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EMR Involved In Virus Exposure At Hospital

Posted on August 5, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Over the past several months, nurses have been campaigning to get more training on the EMRs rolling out where they work.  Without such training, and involvement in the rollout, they’re put at a disadvantage that could lead to patient harm, nurse leaders say.

For example, in June nurses at Massillon, OH-based Affinity Medical Center wrote a letter to the facility’s chief nursing officer questioning the safety of the center’s new Cerner EMR. The hospital’s 250-odd direct care nurses, and the national nursing union National Nurses Organizing Committee, noted that execs had neither increased nurse staffing nor decreased the number of elective procedures scheduled to be performed as the rollout proceeded.

Now, an incident has taken place which should lend more credence to nurses’ claims that they’re not woven into the process of using EMRs enough. Dialysis patients at Boston Medical Center were exposed to hepatitis B earlier this year when nurses with an outside contractor didn’t get adequate access to the hospital’s EMR system, reports EHR Intelligence.

The medical center contracts with an outside company called DaVita to run its dialysis unit. According to EHR Intelligence, two DaVita nurses exposed patients to hepatitis B by using equipment used by an infected patient.

This might be written off as an unfortunate but routine accident, but in this case, the error was preventable. The nurses never got training on how to use the hospital’s EMR system, and were given read-only access to critical records to support patient care.

If the nurses had had adequate access to the EMR, or had been through an EMR orientation, they would have known that an infected patient had used the dialysis equipment, EHR Intelligence notes. Instead, the nurses failed to sterilize the infected equipment, which then exposed thirteen patients to the illness. Five patients had to be specially treated and isolated to prevent further spread of the disease, the site said.

I wish this incident was a fluke, but the truth is, it almost certainly isn’t. Evidence is beginning to pile up that nurses aren’t getting a firm enough grounding in how their hospital’s EMR works before they’re sent off to use it. It’s time for hospital CIOs to take this issue seriously, before their patients end  up dead or injured due to preventable EMR workflow issues.

Patients Question Clinical Decision Support Use

Posted on January 30, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Using clinical decision support technology (CDS) is such a standard and helpful health IT approach – not to mention a central Meaningful Use feature — that we almost take its existence for granted. Apparently, however, patients aren’t as tolerant of computer-assisted decision making as clinicians and IT experts are, according to a new study published in Medical Decision Making.

The study suggests that patients actually distrust physicians who use CDS, labeling them as “less professional, less thorough, and having less diagnostic ability,” according to a report by EHR Intelligence.

The study, done by University of Missouri researchers, showed participants vignettes depicting an exam for an illness or injury. These participants were then asked to rate their reactions to the physicians showed in the vignettes.

The results suggest strongly that potential patients are unnerved by the notion of physicians making use of CDS.  Researchers found that the study subjects were less likely to trust computer-driven diagnoses, and moreover, less likely to be happy with a positive outcome if that outcome involved CDS use.

Perhaps the only social benefit to physicians using CDS was that subjects were less likely to blame a doctor for a negative outcome if the doctor relied on CDS to make a decision.  If a doctor used CDS, ignored its conclusions then had a negative outcome, patients felt strongly that he or she was deserving of punishment.

It’s not exactly good news for healthcare providers that patients are likely to be squeamish about their using CDS. That being said, my guess is that doctors can do a lot to make patients comfortable simply by explaining what they’re doing and making patients feel confident about the process. In the end, after all, patients care most about their relationship with the provider, computer-aided or not.