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Medicine IT

Hospital Turns Away Ambulances When Computers Go Down 406

Posted by CmdrTaco
from the oh-that's-not-good dept.
CurtMonash writes "The Indianapolis Star reports that Tuesday Morning, Methodist Hospital turned away patients in ambulances, for the first time in its 100-plus history. Why? Because the electronic health records (EHR) system had gone down the prior afternoon — due to a power surge — and the backlog of paperwork was no longer tolerable. If you think about that story, it has a couple of disturbing aspects. Clearly the investment in or design of high availability, surge protection, etc. were sadly lacking. But even leaving that aside — why do problems with paperwork make it necessary to turn away patients? Maybe the latter is OK, since there obviously were other, more smoothly running hospitals to send the patient to. Still, the whole story should be held up as a cautionary tale for hospitals and IT suppliers everywhere."
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Hospital Turns Away Ambulances When Computers Go Down

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  • Nurse != Secretary (Score:3, Insightful)

    by casals (885017) on Thursday June 04, 2009 @10:20AM (#28209217)
    ... in theory, at least.
    • by mcgrew (92797) on Thursday June 04, 2009 @10:29AM (#28209373) Homepage Journal

      Secretaries are increasingly like computers.

      If you find an old, pre-1950 dictionary and look up "computer", you'll find that it defines "computer" as a person who is employed to do maths. Thousands of computers were employed for the military, large corporations, etc doing ballistics calculations, statistical math, and the like.

      There are fewer and fewer human secrtaries, as human secretaries are going the way of the human computer. Electronic computers are superceeding human secretaries just as they obsoleted human computers.

      • by ConsumerOfMany (942944) on Thursday June 04, 2009 @11:05AM (#28209917)
        call me when your computer can wear a tight skirt and make me a cup of coffee...
      • by AlecC (512609) <aleccawley@gmail.com> on Thursday June 04, 2009 @11:21AM (#28210133)

        Actually, secretaries are reverting to their original function, except that the job title has changed to Personal Assistant. A secret-ary was an assistant who was entrusted with your secrets (hence Secretary of State, Foreign Secretary). The job title that typists and data-entry staff should have had was "clerk" (if not typist or data-entry clerk). But secretary was more prestigious, and a good job title always helps keeping people satisfied with low pay. The people who were unable to perform their function in this hospital when the computers died were data-entry clerks.

      • Re: (Score:3, Interesting)

        by GMFTatsujin (239569)

        I work as IT support in the health care industry, for what it's worth.

        Most of our nurses are competent, dedicated people who are very good at their jobs: caring for patients, following medical orders, and keeping records about visits. They are awesome people.

        They are not, however, able to use a computer by and large. And that's a real shame, because the computer is one of the most vital and prevalent tools that they are called upon to use every day. They've just built their skills up elsewhere, and compu

        • Re: (Score:3, Insightful)

          by Red Flayer (890720)

          They know just enough to turn the thing on and push exactly the indicated buttons in exactly the indicated order to. Anything outside those parameters means driving off the edge of the map and into a terrifying, unknown world.

          Just wanted to note that maybe a critical health-care setting is one of those places where "this is diverging from my script -- let's see what happens if I do $THIS" could be a bad bad move. Caution when using any unfamiliar systems seems like a positive characteristic for nurses and

    • by Divebus (860563)

      What happens when The Big One hits? Time for a stress test on hospitals now.

      • Re: (Score:3, Insightful)

        by ShieldW0lf (601553)
        How do you guys feel about the DRM in hospitals when you read about this stuff? The people you entrusted (willingly or not) to wield your political authority for you are determined to see it happen. Calls the validity of the whole system into question, doesn't it?
        • A monopoly, of any kind, is a bad idea. Imagine the DMV or Amtrak running your hospitals - no thanks. I prefer the freedom of choice where if I don't like Country General I can go visit St. Josephs instead. If they are crap I can to to John Hopkins or Mt. Sinai or any other place within driving difference.

          Just as we have multiple stores, some of them crap (Walmart), some mediocre (Sears, Penneys), and some of them excellent (Macys), we should have multiple choice in hospitals. Only when you have choice

          • by Ironica (124657) <.gro.kcodnoob. .ta. .lexip.> on Thursday June 04, 2009 @01:24PM (#28211899) Journal

            A monopoly, of any kind, is a bad idea. Imagine the DMV or Amtrak running your hospitals - no thanks. I prefer the freedom of choice where if I don't like Country General I can go visit St. Josephs instead. If they are crap I can to to John Hopkins or Mt. Sinai or any other place within driving difference.

