tag:blogger.com,1999:blog-9551150.post9038390136064030887..comments2024-03-28T01:27:23.408-04:00Comments on Health Care Renewal: A Critical Review of a Critical Review of e-Prescribing ... Or Is It CPOE?Roy M. Poses MDhttp://www.blogger.com/profile/00497209843184497847noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-9551150.post-35388181928479132312012-02-12T13:20:11.398-05:002012-02-12T13:20:11.398-05:00Anonymous February 11, 2012 9:31:00 PM EST wrote:
...Anonymous February 11, 2012 9:31:00 PM EST wrote:<br /><br /><i>Indeed, these are experimental devices such that when their governance of care is studied, the patients whose care is so governed must be consented and informed of the risk of death from unintended adversity. </i><br /><br />Health IT medical devices have gotten special accommodation for many years in this regard, for no reasonable InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-51628671841723974982012-02-11T21:31:27.811-05:002012-02-11T21:31:27.811-05:00From anonymous who signed: "Surely it is unet...From anonymous who signed: "Surely it is unethical not to implement and evaluation interventions which show clear evidence of reducing these harms."<br /><br />The incidence of unintended consequences of CPOE and electronic prescription devices is high, creating death and injury in patients who otherwise would not have suffered if it were not for these new devices. Thus, the authors areAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-26468291403324615332012-02-11T14:02:42.477-05:002012-02-11T14:02:42.477-05:00I add that if you are referring to as "anecdo...I add that if you are referring to as "anecdotal" my statement that <i>"There can easily be scenarios (I've seen them) where poorly done HIT's distracting effects on clinicians is moderated to some extent by process and other improvements</i>", in fact that passage was just an aside to the main points of those paragraphs that:<br /><br /><i>A common scenario in HIT InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-42144736857884448852012-02-11T13:28:12.689-05:002012-02-11T13:28:12.689-05:00--- continued from above ---
However what has bee...--- continued from above ---<br /><br /><i>However what has been totally ignored from your argument is that hundreds of patients are harmed by medication errors every day.</i><br /><br />Indeed my explanation accounts for that issue: <i>In other words, patient Jones was now subjected to a cybernetic error that would not have occurred with paper, in the hopes that patients Smith and Silverstein InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-81312741845654314432012-02-11T13:27:58.234-05:002012-02-11T13:27:58.234-05:00Re: J. Westbrook's comments.
Dr. Westbrook,
...Re: J. Westbrook's comments.<br /><br />Dr. Westbrook,<br /><br /><i>Unlike the US, CPOE is not a commonly used term to describe these systems in Australia or the UK.</i><br /><br />That is a fair comment. <br /><br />Since the article was intended for an international audience, though, perhaps that distinction should have been noted. <br /><br /><i>In your attempt to find fault with all InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-80623739177567764932012-02-10T23:01:06.676-05:002012-02-10T23:01:06.676-05:00The paper clear states the study took place in two...The paper clear states the study took place in two major teaching hospitals. You might also note this is an international journal and thus is intended for a global audience. Unlike the US, CPOE is not a commonly used term to describe these systems in Australia or the UK. The CMS definition you present is entirely consistent with e-prescribing systems as applied in this study.<br /><br />In yourAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-46998460995187499112012-02-10T10:50:19.921-05:002012-02-10T10:50:19.921-05:00Live IT or live with IT said...
if they can't...Live IT or live with IT said...<br /><br /><i>if they can't deliver and administer the meds ordered by the MD correctly when the patient is in the hospital, that is pretty sad. </i><br /><br />Hospitals are under financial duress and it leads to bad processes and "inexpensive" employees - and errors. (I am not going to get into the issue of executive salaries and perks, however; InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-13842553645896353992012-02-10T10:45:29.442-05:002012-02-10T10:45:29.442-05:00Anonymous February 9, 2012 8:50:00 PM EST wrote:
...Anonymous February 9, 2012 8:50:00 PM EST wrote:<br /><br /><i>The study was flawed due to its failure to consider delays in care and medication administration as an error caused by these experimental devices</i><br /><br />I agree with that assessment. A temporal dimension was not considered. I am adding this comment as a footnote to the main blog post.<br /><br /><i>d, what is an "InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-16556384905544926842012-02-10T00:55:24.955-05:002012-02-10T00:55:24.955-05:00Seriously, I mean really, if they can't delive...Seriously, I mean really, if they can't deliver and administer the meds ordered by the MD correctly when the patient is in the hospital, that is pretty sad. <br /><br />Indeed, I wonder what the definition of failure to administer was, a difference between what the doctor ordered vs. what was delivered and administered or was is what the computer said to deliver vs. what it said was Live IT or live with ITnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-31045833594490207642012-02-09T20:50:48.185-05:002012-02-09T20:50:48.185-05:00The study was flawed due to its failure to conside...The study was flawed due to its failure to consider delays in care and medication administration as an error caused by these experimental devices. <br /><br />Delays are widespread with CPOE devices. One emergency room resorted to paper file cards and vacuum tubes to communicate urgency with the pharmacy. Delays were for hours.<br /><br />And, what is an "illegal" prescription, anyway?Anonymousnoreply@blogger.com