharge order already written, the finding of significant fever, tachycardia, etc. should have raised alarms for the staff person and sent that individual to someone who could make a clinical-care decision.dmillho1https://www.blogger.com/profile/05412145869817724201noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-84036906231036515402012-07-14T02:05:08.127-04:002012-07-14T02:05:08.127-04:00The fact that the hospital has a special "Sto...The fact that the hospital has a special "Stop Sepsis" program, with an associated "screening tool", makes this story even more remarkable. Could clinicians be relying too much on this tool to detect sepsis, and not be sufficiently aware of limitations it may have? <br /><br /><i>"A screening tool in the Stop Sepsis program, used when a patient first arrives in the Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-75023236312117703182012-07-13T22:41:37.152-04:002012-07-13T22:41:37.152-04:00I hope they sue the EMR vendor.I hope they sue the EMR vendor.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-49354694170138603452012-07-13T13:23:16.726-04:002012-07-13T13:23:16.726-04:00While the EHR may have contributed to this sad eve...While the EHR may have contributed to this sad event, I believe the person who collected the data just before this boy was discharged is accountable as well. That person should have seen that a change was happening and reported to someone who could and would take action.dmillho1https://www.blogger.com/profile/05412145869817724201noreply@blogger.com