            Unless the pain in your abdomen is so intense, you ARE GOING to the closest hospital no matter who runs them, because you don't know what's going on and whether you have time to go to the next one.

            We were in that situation about a year and a half ago. There's a Catholic Healthcare West hospital just a mile from our house. CHW played a large role in my cousin's death, and given all the lawsuits pending against them for their billing practices, I had vowed never to darken their door. But when my husband had a kidney stone (and we had no idea what was going on), and the next hospital was several more miles away, I took him to the closest ER anyway.

            That's why healthcare is a market failure. There is not perfect access, or anything even approaching it. You cannot make informed decisions based on quality of service and cost and all that when you think you might be dying. You'll go wherever's closest, no matter HOW badly they do their job, if you think that they're at least basically competent WRT lifesaving.

            BTW, JC Penney has much better quality than Macy's. You might try "Nordstrom" in that last slot.

            • Re: (Score:3, Informative)

              by flablader (1258472)
              If you had no idea what's going on, you call an ambulance; you do NOT drive someone to the hospital yourself. Here's why:
              - You don't know if whatever is happening is going to get worse and if it does, you don't have the equipment on hand to deal with it.
              - Not all hospitals are equal. The closest hospital may not be equipped to handle your emergency. My wife used to work in one such hospital and people have died because someone drove them in instead of calling an ambulance. Hospitals are rated by what
              • Re: (Score:3, Insightful)

                by HornWumpus (783565)

                If you can get to an ER in less time then the Ambulance would take to arrive you are ahead of the game anyhow.

                That's typically true no matter where you live. Emergency response times suck universally.

                If you can safely move the person you call 911 and start driving. The ambulance can meat you halfway if things are that bad.

    • by unlametheweak (1102159) on Thursday June 04, 2009 @10:53AM (#28209753)

      Nurse != Secretary (Score:1)

      I think this has more to do with Management not being able to properly bill insurance companies. Because profit is more important than human lives.

      • by wealthychef (584778) on Thursday June 04, 2009 @11:01AM (#28209861)
        We don't know that human lives were at stake here. First of all, the situation lasted from 1AM to 3AM on a Wednesday morning, so I doubt if anyone was even turned away. Also, the summary implied that there were other options for the patients. Hospitals now are very complex systems, and losing track of a patient could mean making an error that bodes worse for the patient than not admitting them, like administering the wrong medicine or applying the wrong procedure. We don't know the whole story, but I'm thinking it's not as bad as the sensation-grabbing news reporters might like it to seem.
        • As a former EMT (Score:5, Informative)

          by drachenfyre (550754) on Thursday June 04, 2009 @12:53PM (#28211497) Homepage
          The hospital going on divert simply means "If you can take a patient somewhere else without threatening their well being, please do so". It doesn't mean that if I rolled up with someone in cardiac arrest that they'd refuse my patient and send me elsewhere. Hospitals go on divert hundreds of times a day in this country. This isn't news. Move along.
      • Re: (Score:3, Interesting)

        by MrMarket (983874)

        Your statement about Methodists' incompetent management is valid. Every three year's or so they've had some terrible [google.com] safety [google.com] failures. Quality care is just not a priority for them.

        This is not so much a story about electronic records as much as it is about Methodist keeping up it's infamous safety record.

  • by Moryath (553296) on Thursday June 04, 2009 @10:21AM (#28209241)

    please bring your own toilet paper.

    But seriously... this is one of the biggest problems with the "paperless" society. Yes, it's nice to have electronic copies of things, but magnetically-stored data (or even optically-stored data) degrades far faster than a paper copy.

    We can try and try to hope otherwise, but at the end of the day I worry we're dooming ourselves with our "modernized" recordkeeping. Sure, we have "tidbits" of things from 1000,2000,3000,4000 years ago... but 1000 years from now, most of our own records - much like the oral histories of certain societies that didn't get heavily into good recordkeeping on more solid forms - may well be completely gone.

    • by qbzzt (11136) on Thursday June 04, 2009 @10:27AM (#28209335)

      Most of our records would be worthless in a hundred years. Actually, most of them are nearly worthless in a year. Would it really matter to somebody in the future that I spend $15.19 on June 1st at Lulu.com, for example? Because record keeping is so cheap compared to historical examples, we keep a bunch of records nobody would have bothered with in the past.

