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Hospital Turns Away Ambulances When Computers Go Down
CurtMonash writes "The Indianapolis Star reports that Tuesday Morning, Methodist Hospital turned away patients in ambulances, for the first time in its 100-plus history. Why? Because the electronic health records (EHR) system had gone down the prior afternoon — due to a power surge — and the backlog of paperwork was no longer tolerable.
If you think about that story, it has a couple of disturbing aspects. Clearly the investment in or design of high availability, surge protection, etc. were sadly lacking. But even leaving that aside — why do problems with paperwork make it necessary to turn away patients?
Maybe the latter is OK, since there obviously were other, more smoothly running hospitals to send the patient to. Still, the whole story should be held up as a cautionary tale for hospitals and IT suppliers everywhere."
Lawyers, patient safety, and actually getting paid. Vast amounts of documentation must be provided to Medicare/Medicaid and Insurance companies in order to get paid for services. Event the smallest amount of missing or inaccurate documentation can be the difference between getting paid $5 and $5000, the difference between getting paid and getting fined and losing your ability to bill Medicare, etc...
Ed R.Zahurak
You know, oblivion keeps looking better every day.
The prevailing attitude in the medical industry is that unless patients are telling you where it hurts, they're lying. Doctors will tell you that patients are "forgetful" or possibly "confused about their past conditions and may not understand what was wrong with them". Their lawyers tell them that patients are drug addicts looking for the next narcotic hit or looking to sue them for a big fat malpractice settlement. If I say I'm allergic to iodine, but forget about an allergic reaction I had to antibiotics when I was 3, and they administer antibiotics, they're still on the hook if I decide to sue. "Look at my file! It says I'm allergic ot antibiotics! I said I was allergic, but he wasn't listening!"
Is it sad that I am more likely to recognize you and your posts by your sig than your name or UID?
Actually, secretaries are reverting to their original function, except that the job title has changed to Personal Assistant. A secret-ary was an assistant who was entrusted with your secrets (hence Secretary of State, Foreign Secretary). The job title that typists and data-entry staff should have had was "clerk" (if not typist or data-entry clerk). But secretary was more prestigious, and a good job title always helps keeping people satisfied with low pay. The people who were unable to perform their function in this hospital when the computers died were data-entry clerks.
Consciousness is an illusion caused by an excess of self consciousness.
"Turning away ambulances" is not how it really happens. Let me describe it for you:
The hospital determines it is nearing its capacity to handle emergent cases. The hospital contacts the regional EMS dispatch to let them know. In my area, this is the county Fire Control. When an ambulance calls in that they have arrived on scene, the dispatcher will say, in this case, "Methodist Hospital is the only closed facility." The crew will let the patient know that they can't take them to that hospital. Also, when the crew calls dispatch for a clearance to transport the patient, if the hospital they are going to is closed, dispatch will tell them so (in NY, a patient can demand to be transported to even a closed hospital, but we do our best to convince them to go somewhere else). A hospital ED cannot turn away patients at the door, even if they come by ambulance.
So what if its a truly life threatening situation that can't be stabilized in the field? Say, full cardiac arrest, or uncontrollable arterial bleed? The ambulance will go to the closest facility, even if that is the closed facility, and will not be turned away. The ambulance will contact the receiving hospital directly and give a report on route, giving the hospital time to clear an appropriate room and mobilize the necessary staff to receive the patient.
Hospitals can close for a lot of reasons. Sometimes, a few staff members call in sick and they can't find coverage, so the capacity of the system is reduced. Sometimes a lot of patients come in all at once. Sometimes the hospital's support systems like EMR fail, but it could even be their admissions and billing system that decides to fail and causes the hospital to divert patients. It happens, but the system is designed to handle it.
No sig now
I was an EMT and LPN in the Air Force, back in late 80's and worked 2 years in military and VA hospitals. While there were computerized records, the actual treatment notes stayed on a clipboard that was on the end of the patient's bed. Any pre-existing issues were also noted there.
The dangers of treatment without prior records sounds pretty tenuous. I wonder if this has more to do with the dangers of not being able to bill 'accurately'? Nicest thing about working in a socialized medical system (military medicine is set up as such) was not having to worry about every nickel and dime. Doctors I spoke with liked it, even though they were paid a lot less than they would be in civilian practice. They didn't have to worry about office expenses, insurance, etc. and didn't have HMO's second guessing their work and suggesting cost-saving measures.
I drank what? -- Socrates
The hospital going on divert simply means "If you can take a patient somewhere else without threatening their well being, please do so". It doesn't mean that if I rolled up with someone in cardiac arrest that they'd refuse my patient and send me elsewhere. Hospitals go on divert hundreds of times a day in this country. This isn't news. Move along.
A monopoly, of any kind, is a bad idea. Imagine the DMV or Amtrak running your hospitals - no thanks. I prefer the freedom of choice where if I don't like Country General I can go visit St. Josephs instead. If they are crap I can to to John Hopkins or Mt. Sinai or any other place within driving difference.
Unless the pain in your abdomen is so intense, you ARE GOING to the closest hospital no matter who runs them, because you don't know what's going on and whether you have time to go to the next one.
We were in that situation about a year and a half ago. There's a Catholic Healthcare West hospital just a mile from our house. CHW played a large role in my cousin's death, and given all the lawsuits pending against them for their billing practices, I had vowed never to darken their door. But when my husband had a kidney stone (and we had no idea what was going on), and the next hospital was several more miles away, I took him to the closest ER anyway.
That's why healthcare is a market failure. There is not perfect access, or anything even approaching it. You cannot make informed decisions based on quality of service and cost and all that when you think you might be dying. You'll go wherever's closest, no matter HOW badly they do their job, if you think that they're at least basically competent WRT lifesaving.
BTW, JC Penney has much better quality than Macy's. You might try "Nordstrom" in that last slot.
Don't you wish your girlfriend was a geek like me?