TEPR notes
Here are some interesting tidbits from the annual TEPR conference, which concluded Wednesday:
- NextGen Healthcare Information Systems announced a partnership with British clinical decision support developer Isabel Healthcare. Isabel co-founder Jason Maude says that the deal creates the first direct link of diagnostic decision support to an ambulatory EMR product.Maude started the company with Joseph Britto, M.D., who was the attending physician when a misdiagnosis by a resident at a London hospital nearly took the life of Maude’s daughter, Isabel, at age 3. I wrote about Isabel Healthcare a couple of years back when I was on staff at a certain magazine that’s now dying a slow, painful death.
The way Maude and NextGen CMO John Dulcey, M.D., described the diagnostic support engine this week reminded me of the misdiagnosis detailed in Atul Gawande, M.D.’s book, Complications: A Surgeon’s Notes on an Imperfect Science. Turns out that Gawande’s patient at Brigham and Women’s Hospital in Boston and the young Isabel both had necrotizing fasciitis, aka flesh-eating bacteria.
Maude says that Isabel, now 9, is mostly healthy, though she requires a series of skin grafts as she grows.
After our discussion, Maude said he would get back in touch with Sorrel King, who founded the Josie King Foundation in memory of her own daughter, who did not survive a medical error at Johns Hopkins University. The Josie King Foundation is participating in the Institute for Healthcare Improvement’s 100,000 Lives Campaign.
- Allscripts Healthcare Solutions is publishing a book entitled The Electronic Physician: Guidelines for Implementing a Paperless Practice. Allscripts product management VP Stuart Scholly calls it a collection of best practices for EMR implementation compiled from company experts and customers.Allscripts itself, and not any specific individual, gets the author credit, though Scholly says the book does not even mention the company after the first chapter, so as not to have others take it as a sales tool.
The book should be available on Amazon within a couple of weeks. It lists for $29.95, or $41.95 if you’ve got Canadian currency.
- Speaking of books, David Classen, M.D., of First Consulting Group and the University of Utah School of Medicine, called the 2003 Institute of Medicine report on patient safety “the greatest compendium of patient safety and quality ever published.”Classen, of course, is a member of the IOM committee that produced that volume, but the more people know about patient safety, the better.
- Of all the renowned healthcare institutions in New England—think Mass. General, Dartmouth-Hitchcock, Lahey Clinic—it is MaineHealth that is the first in the region to buy the ever-popular Visicu eICU remote intensivist technology.
I’m a practicing physician in Minnesota. I am sympathetic to the tragedy of losing a young child…..BUT there are elements of the Josie King story that trouble me. From what I can glean from the case as presented in magazine articles, there was more going on than neglect of giving hydrstion to the patient. She had just been trsnsferred out of the PICU where she had been treated for severe burns. By the way, what caring parent lets a toddler get out of sight, into a bathroom where there is a tub, regardless of the water temperature? That was the first in a chain of errors. If you think I am being harsh in my judgement, just remember how harsh Mrs King is being on the hospital staff. The final hours of Josie’s life sound more like the onset of septic shock, not progressive dehydration. It could have been C diff colitis or some other nosocomial infection. The entire medical record is not available for public consumption of course. There is the grieving family with their impressions of how thirsty the little girl was. Severe burns are still injuries that can kill patients. Let us not be stampeded into assuming that every hovering parent knows more than the medical staff. Give me a dime for every wrong self diagnosis I’ve heard from patients and families and I wouldn’t have to worry about where and when I can retire.
Although I have been against posting anonymous comments that are critical of public figures, I decided to post this one because I was able to trace it back to an IP address of the Quello Clinic in Minneapolis. Again, if you wish to post anonymously, please at least send me an email identifying yourself to me. That helps prevent this blog from being a vehicle for unfairly dragging people through the mud.
[…] right. I first interviewed Isabel founder Jason Maude probably in 2002 or so, and I first blogged about the company in 2005. I mentioned Isabel in a 2007 post that, interestingly, also alluded to […]