      • Re: (Score:3, Insightful)

        by mcgrew (92797)

        No, they kept them. Most of them are gone because their use has gone (like your bill) or the media has disintegrated. Its far easier to save and retrieve the info now.

        There was a huge fire at some St Louis military building a couple of decades ago, and hundreds of thousands of records were lost. It caused a big headache for countless veterans, who needed copies of those records.

        That can't happen today; there are multiple backups at multiple locations.

      • One of the things that drove the revolution in understanding of Koine Greek (as used in the New Testament) over the last 200 years or so was the discovery of a massive cache of routine commercial transactions in Egypt, written on Papyrus. So, your $15.19 @ Lulu.com might be more relevant than you realize.
    • Try this. Print it out and file it away. Use the electronic copy, and go to the cabinet if something goes wrong. Problem solved.
      • Re: (Score:2, Interesting)

        by ljaszcza (741803)
        No, in the modern US medical system, the paperwork amounts to tons of paper. The manpower needed to maintain it; file new info, pull deceased patients is huge, for a large hospital, the space requirements are huge. The possibility of error (misfiling info, patients with similar name, married name changes, etc)is huge. From a legal point of view, you are probably more safe shutting the place down because EMR is down rather than trying to deal with a backup paper system. It's not best for the patients, but th
    • by mcgrew (92797) on Thursday June 04, 2009 @10:41AM (#28209567) Homepage Journal

      They've been talking about the "paperless office" for over twenty years now, but it hasn't happened yet. There is far more paper in my office than there was 20 years ago, in fact.

      However, IINM the Japanese have paperless toilets that wash your butt with a water spray and dry it with hot air.

      The thing about electronic records is that they can be instantly duplicated and sent anywhere instantly. They're easy to back up, without the errors and degredation of past, analog copying methods.

      I'm healthy and don't go to the doctor very often. My old family doctor retired about fifteen or so years ago, and when I went to have butthole surgery (hemmoroids, too much sitting on my ass like any nerd) I discovered that I had no medical records!

      Unless it's acid-free paper, a book will last maybe fifty years before it starts deteriorating. I have old paperback books I bought when I was young that are nearly unreadable now. Paper is far more nebulous than electronics.

      The thing that will kill today's literature (and many other records) for future humanity isn't the supposed fragility of electronic records, but the insane lengths of copyright. If you don't allow electronic copies of your work, it's unlikely to last much longer than a single human generation.

      • by Reziac (43301) * on Thursday June 04, 2009 @12:26PM (#28211089) Homepage Journal

        "Unless it's acid-free paper, a book will last maybe fifty years before it starts deteriorating. I have old paperback books I bought when I was young that are nearly unreadable now. Paper is far more nebulous than electronics."

        Your old paperbacks are not good examples, as they were =intended= to have short-term durability and be more or less disposable -- similar to today's CDRs. A better comparison from a backup standpoint would be good quality hardbacks.

        Here's a 5.25" floppy. It's less than 15 years old. I'd warrant not 1% of the people reading this post have the equipment required to read this once-common format -- assuming, of course, that the data on the disk is still readable, which is highly doubtful.

        Conversely, I have here a book published in 1848. It's still perfectly readable to anyone with eyes, no other equipment required.

        The problem really is how often one must upgrade the storage media, and how durable it is in the face of failure. Books can burn, but meanwhile they can be copied by anyone with pen and ink. Digital media requires matching hardware just to read it, another set of hardware to print it out, and rigidly regular backups to newer media forms as old ones age out and ultimately become unavailable.

        • by Sycraft-fu (314770) on Thursday June 04, 2009 @02:11PM (#28212555)

          Because the whole strength of digital media is that you can easily copy/regenerate it. If the data is important, it isn't difficult to keep transferring it to new formats. For that matter, it isn't difficult even if the data isn't important. I have papers I wrote back in high school, well over a decade ago. The original computer on which they were written is long gone to a landfill, but I can transfer the data to new drives as often as I like.

          Now can your book be copied? Sure, but only with a good deal of effort. Even if you are using a machine to make the copies it is a hell of a lot more work than copying digital data. If you are doing it by hand, it is a major marathon. So even though the book CAN be copied, it is much less likely for it to actually BE copied.

          Digital also has the advantage of not having physical boundaries. You can easily copy digital data to anywhere in the world that is wired. If you need to back something up against an extreme catastrophe, like a city getting burned down or something, this is easy to do. For paper, much harder. You have to truck it to where it needs to go and do so regularly.

