If Your Electronic Medical Record Goes Down
(With apologies to the If You Give A Mouse A Cookie author)
If your Electronic Medical Record goes down (and your whole hospital is dependent upon it),
Then doctors can’t get labs and study results.
If doctors can’t get labs and study results,
Then doctors can’t write orders.
If doctors can’t write any orders,
Then nurses can’t do any orders.
If nurses can’t do any orders,
Then patients won’t get any better.
If patients don’t get any better,
Then patients can’t be discharged.
If patients can’t be discharged,
Then the hospital fills up with patients.
If the hospital fills up with patients,
Then there’s no place to put new patients or patients who get sicker.
If there’s no place to put new, sicker patients,
Then patients get worse, and you lose the whole point of having the hospital in the first place.
Here’s to good contingency plans, ’cause we all pretty much froze, opossum-in-the-headlights-style, today. How do we write orders? How do we write notes? How do we call consults? How do consults read prior notes and information?
IT people that work at a hospital: yes, your department now truly influences whether patients get better or worse, and indirectly, live or die.
(We had a ‘read-only’ version, which functioned reasonably well, but was far from optimal, to be sure.)
Ouch!!! Contingency plans are definitely a must.
Downtime procedures should always be included in training. The “problem” is that the applications generally keep running so smoothly that people forget how to function during a downtime. As much as we strive to have “no downtime” – sometimes a regular scheduled downtime isn’t such a bad thing after all. But thanks for the nod. IT does work hard to keep information at your fingertips!
I loved this post and agree totally. (And also, your post’s words should be sung to the tune of “The Knee Bone Connects to the Thigh Bone, and the Thigh Bone…”
(heh)
I know this is a very big issue in all clinical areas. I had a heart surgeon with a patient on the table, and he could not get the video up to see the cath procedure done prior. It is very important that IT departments keep their finger on the pulse of the network, applications, and workstations. Often, IT depts don’t control applications, GE, Philips, Seimens, etc., hold those reins. With power outages, seismic activity, and who knows what else can happen at any time, downtime, manual procedures must be kept current and functional. We are all dependent on our digital environments, for ease of use, prompt response to queries, documentation, but we must remember how we did it before automation. Thank you for your blog entry.
I feel your pain. Here’s my advice on how to handle the down time, based on my own experience simiar to yours –
http://theblogthatatemanhattan.blogspot.com/2007/03/when-electronic-medical-record-goes.html
IT people that work at a hospital: yes, your department now truly influences whether patients get better or worse, and indirectly, live or die.
Yes, they do. Is their training appropriate for such a role?
See “Common Examples of Healthcare IT Failure” at this URL.