The Washington Post has an article on how Cedars-Sinai reverted to pen and paper after an electronic medical record deployment misfire and is now a ‘cautionary tale’. This is worth reading with all of the attention and money these systems are getting. Note the $35 million dollar price tag with nothing to show for it: ‘…For every doctor, nurse and executive here, there is a different explanation of what went wrong. The technology, created in-house, was clunky and slow. Only a fraction of the 2,000 doctors with privileges at the hospital were involved in developing the system, even though they faced a dramatic change in the way they practiced medicine, from jotting notes on a clipboard to logging onto a computer to type in their treatment and medication orders. Training was insufficient, and administrators opted for what Hackmeyer called a “big bang” implementation rather than switching one ward at a time…’

Update: The authors opinions on the JAMA CPOE article at the Hospital of the University of Pennsylvania in Philadelphia made it into Health-IT World: The article is here (second story down). Editor’s note: Dr. Silverstein is responding to a research article in the Journal of the American Medical Association JAMA which concluded that a Computerized Patient Order Entry (CPOE) system called TDS, now obsolete, made some medication prescribing errors more frequent. A reasonable assessment of the recent CPOE controversy was made by Don Detmer, MD, the President and CEO of the American Medical Informatics Association. He writes that healthcare IT is of great value, is moving forward, and that those in clinical IT need to rigorously assess issues and problems and correct them iteratively, as in any evolving field. He is confident that AMIA and its researchers, clinicians, and educators are committed to these objectives and will continue to raise the performance bar for clinical IT. I heartily agree. However, other topics such as IT project leadership need to be addressed as well. I’ve put my commentary on this topic here.