          So yes, there is lots of digital data out there with very little permanence, but that is because there is lots of digital data out there with very little relevance. The amount of information we generate today as compared to the pre digital age is staggering. It is thus no surprise that we keep much less of it.

          However because it is so much easier to back up, we can back up much more data as is needed, and do so in a much more reliable fashion. Paper seems great until you consider the amount that we know has been lost on paper (massive numbers of Mayan codicies for example) and consider that there's even more we are never aware of (because it was lost and no documentation of the loss was made).

          If you sniff around on the Internet, you'll find that there are archives of plenty of old data, data that shipped on floppies or punch card or tape and so on. The data has been copied and recopied and is preserved.

    • Re: (Score:3, Insightful)

      by Dare nMc (468959)

      probably not in this case. I means 3 years of McCains records were 1500 pages, for a healthy person. A hospital that treats a 1000 sick people a day, your talking moving millions of pieces of paper a day. So then your talking the need for a library, and librarians, fire suppression...
      So while I agree old books, when unused, last longer. When used daily, for instance cash in constant circulation, lasts about 3 months.

      • Someone mod parent up. The way the medical-legal system has evolved now it's no longer practical to have a paper chart as the sole medical record.

    • Re: (Score:3, Informative)

      Well, first of all, I'm not sure my medical records need to last a thousand years...

      But more importantly, this is completely irrelevant:

      magnetically-stored data (or even optically-stored data) degrades far faster than a paper copy.

      I assume you're either making some completely uninformed, Luddite claim, or you're talking about the physical media -- in which case, you're ignoring RAID, offsite backup, checksumming (and digital signatures), and other things that are very difficult/costly or even impossible to do with paper, and which make a properly managed digital copy much, much more durable than a pa

  • A one word answer (Score:5, Insightful)

    by Vinegar Joe (998110) on Thursday June 04, 2009 @10:22AM (#28209267)

    "But even leaving that aside - why do problems with paperwork make it necessary to turn away patients?"

    Lawyers.

    • More-words answer. (Score:5, Informative)

      by TrebleJunkie (208060) <ezahurak&atlanticbb,net> on Thursday June 04, 2009 @10:31AM (#28209411) Homepage Journal

      Lawyers, patient safety, and actually getting paid. Vast amounts of documentation must be provided to Medicare/Medicaid and Insurance companies in order to get paid for services. Event the smallest amount of missing or inaccurate documentation can be the difference between getting paid $5 and $5000, the difference between getting paid and getting fined and losing your ability to bill Medicare, etc...

      • >>>Vast amounts of documentation must be provided to Medicare/Medicaid and Insurance companies in order to get paid

        Just imagine how much easier it would be if we simply paid cash, you know like our ancestors did prior to World War 2. Walk in; get your service; and hand-over the cash, check, or credit card. That's what I do today. I even get a 10% discount from my doctor since he says my approach makes his life much simpler.

      • by Reziac (43301) * on Thursday June 04, 2009 @12:28PM (#28211121) Homepage Journal

        In other words, getting paid is more important than human lives.

        This seems to contradict the mission statement of the hospital industry as it was conceived, but I think is a good indicator of where insurance-driven (which is to say, privately socialized) medicine is headed.

        • Re: (Score:3, Insightful)

          by SirGarlon (845873)

          In other words, getting paid is more important than human lives.

          GP mentioned patient safety but didn't elaborate, so I will take the opportunity. Nurses are responsible for actually delivering most of the patient care in a hospital (nearly everything outside of the operating room). A good portion of a nurse's work is paperwork. Therefore, if nurses are swamped in paperwork, this has bad implications for the quality of patient care. The likelihood of a life-threatening medical mistake goes up.

          Put another

    • Re:A one word answer (Score:5, Interesting)

      by lorenlal (164133) on Thursday June 04, 2009 @10:34AM (#28209467)
      Funny aside. I happen to know a few physicians pretty well outside their professions. I heard a lovely story involving a surgeon in an office that didn't use paper records. Everything was done through an EMR system.

      The "computers were down" as the story was relayed. The surgeon called the family physician asking him about the medical history of the patient. The family doc (primary) asked what was wrong. The surgeon replied that the patient was in the waiting room, but since the EMR system was down, he didn't know anything about the patient. The primary responded with, "By any chance... Did you ask them?" to which the surgeon responded, "What?" The surgeon had a perfectly compus mentus patient, and didn't even bother to ask them a question because the EMR system was down.

