Each day I roll into work ready for another exciting day of pharmacy technology. I’m usually bright-eyed and ready for a new challenge because I’ve spent the previous night scouring the web and reading about all the incredible technology being put into place all over the world; tablet pcs, electronic paper and ink, advanced nanoparticles, automated dispensing devices, mobile phones, advances in social networking, and so on ad infinitum. Then there are days like today when I have something land in my lap that just makes me shake my head and wonder if healthcare will ever catch up to the rest of the world.
Our Siemens Pharmacy System is interfaced with the clinical system used by nursing and physicians; Soarian Clinicals, which is also from Siemens. Of course the interface between these two systems is supposed to be bidirectional, meaning that information such as allergies can be entered in either system and they’ll always be synched up. According to Siemens it works great, according to me it doesn’t. We constantly have to track down patients with allergies that are different in the two systems. In fact, we now have a person dedicated to following up on such issues; another band-aid approach to a problem. Siemens tells me the system is “working as designed”. Well, if that’s the case it’s a poor design.
My browser of choice is Firefox, reasons can be found here. I use several plug-ins on my browser that help me keep up with information in the world around me, create bibliographies, clip web pages, etc. These plug-ins store information in such a way that I can access them across many computers, in different browsers, on different operating systems and even on devices that have no business talking to each other. And this is all done independent of the circumstances under which the information is stored. I can create information with my iPod Touch, walk over to my daughter’s MacBook and use the same information. I can clip a webpage on my PC and pull it up on my colleague’s iPhone, and it’s always accurate and up to date.
Information can be stored, altered, and shared via free tools like DropBox and Live Mesh. Why can something available for free to every Tom, Dick and Harry in the universe handle data better than our multi-million dollar hospital information system? Simple, the general public would never use something that was so poorly designed and unreliable. Would you use a word processor that lost sentences when shared with others for collaboration, i.e. Google Docs or Zoho Writer? Of course not. Unfortunately we don’t hold healthcare systems to the same standard. The ARRA stimulus money will make little difference to advances in healthcare technology if all we do with it is develop more expensive junk. We desperately need to simplify, standardize and centralize first. Go ahead, give it some serious thought and then try to tell me I’m wrong.
The simple answer is that the companies that have monopolies on Healthcare information systems are there because of opportunity. They were there at a time when the industry needed something. The sad part is that something was created without much of the development rigors we have seen in competent industries. These might include financial or retail. We have software that in many cases was initially created in someone’s garage.
My second point is open source. The reason Firefox is such a great platform is because they design API (application programming interfaces) and give the code to everyone. That allows cool things to happen, and we benefit from it. Intellectual Property paranoia in the private sector for healthcare IT has left most hospitals with a stale, unsatisfactory product.
Although I will say I have been very impressed with Epic in general. They put more thought behind their decisions, and really listen to their customers. It is by no means perfect, it is clear to me the leadership really wants to make it work. Once they allow API type interfacing, I will know they are truly in it for the patient.
Amen, brother!
[...] – HER Bloggers: “One of the biggest challenges for linking together different health information systems is the inconsistency in referring to a given individual – be that a physician, a patient, or whomever. One system, for example a lab system, may refer to “Patient x” one way (using their own arbitrary internal patient identifier number), while a different system (for example, a hospital) may use a completely different identifier. Between ambulatory EHRs, each one will also likely refer to a given patient with different, internal methods. Cross-linking these systems so that a unified dashboard can be created that displays all the information from all these systems is made much more difficult as a result.” – Exactly! See my post on a similar issue from yesterday here. [...]