Vendors, this is your wake-up call
I just re-read a BusinessWeek story from about a month ago and was shocked to read the following passage:
Geisinger Health System in Danville, Pa., wanted all that when it spent $35 million to purchase and install software from Epic Systems, a large vendor in Verona, Wis. But in June 2005, during a pilot run of a computerized order-entry system at Geisinger’s flagship medical center, errors began appearing at a rate of several a week in the hospital’s psychiatric unit. “The pharmacy would interpret an order as one drug at one dosage, and the patients were ordered the wrong medications at different dosages,” recalls Jean Adams, a nurse in charge of the IT team. Fortunately, astute staffers discovered the problem after a few weeks and began verifying the computer drug orders using the phone. Full implementation of the Epic system was put on hold. Adams says Geisinger traced the trouble to incompatibility between a common pharmacy database and Epic’s system.
Epic CEO Judith Faulkner says the episode at Geisinger, and similar incidents at other hospitals, taught her company that physician orders and pharmacy records cannot use distinct technologies. “It doesn’t work when you mix and match vendors,” Faulkner says. “It has to be one system, or it can be dangerous for patients.”
Am I right in interpreting this to mean that Judy Faulkner believes that the inability to integrate systems is a risk to patient safety? Really?
This shouldn’t have to be a warning to customers that they should only buy from one vendor. This should be a wake-up call to vendors that they had better start cooperating with each other.
As an American taxpayer, I don’t want my money spent on systems that can’t interface and can’t interoperate. That’s not “meaningful use.” It sounds more like blackmail by a vendor.
Neil, I’ve been saying that for years. Open ended architecture has to be implemented that will allow systems to communicate with each other without having to write an interface that extracts (or suppose to extract!) the correct data. Increasing the number of interfaces increases the chance of errors. The second issue that I will mention is that a reimbursement structure needs to be in place. At our institution, we are not reimbursed for our telemedicine services. And with our new EMS telemedicine project, reimbursement for all participants has to happen. If not, how will projects like these work? Standards for STEMI and stroke have introduced a higher level of care. These standards will be held and those hospitals that provide that service are going to eventually graded. Telemedicine does work. Europe has shown it for many years. The bar has been set – who is going to pay for the process to reach the bar?
Neil, interoperability has been a problem that will never go away. Vendors have turf to protect and EPIC is no different. You have to remember also there are anti-trust issues of vendors get too cozy.
Some states are mandating reimbursement for telemedicine now. This is the trend. Also, many vendors are now adopting NEMSIS standards for importing and exporting patient data. This is becoming a standard for exchange of data between noninteroperable data systems. For more information and links on these issues see our newsletter at: http://www.lifebot.us.com/lifebotnewsmar2010.htm
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