      Sometimes the lawyers don't even have to be involved for epic failure.
      • Re:A one word answer (Score:5, Informative)

        by TinBromide (921574) on Thursday June 04, 2009 @10:44AM (#28209623)
        The prevailing attitude in the medical industry is that unless patients are telling you where it hurts, they're lying. Doctors will tell you that patients are "forgetful" or possibly "confused about their past conditions and may not understand what was wrong with them". Their lawyers tell them that patients are drug addicts looking for the next narcotic hit or looking to sue them for a big fat malpractice settlement. If I say I'm allergic to iodine, but forget about an allergic reaction I had to antibiotics when I was 3, and they administer antibiotics, they're still on the hook if I decide to sue. "Look at my file! It says I'm allergic ot antibiotics! I said I was allergic, but he wasn't listening!"
        • Re: (Score:3, Insightful)

          by rgviza (1303161)

          yup. You can't depend on a patient to tell you everything in their chart. You are supposed to read their chart. My cousin is an orthopedic surgeon in a trauma center and we've had this conversation. It's not just for liability, it's for the patients own good, the exception being if they are in critical danger and need immediate attention. Without the chart they can inadvertently kill you simply by picking the wrong meds.

          It's true they don't want to be sued but the big danger is accidentally killing you.

          -Viz

      • Check out the lyrics to this song *NSFW* [moron.nl] for why asking the patient is not a good idea. It's humour, but poignant.
        • Crap, sorry... It's to the tune of "Any Dream Will Do" if you want to sing along in your own head.
    • by PIPBoy3000 (619296) on Thursday June 04, 2009 @10:36AM (#28209501)
      As someone who works in healthcare, I've discovered that providing good care is entirely about information. If we don't know someone's drug allergies, medical history, and can't effectively communicate between departments, patient safety is impacted. Turning away patients may actually save lives if a hospital is unable to provide communication and medical background for a patient.

      When I'm unable to get to the network for some reason, I feel extra stupid as a developer. I can't search for code examples on Google, migrate code to staging servers, and so on. Healthcare is similar, with providers not being as effective as if they had their full EMR at their fingertips.

      Turning away patients results in loss of income, so they're basically losing money in order to improve the safety of their patients.
    • Re: (Score:3, Interesting)

      Patient safety is another one. If you can't keep up with the paperwork then the next doctor that sees the patient has no idea what drugs were given, etc. Without all the facts available, diagnosis and treatment go out the window.
    • Not just lawyers - doctors.

      Without paperwork, they don't know who is in the ER, who is being treated for what, who is allergic to what, who is waiting on what treatment, etc... etc...

      There's a lot of data flowing around an ER, and the quality of the data (is the paperwork up to date) may mean the difference between life and death.

    • Re: (Score:3, Insightful)

      by MollyB (162595)

      I think castigating an entire group of professionals is short-sighted. Perhaps if ours was a less-litigious society, lawyers wouldn't be so powerful. After all, many patients employ lawyers in frivolous lawsuits against hospitals (not all, of course) which may make such detailed health records necessary (even to begin services). Lawyers are just functionaries. Blaming them is like blaming the hammer for hitting your thumb instead of the nail.

      I agree with the sentiment above that we place too much faith in o

  • by 4e617474 (945414) on Thursday June 04, 2009 @10:24AM (#28209291)

    Why do problems with paperwork make it necessary to turn away patients?

    In an ER, "paperwork" includes information on whether they'll kill you if they give you a certain drug or transfusion. Stuff like that.

    • Certainly... But turning away ambulances? They don't even know if it's just a bone that needs setting, a cut that needs stitching, or a similar condition. Triage, people!

      • by tomhath (637240) on Thursday June 04, 2009 @10:37AM (#28209521)
        They sent word to out the ambulances to divert to another hospital. It's not like they turned them away at the door. Basically they couldn't keep up with the number of patients without compromising patient safety or having incomplete records. In a real emergency they could still have treated patients, but in a lawsuit happy country like the USA they don't dare skip record keeping in a non-emergency situation.
        • Re: (Score:3, Insightful)

          by idontgno (624372)

          On some level, then, their operating practices and capacity (ER beds, staff, etc.) have been optimized to provide the service levels enabled by (relatively) low-friction electronic records access. One they fall back to paper records, apparently that becomes the friction point in their processes and their service delivery falls back to levels comparable to pre-EMR days. To a hospital administrator, that means wasted capacity (fewer patients seen, more idle ER facilities). To the staff, that means frustration

