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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."
please bring your own toilet paper.
But seriously... this is one of the biggest problems with the "paperless" society. Yes, it's nice to have electronic copies of things, but magnetically-stored data (or even optically-stored data) degrades far faster than a paper copy.
We can try and try to hope otherwise, but at the end of the day I worry we're dooming ourselves with our "modernized" recordkeeping. Sure, we have "tidbits" of things from 1000,2000,3000,4000 years ago... but 1000 years from now, most of our own records - much like the oral histories of certain societies that didn't get heavily into good recordkeeping on more solid forms - may well be completely gone.
"But even leaving that aside - why do problems with paperwork make it necessary to turn away patients?"
Lawyers.
"The average reporter we talk to is 27 years old......They literally know nothing." - Ben Rhodes
In an ER, "paperwork" includes information on whether they'll kill you if they give you a certain drug or transfusion. Stuff like that.
Finally modding someone offtopic when they rant about what "Begging the Question" means: priceless.
It may not be necessary, but it is a cautious move. Information is important when treating patients. Their history is important. When making decisions on what treatments to provide the doctors consider the patient's history. If you do not have their history and a nearby hospital does then it seems like an easy choice to send the patient elsewhere.
Most of our records would be worthless in a hundred years. Actually, most of them are nearly worthless in a year. Would it really matter to somebody in the future that I spend $15.19 on June 1st at Lulu.com, for example? Because record keeping is so cheap compared to historical examples, we keep a bunch of records nobody would have bothered with in the past.
-- Support a free market in the field of government
As someone who works in healthcare, I've discovered that providing good care is entirely about information. If we don't know someone's drug allergies, medical history, and can't effectively communicate between departments, patient safety is impacted. Turning away patients may actually save lives if a hospital is unable to provide communication and medical background for a patient.
When I'm unable to get to the network for some reason, I feel extra stupid as a developer. I can't search for code examples on Google, migrate code to staging servers, and so on. Healthcare is similar, with providers not being as effective as if they had their full EMR at their fingertips.
Turning away patients results in loss of income, so they're basically losing money in order to improve the safety of their patients.
Nurse != Secretary (Score:1)
I think this has more to do with Management not being able to properly bill insurance companies. Because profit is more important than human lives.
We don't know that human lives were at stake here. First of all, the situation lasted from 1AM to 3AM on a Wednesday morning, so I doubt if anyone was even turned away. Also, the summary implied that there were other options for the patients. Hospitals now are very complex systems, and losing track of a patient could mean making an error that bodes worse for the patient than not admitting them, like administering the wrong medicine or applying the wrong procedure. We don't know the whole story, but I'm thinking it's not as bad as the sensation-grabbing news reporters might like it to seem.
Currently hooked on AMP
In other words, getting paid is more important than human lives.
This seems to contradict the mission statement of the hospital industry as it was conceived, but I think is a good indicator of where insurance-driven (which is to say, privately socialized) medicine is headed.
~REZ~ #43301. Who'd fake being me anyway?
Engineers, statisticians, and accountants are hired more for their way of thinking than for number crunching. The engineer asks "How does it work?" The statistician asks "How often does it happen?" The accountant asks "How much will it cost?" The computer asks "Cancel or Allow?"
Nuclear engineers build weapons. Civil engineers build targets.
Actually how about eliminating the problem itself ? If the paperwork is overwhelming, with a reasonable minimum workforce present in the hospital, the government (the recipient of said paperwork),
I work for a non-profit healthcare provider, where 94% of our patients are below 200% of the Federal Poverty Level. Most of *our* paperwork does go to the government... the County as part of the Public-Private Partnership fund, the State as part of OAPP, the Feds as part of our FQHC billing, etc. (Only about 17% of our patients even have Medicaid or Medicare). A lot of that paperwork also goes to our private funders; foundations and corporations that donate to specific programs and then expect us to report on our results.
But for most hospitals and doctor's offices, most of that paperwork is for billing private insurance companies. A fraction is for billing public insurance for those without private. Some is sent straight to the patient. A lot is for accreditation and patient records, too (and The Joint Commission is a private, non-profit entity... they are who is usually accrediting hospitals and ambulatory care).
needs to accept the fact that there isn't any paperwork, and foot the bill anyway.
As mentioned above, they're not generally footing the bill.
Obviously this will present docters with patients without medical records. But better to be treated a bit worse than not at all.
It's not "a bit worse." Incomplete or inaccurate medical records kill thousands of people every year, and many more suffer permanent or temporary injury as a result. Giving me or my son certain common antibiotics via IV can kill me. Medical records are EXTREMELY important, because people are very different from each other.
Obviously any sort of national healthcare system will preclude having this common-sense approach, as any system that does not make it the responsibility of the patient to ensure medical bills are paid will ration health care ("total health care resources" are limited. Either you let people pay for them, or you ration them). Rationed health care means "no government approval, no healthcare" both in theory and in practice.
I really don't know where this keeps coming from. Obviously, just like every private insurance company in creation, a government-run health plan would also decide what was worth the money and what wasn't. This does not currently and could not in the future prevent people from paying out of pocket if they think it's worth it. I'm not sure how people get from "government provides health care" to "government prohibits the purchase of health care by private entities."
It is very true that, when confronted with the incredible costs of certain treatments and medications that are declined for coverage, people find themselves unable or unwilling to pay. It's therefore unlikely that people will just pay out-of-pocket for those services which are not covered. This does not mean they are prevented from doing so by legislation; it simply means that the person footing the bill is likely to weigh the situation differently.
[wtf is up with /. formatting today? I've tried everything to put line breaks in the right places, but it keeps running paragraphs together anyway. Bah.]
Don't you wish your girlfriend was a geek like me?
Because the whole strength of digital media is that you can easily copy/regenerate it. If the data is important, it isn't difficult to keep transferring it to new formats. For that matter, it isn't difficult even if the data isn't important. I have papers I wrote back in high school, well over a decade ago. The original computer on which they were written is long gone to a landfill, but I can transfer the data to new drives as often as I like.
Now can your book be copied? Sure, but only with a good deal of effort. Even if you are using a machine to make the copies it is a hell of a lot more work than copying digital data. If you are doing it by hand, it is a major marathon. So even though the book CAN be copied, it is much less likely for it to actually BE copied.
Digital also has the advantage of not having physical boundaries. You can easily copy digital data to anywhere in the world that is wired. If you need to back something up against an extreme catastrophe, like a city getting burned down or something, this is easy to do. For paper, much harder. You have to truck it to where it needs to go and do so regularly.
So yes, there is lots of digital data out there with very little permanence, but that is because there is lots of digital data out there with very little relevance. The amount of information we generate today as compared to the pre digital age is staggering. It is thus no surprise that we keep much less of it.
However because it is so much easier to back up, we can back up much more data as is needed, and do so in a much more reliable fashion. Paper seems great until you consider the amount that we know has been lost on paper (massive numbers of Mayan codicies for example) and consider that there's even more we are never aware of (because it was lost and no documentation of the loss was made).
If you sniff around on the Internet, you'll find that there are archives of plenty of old data, data that shipped on floppies or punch card or tape and so on. The data has been copied and recopied and is preserved.