Monday, December 28, 2009

Finnish EHR's Clumsy, Mission Hostile, Consume Doctors' Precious Time

It seems common wisdom in the U.S. that the "Europeans are way ahead of us" in computerized medicine.

Perhaps the common wisdom is not so wise. This from Finland:


Clumsy computer systems consume doctors’ time

When Arto Virtanen, a doctor at a public health clinic, wants to access the information of a young patient, 12 windows of different sizes open up on different parts of his computer screen. Virtanen has to deal with each of them every time a patient visits him for routine postnatal care.

“It used to be that a municipal doctor would see six or seven patients in an hour, when documentation was not at its present level”, Virtanen says. “Then there came more paperwork, and four patients were seen in an hour. Now if a doctor wants to read all the information about a patient in the information system, there would only be time for consultations with, say, two patients in an hour.”

Clumsy computer systems are already seen as a danger to patient security, says Tiina Lääveri, a member of the board of the Finnish Medical Association, who has acquainted herself with the various systems.

Clumsy retrieval of data is one source of danger. Important information can disappear into the nooks and crannies of the software.

“There can be 100 pages of text without any summary, out of which a doctor should find information in a couple of minutes."

In hospitals, the systems do not separately tell nurses about changed dosages of medicines.

“The information is there, mixed in the mass of all of the rest of it, where it gets lost.”

In addition to causing outright dangers, computer systems waste precious working hours. In addition to actual medical data, the computer requires the recording of various items of statistical information.

Patients can see the problem as well. Up to 43 per cent of time reserved for a patient with an appointment to see a public health doctor can be spent dealing with a computer, according to a study published earlier this year in Lääkärilehti, the publication of the Finnish Medical Assotiation.

A national health archive now under development would not help things, as data would still be handled with existing software.

“Software companies have started to become interested in listening to users only in recent years”, Lääveri says.

Virtanen in Rajamäki would like to see more compatibility between systems. “There could be a common database, which should be easily accessible by a network browser”, Virtanen says.

“It might also be constructed according to what this working process really is.[You don't say? - ed.]

Can health IT be any more mission hostile than this? (Unfortunately, the answer to what started as a rhetorical question is probably "yes." See this post on the US military's EHR AHLTA, and see my eight part series "Are Health IT Designers, Testers and Purchasers Trying to Harm Patients?" on mission hostile commercial HIT starting here.)

Reports of difficulty in EHR Utopia have leaked out of other European countries such as the Netherlands and Germany, not to mention the UK.

The most startling observation is that “software companies have started to become interested in listening to users only in recent years."

What manner of cavalier simpletons and opportunists populate such health IT companies?

-- SS


It appears AHLTA may be a bad as it is due in part to "politics as usual" a.k.a. corruption. See "Company won earmarked funds for work on military health records." If such conduct has been commonplace during AHLTA'a tortured history, it could explain just how AHLTA became as terrible as the senior military officials describe it in the linked article above.

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