          • by aukset (889860) on Thursday June 04, 2009 @11:32AM (#28210293) Journal

            "Turning away ambulances" is not how it really happens. Let me describe it for you:

            The hospital determines it is nearing its capacity to handle emergent cases. The hospital contacts the regional EMS dispatch to let them know. In my area, this is the county Fire Control. When an ambulance calls in that they have arrived on scene, the dispatcher will say, in this case, "Methodist Hospital is the only closed facility." The crew will let the patient know that they can't take them to that hospital. Also, when the crew calls dispatch for a clearance to transport the patient, if the hospital they are going to is closed, dispatch will tell them so (in NY, a patient can demand to be transported to even a closed hospital, but we do our best to convince them to go somewhere else). A hospital ED cannot turn away patients at the door, even if they come by ambulance.

            So what if its a truly life threatening situation that can't be stabilized in the field? Say, full cardiac arrest, or uncontrollable arterial bleed? The ambulance will go to the closest facility, even if that is the closed facility, and will not be turned away. The ambulance will contact the receiving hospital directly and give a report on route, giving the hospital time to clear an appropriate room and mobilize the necessary staff to receive the patient.

            Hospitals can close for a lot of reasons. Sometimes, a few staff members call in sick and they can't find coverage, so the capacity of the system is reduced. Sometimes a lot of patients come in all at once. Sometimes the hospital's support systems like EMR fail, but it could even be their admissions and billing system that decides to fail and causes the hospital to divert patients. It happens, but the system is designed to handle it.

      • I assume they mean Methodist's main campus, since the lump IU in there as well.

        If so, there are a couple other hospitals within a few minutes drive by ambulance. It was probably faster for the patient to just go there.

    • by swillden (191260)

      Why do problems with paperwork make it necessary to turn away patients?

      In an ER, "paperwork" includes information on whether they'll kill you if they give you a certain drug or transfusion. Stuff like that.

      In some cases that's true, but not usually. It's only true if they already have records for the patient, and if they have identified the patient, and if they have bothered to look it up. The first is often not true and in urgent care situations the second and third are not usually done. Not until the emergency situation is stabilized, anyway. If you have an issue that could create serious problems if you were given the wrong drugs, etc., you should get a medic-alert bracelet or similar with the informat

      • Re: (Score:3, Insightful)

        by 4e617474 (945414)

        If you have an issue that could create serious problems if you were given the wrong drugs, etc., you should get a medic-alert bracelet or similar with the information.

        Do you have a blood type other than AB positive, and if so, do you have this information on a medic-alert bracelet? There's information that you expect to have in advance (you're right, it doesn't amount to much), information you gather and have to make note of (I give him drug X, so don't give him drug Y, it won't mix, and by the way, he says he's diabetic), information that has to get to and from other parts of the hospital (uh yeah, his potassium was high when he came in, you might want to take him off t

  • Problems with paper work don't make it necessary to turn away patients. But the paperwork is what brings the money to the hospital. Backlog of paperwork means backlog of income and meanwhile bills and wages have to be paid.

    • Re:they don't (Score:5, Informative)

      by TheMeuge (645043) on Thursday June 04, 2009 @10:38AM (#28209523)

      It's a reply that WILL get you karma from "fight-the-machine", "vaccines-cause-autism", and "they're-hiding-cures" crowd... but one that has no bearing at all on reality, and only reflects your ignorant disdain for the healthcare system.

      The reason why they can't operate without the electronic system likely has to do with the mountains of required documentation that needs to be filled out for every patient, and the fear that without the electronic system they may miss a counter-indication and kill a patient, whose family will then proceed to sue the hospital, the software company, and the universe for three thousand gazillion dollars. If the patient is stable and there is another hospital nearby, why risk it?

      P.S. If you think that a hospital would have trouble billing people without the electronic records, and that they'd turn away the ($1000 minimum) ER patients because of that, you're delusional.

  • by capt.Hij (318203) on Thursday June 04, 2009 @10:26AM (#28209321) Homepage Journal

    why do problems with paperwork make it necessary to turn away patients?

    It may not be necessary, but it is a cautious move. Information is important when treating patients. Their history is important. When making decisions on what treatments to provide the doctors consider the patient's history. If you do not have their history and a nearby hospital does then it seems like an easy choice to send the patient elsewhere.

  • by FunkSoulBrother (140893) on Thursday June 04, 2009 @10:28AM (#28209361)

    That headline makes no sense.

    • Re: (Score:3, Insightful)

      by Psiren (6145)

      Aye. I was going to vote it down, but there's no "Piss Poor Grammar/Spelling/Punctuation" option. Shame.

