When clinical IT is dangerous

Dr. Andy blogs on a study published in Pediatrics: Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System.

It’s tragic, but not really surprising. Big IT implementations usually have negative consequences at first. In industry it can mean missed orders or mayhem on the factory floor when an ERP system goes in. In physician offices, installation of an Electronic Health Record usually reduces the number of patients who can be seen at first. In an emergency setting in a children’s hospital, Computer Physician Order Entry (CPOE) means increased deaths. (Leapfrog Group, are you listening?)

Mickey’s assessment of this study is as follows:

The major factor seems to be centralization of procedures that removed the ability to be ready to roll instantly in emergencies.
The first test for any medical computerization should be to ask the doctors: will this help you? I think we need to do more with really simple systems that are add-ons to programs that do word processing or web-page design.

Look before you Leap.

December 15, 2005

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