Lazycoder

Changes in medical technology

Scobleizer: Microsoft Geek Blogger

Robert suggests putting video cameras in patients rooms to protect the hospitals from malpractice suits and up the level of care?

You want a video of a doctor putting their finger in your butt? There are a lot, and I mean a LOT, of privacy issues regarding some of the things you are suggesting. How can you tell from a video tape if the clear liquid that a nurse injected into that line really is the correct drug in the correct dosage? All that a video camera is going to capture is the gross, and by gross I mean large, stuff. Like nurses smacking patients that they don’t like and such.

Here’s the thing, I agree that the technology has to get better and at a lot of hospitals it is. Who’s going to pay for it? It’s not just a matter of cost though. Hospitals are pretty rich. Look at the average patients chart, well you can’t really. You can look at your own chart. HIPPA probably won’t let you look at your wife or another family members, maybe your sons. Take a good, long look at all of the informtion contained in it. Now, count up how many people you see in the waiting room and think about how long it will take to enter in all of their data. Again, that’s just the people you can see in that waiting room, on one floor, in one hospital. Imagine doing that for just everyone that works at Microsoft. And those people probably don’t have anything all that serious wrong with them. We have entire file drawers dedicated to a single patients chart for some of our bone marrow transplant patients. A lot of that information is kept in an EMR, electronic medical record, but what happens if the patient is in a car wreck on vacation and they are seen at another hospital? How do you keep the information synchronized statewide, let alone nationwide or worldwide. If anyone says BizTalk I’m gonna smack them with a cluebat.

How do you convince machine manufacturers that it’s in their best interest to make their data available in a standard format? How long did it take for Microsoft to open up it’s Word format? Doesn’t it make sense to have a standard format for information? So I can open up my Excel worksheet in Lotus 1-2-3 right? Every manufacturer is going to say, “our format should be the standard because we did the most research and determined that this is the best way to represent this data”. What happens if their machine supports a very useful diagnostic feature that doesn’t fit into the standard? Do you think there are standard data interchange formats for medical data? There’s standard terminology, but what data points mean can vary from institution to institution and , most often, from physician to physician. How do you represent that in a standard format? There have been some attempts at medical information standards, but the problem is that there isn’t one large guiding force in the medical industry.

I’m right there with him that things have to change. Heck, I’m one of the people working to make them change. It’s a LOOOOOOOOOOOOOOONNNNNG uphill battle, but we are winning it somewhat. Look at the new ER in Issaquah, check out the system that Swedish hospital has in place. Tablet PC’s and everything. I know a few hospials that my wife worked for in New Mexico were completely electronic. The Group Health hospital I was at just this morning (HIPPA VIOLATION!) has Dell terminals in every room and their EMR is synchronized between all GHC facilities. Is the system failproof, hell no. A nurse this morning couldn’t enter some data because someone was “fiddling with the system.”.

Lets look at his IV pump example.

the machine putting fluid into a patient makes the same beep whether it’s out of fluid or has a blockage in the line)

In either case, a blockage or out of fluid, a nurse is still going to have to check it and either clear the blockage or replace the bag. How does having a different beep really help? Isn’t the idea behind the beep just to call attention to the machine? Which case is more important. How much does an MRI machine cost? What does a blood pressure cuff have to say to an IV pump? A malpractice lawsuit is much less expensive than replacing every piece of equipment in a hospital with a new piece that can talk to the others. You don’t really solve any problems by making the machines smarter, in fact you create new ones. You still rebooting your Tablet PC every night? Imagine doing that for every piece of machinery in a hospital every night? If you don’t, what happens when you are working a trauma case and you have to look up a patients chart only to have your Tablet lock up because it’s been on for 5 days straight. Worse yet, what happens in a disaster? Think a lot of doctors were booting up their PC’s during the Tsunami? A paper chart is never “down for maintainence”.

Can you tell he hit a hot button for me? I deal with this EVERY DAY. We have to deal with data whose meaning changes over time even if the actual data doesn’t due to advances in technology and knowledge. The amount of data and the complexity of the data is MASSIVE.