  • by modmans2ndcoming (929661) on Thursday June 04, 2009 @10:28AM (#28209367)

    The hospital I work for is implimenting a form cycle that allows forms to be printed and scaned back to the EMR. Such a system woudl allow my hospital to use the old paper system but maintain the records electronicly if there was ever a temporary interuption of the EMR.

    • by lorenlal (164133)
      It also provides a verifiable paper record. Something our voting system could use too.
    • The problem I see with that is how do you search for stuff exactly? Our system does that too for ER notes, but it can be difficult with how poorly people's handwriting can be.

  • They were afraid that without their data system they wouldn't be able to bill for the services to the patients.
  • Not a huge deal (Score:5, Informative)

    by Mayhem178 (920970) on Thursday June 04, 2009 @10:35AM (#28209479)
    The summary is a bit sensationalist. Being a resident of Indianapolis, I know for a fact that there are a ton of hospitals around this area. Chances are St. Vincent's got a lot of those patients. I'm certain that Methodist would not have turned away any patients that they were not absolutely certain would receive adequate aid at another hospital, or if they thought that the patient in question was in no condition to be re-routed.

    As for paper vs. electronic records, hospitals keep both. The point is that paper records take a lot longer to manage, and if they can safely do so, it's in everyone's best interest for them to send patients to other hospitals in order to get caught up on paperwork. If their paperwork keeps piling up, the chances of losing important data increase by a large margin, and that's bad for all parties involved.

    No, I say that Methodist made the right call here.
  • by johnlcallaway (165670) on Thursday June 04, 2009 @10:37AM (#28209519)
    It sounds like they were not accepting patients that couldn't make it to another hospital. Since they were accepting walk-ins, it's very likely an ambulance with a critical patient would have been accepted. If that was true, no one was being denied healthcare. Here in Phoenix, it's hard to go 5 miles without seeing another hospital. I was recently in a motorcycle crash and was not taken to the closest hospital because of the type of injury I had and the reputation the hospital had to handle orthopedic type injuries. I was not in a life threatening situation, just a simple fracture of my fibula, and didn't even go into surgery for 24 hours. I could have ridden several hours to another hospital and still have been just fine.

    Hospitals are businesses and have to make money. If they don't get accurate records, they can't bill the insurance companies. While this is an indication of issues with a specific hospital's computer and backup systems and a possible risk with other hospitals, I see no cause for alarm.

    I recently had to go to emergency for severe stomach pains and ended up having my gall bladder taken out. I had to wait 5 hours for a room because they were 'code purple'. All beds in hospital and emergency were full. I hope they were turning away non-critical patients also. I wouldn't be surprised if this happens far more often than what the news story reported.
  • In a completely computer-oriented hospital system (as more and more hospitals are doing, due to the tax benefits and lack of penalties), it's important that it's up and functional always.

    Take for example: you don't want to give a patient food that they're allergic to, or medicine that they're allergic to for that matter. All of that is tracked by computers.

    When there's actual paperwork involved with a computerized medical establishment, it gets very hairy. A patient may have notified someone of an import

  • It's here! (Score:3, Funny)

    by DarrenBaker (322210) <darren@fCOLAlim.net minus caffeine> on Thursday June 04, 2009 @10:40AM (#28209553) Homepage

    I've been waiting for this news for years. Computers that perform fellatio? YES!

    Imagine a beowulf cluster of those...

  • Let me see.... (Score:3, Insightful)

    by camperdave (969942) on Thursday June 04, 2009 @10:47AM (#28209677) Journal
    "Hospital Turns Away Ambulances Computers Go Down"

    I guess they meant "The computers in the Away Ambulances for Turns Hospital stopped working".

    Or maybe, "The Computers went down when the Hospital started Turning Ambulances Away." - some sort of sympathy strike action, I suppose; or maybe the hospital uses some computer repair technicians that call themselves PC medics, or PC Doctors and they ride around in "ambulances" that are full of tools and replacement parts. They arrived to do some maintenance and someone turned them away, resulting in the computers crashing.

    Or perhaps the article title needs some clarifying punctuation.
  • Years ago, probably in the early 1980's, a friend of the family had to be checked into a hospital. She was on dialisys (kidney disease) and obese and had other troubles associated with the combination of those two conditions. Things went wrong for her pretty frequently.

