Wednesday, May 14, 2008

NZ Hospital cannot guarantee patient safety because of IT failure

This story has caused a stir in the New Zealand press: bad health IT creates mayhem.

I fear such events are far more common in healthcare than we know, publicity only occurring when someone goes to the press (often at risk to their career, unfortunately).

It appears this hospital went out of its way to violate just about every concept presented in the biomedical informatics literature about the potential risks of clinical IT when developed and managed by non-clinicians.

Bad health informatics can kill, but doctors shouldn't worry about it. As in my posts here and here, doctors can't understand IT because they're too consumed with patient care issues, the rate of change of IT is too fast for their limited minds, and a degree doesn't get you anything, anyway. The IT leaders from the School of Hard Knocks will make it all better, real soon now.

Greymouth hospital not safe: senior doctor

The Ministry of Health is to investigate claims from a senior doctor that Grey Base Hospital cannot guarantee patient safety because of a systems failure.

Dr Judy Forbes, joint head of the anaesthetics department, wrote to the West Coast District Health Board with her concerns about a month ago, and addressed the board in person for three minutes at its last meeting.

A copy of a letter written after that meeting has been leaked, and another Grey hospital doctor says it is "entirely factual".

Dr Forbes' letter makes a number of allegations, and raises concerns about the "endless stream" of locums.

Most concerns relate to a new computer system which was brought in around Easter. The theatre booking system has been moved away from surgeons and replaced by a central booking office at the hospital reception, managed by IT (information technology) staff. [That'll show those pesky surgeons who's best suited for HIT leadership! - ed.]

Dr Forbes said some patients had been put on the surgery list for the wrong procedure with the wrong anaesthetic.

Other allegations included patients receiving appointment letters the day after their appointment, a knee replacement patient receiving a letter for a dental procedure, a patient on the list for a two-hour procedure having it done in another hospital six weeks earlier under contract with the West Coast board and a patient given the wrong medical advice by IT staff to stop medications without clinical consultations.

In another alleged incident, an elderly woman admitted for an incarcerated hernia was sent home for a day or two, awaiting equipment from Christchurch. She contacted the booking office a month later as she still didn't have an appointment.

Dr Forbes, who has worked at Grey Base Hospital for 15 years, said most of her time recently was spent "fighting fires".

"In addition to working with an endless stream of locums, surgeons and anaesthetists with unknown skill and experience, I am often the only New Zealand-qualified doctor involved in the patients' care and thus responsible for the outcome."

She also alleged patients were often seen by the surgeon for the first time in the anaesthetic room.

Dr Forbes told the board the hospital didn't meet the Health and Disabilities Service consumers rights code.

Fellow Greymouth anaesthetist Dr Susie Newton said today the letter was "entirely factual".

To which I can add, I wouldn't have entirely believed it were it not for the fact that I've seen even worse endangerment of patients by bad health IT with my own eyes.

-- SS