Thursday, March 10, 2005

Mistaken for a Panacea

Computerized physician order entry (along with its running buddy, the elusive electronic medical record) has been the holy grail for those medical public policymakers who believe that there is a relatively simple solution to medical errors in hospitals. Unfortunately, the perfect solution has yet to be found. As this new article in JAMA illustrates, the process of implementing such a system is fraught with complexities that were previously unimaginable.

Industry leaders in other fields have rightly identified medical errors as a problem, but have yet to understand that the solutions generated by those highly skilled IT folks from the business world rarely work unless there is a large amount of input from those who actually care for patients. A perfectly workable solution in the eyes of a computer programmer can seem like a maddeningly obtuse obstacle to a physician or nurse working at 2AM. As well, while other industries can take a "trial and error" approach to making their systems safer, those "errors" in this instance translate into "patients."

Other thoughts about this can be found at GruntDoc and Surgical Diversions. My personal,longstanding conviction is that the dreaded Microsoft corporation is the only company that has the scope, understanding, and practical knowledge of how to "make software work for everyone" to achieve the desired result. I'd love to see them hire a few dozen practicing physicians and nurses as consultants and collaborators and get busy. Unfortunately, there is that pesky monopoly problem that would have to be avoided......