    The hospital food cart kept bringer her food that would flat out kill her: no kidneys means no ability to deal with floods of certain chemicals -- potassium, for example. She used to joke about committing "bananacide". She could just eat

    • Re: (Score:3, Insightful)

      by Anonymous Coward

      "She would plead with the staff, but they didn't change anything."

      That hospital had a much bigger problem than a bad computer system. Mistakes--even life-threatening ones--will happen, but your friend noticed the mistake and no one would fix it or even investigate?

      In the hospitals my family has stayed at, when there's a problem (like getting soup when you're on a low-water diet), you tell the nurse and the nurse goes and gets a different meal.

      Could the computer system be improved? Sure! Line #4 could hav

  • by vantar (1123257) on Thursday June 04, 2009 @10:53AM (#28209757)
    Since the article is making such a big deal about the rerouting of patients I would like to point out that the the nearest other hospital was Wishard Memorial Hospital, 1.5 miles away as the car drives.(Source:Google Maps) Its not like patients were being denied treatment because of this problem.
  • by davmoo (63521) on Thursday June 04, 2009 @10:56AM (#28209791)

    It doesn't matter that the headline is worded funny, because the majority of you responding so far obviously did not RTFA. But then why should I be surprised, this being Slashdot and all.

    If you had read the article, you would know that the hospital only requested that ambulances *in route to the hospital* reroute to other area hospitals (and Indianapolis has no shortage of hospitals). Patients who were already there were not turned away, and patients who showed up using methods other than ambulances were not turned away.

  • by Tyrun (944761) on Thursday June 04, 2009 @10:58AM (#28209835)
    Turning away patients isn't all that surprising. Hospitals do it all the time whenever they reach capacity. It's called overflow and it's quite common. In this instance their capacity was diminished because their system was in the gutter. Just my $.02
  • Workflow (Score:4, Insightful)

    by bzzfzz (1542813) on Thursday June 04, 2009 @11:13AM (#28209993)

    The problem is not so much access to historical records in these situations as it is workflow. After all, a patient sent to another hospital will not have the benefit of medical history records created at another hospital or clinic.

    Workflow is where there is trouble. If you're reading this you probably use a GPS or Google maps to get around, probably both. Do you still have any paper roadmaps? I don't. Your process for getting to a new place depends on the technology. Same with hospitals. They increasingly depend on automated workflows for scheduling, for dispensing drugs, for managing lab and x-ray orders and results, and so on.

    Hospitals have switched to these systems because they require fewer staff. They have largely dismantled the paper+clipboard+courier systems that preceded them. These older systems were complex and cannot be resurrected quickly. There aren't enough people to implement them. The institutional memory on how to use them is lost.

    I would guess that, in this particular case, they've gone back to paper prescriptions, signed by doctors, and taken by courier to the pharmacy, with a paper label on the dispensed drugs. That must be scary, because all the safeguards in the automated system -- checks for allergies, interactions, appropriate dosage for patient weight, not to mention barcode scans at multiple points to guard against mistakes -- are gone. Who will do the manual crosschecking? Have they been trained?

    As Isaac Asimov once wrote, ""I do not fear computers. I fear the lack of them."

  • by nimbius (983462) on Thursday June 04, 2009 @11:14AM (#28210025) Homepage
    for this hospital. any competent facility with an electronic system such as this obviously has a competent IT staff dedicated to a recovery procedure of some sort. redundant systems, generator backed servers, and perhaps even colocation while new for healthcare IT should be considered.

    if its like every other IT shop, the "budget" was cut and IT got the short end of the stick again.
  • Paperwork (Score:3, Insightful)

    by DragonWriter (970822) on Thursday June 04, 2009 @11:41AM (#28210411)

    But even leaving that aside -- why do problems with paperwork make it necessary to turn away patients?

    Because orders for (and, where applicable, results from) lab tests, diagnostic imaging, medications, etc. are all "paperwork", and all rather essential parts of patient care, and are particularly time sensitive in the case of emergency care. If you can't process "paperwork" (with or without paper) accurately and timely, you can't properly treat patients.

    Which is why an EHR system shouldn't be purchased without reliability (uptime, etc.) guarantees.

  • by lionchild (581331) on Thursday June 04, 2009 @11:49AM (#28210531) Journal

    This is the biggest reason I can point out for a patient to be an ACTIVE participant in knowing what their treatment is in a hospital or other medical facility with electronic record systems. You need to know what you're supposed to be getting and when. If you don't, you should be asking questions until you get satisfactory answers.

Never put off till run-time what you can do at compile-time. -- D. Gries

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