Category Archives: hmmm

WSJ: Welcome to the Wired Hospital

The November 13th print edition of the Wall Street Journal had a full page article on page R23 about Beth Israel and Deaconess hospitals experience with its electronic medical record (EMR). These hospitals have a long (1977) history of computerization and are described as forward thinking in its use of EMR’s. Editor: Unfortunately, this forward-thinking hospital apparently misses the boat with regard to making this kind of software available as free or open source. Such a closed system makes widespread adoption by other hospitals of these life-saving technologies unlikely.

The article is of interest for implementation details such as how access is controlled: by entering id, password and a security code taken from a hand-held device called SecurID which displays a code that changes approximately every minute. Dr. Slack, who is ‘among the pioneers in the field’ is quoted as saying ‘Blaming the already beleaguered doctor for being too old or too computer-phobic or too conservative is a handy excuse for bad computing… he goes on to say: ‘…In many regards, we as physicians have relied too much on memory.’ and the system is proported to reduce that reliance with the ready availability of clinical information along with the EMR. Finances and effect on the bottom line are discussed. The article estimates that the system would take $50 million dollars and several years to be built from scratch at other hospitals and reports efforts to market these technologies. Seeks Rational Doctor/Patient Relationship has an intriguing idea: ‘…a systematic approach to defining the fundamental elements of the
health care contract. By this, we mean creating agreement about the essential elements that make the health care
relationship work: who’s doing what, and how are we steering the treatment ship…
There exists between doctors and patients certain identifiable patterns of misunderstandings
which generate unrealistic expectations, adversity and litigation.

The remedy for these misunderstandings is role clarification and collaborative