Governments seem to be suckers for computer salesmen who tell them that computerizing their operations will save them money and allow them to operate more efficiently.
It doesn’t happen. The one certainty is that the process will cost way more than budgeted and the big uncertainty is whether it will work at all. I could give innumerable examples but the one that stands out is Britain’s experience of linking all their government hospitals into one network with all the records of all the patients in the country on it. The Brits spent over 12 BILLION pounds over a period of about a decade on it. It never worked and has just recently been scrapped
Unbelievably in the circumstances, computerization is one of the far-fetched dreams of Obamacare. You would think the British experience would have engendered caution but it has not.
One of my readers is an anesthesiologist who is a computer enthusiast and an instructor for Electronic Hospital Records. He reports below one of the more successful uses of computerization in hospitals.
Its limited degree of success stems largely from the fact that a “tried and true” system was bought “off the shelf”. It is when governments order an entirely new system for themselves that the woes often become insurmountable:
We just installed Electronic Hospital Records here Nov 6. Amusing how the State Government canâ€™t seem to do anything right â€“ any claim that Government can do medicine â€œmore efficientlyâ€ is laughable.
Gettling into the game late is an advantage â€“ the EPIC system has been used successfully in U T hospitals in Texas and many other places â€“ successfully.
So using a product that has been made better by several generations should be an advantage â€“ but think again when State Government interferes.
Problem # 1
HER was funded by Medicare Stimulus, with a deadline; much was done in haste to meet mandated deadline, Nov 6.
Instead of using a product â€œas isâ€, each of multiple State Hospitals just â€œhad to haveâ€ â€œcustom featuresâ€ that simply were not on the original system.
As I know (wife was a programmer for many years) people just canâ€™t wish for â€œcustom programmingâ€ and get what they want in a reasonable period of time. Multiple delays.
Problem # 3
Anesthesia machine and monitor vendors were NOT informed that EHR was planned until several months ago. Modules for the machine and monitor to â€œtalkâ€ to computers was ordered late; this kind of hardware must be custom ordered; it isn’t sold in Radio Shack or Best Buy. When we went â€œliveâ€, many modules were not yet available, so data had to be entered manually.
Problem # 4
By the â€œgrapevineâ€, our system was a â€œlow budgetâ€ version, with low level support; when a problem occurs (like computer wonâ€™t boot etc..), it may be hours before a support person shows up in the operating room; and often, personnel donâ€™t know whatâ€™s happening because the system is so specialized. Likely support package was low budget as well.
Problem # 5.
No surprises here since, in the past, institutions have lost tons of money when new computer systems fail at billing:
ALL my records from the last 3 weeks are listed as â€œnot closedâ€ (records are â€œclosedâ€ when all signatures are checked by myself, and listed as â€œcompleteâ€).
Although records are listed as â€œclosedâ€ in my workspace, on the central system they are listed as â€œopenâ€; billing cannot occur electronically with open records.
So now entire anesthetic records are printed, and searched by hand for completeness before paper records are submitted for billing; rumor has it that this system will not work properly until local software is upgraded.
EHR is better medicine â€“ looking up patient records online is fast, no paper must be searched for and manually delivered; and paper records are often â€œlostâ€ because multiple people are using them, often without the record people knowing who has the record at the moment; worst time is days post op, when records are being used by business managers for billing; to dictate reports etc. With HER, we simply search patientâ€™s name or numbers.
But PLEASE â€“ anyone saying EHR saves money is a fool; besides hardware, a system of IT support is needed; on top of this, the system charges a fee.
Posted by John J. Ray (M.A.; Ph.D.). For a daily critique of Leftist activities, see DISSECTING LEFTISM. To keep up with attacks on free speech see TONGUE-TIED. Also, don’t forget your daily roundup of pro-environment but anti-Greenie news and commentary at GREENIE WATCH . Email me here