Pharmacists

Big Brother Arrives: Monitoring Patient Safety Compliance By Remote Video

Today came the announcement that Suzanne Delbanco, founding director of the Leapfrog Group, has assumed the presidency of a company that tracks compliance with safety and quality practices via remote video. Big Brother, meet the Joint Commission.The report, in today’s Modern Healthcare, describes the process this way:Video auditing refers to a system in which cameras are mounted in targeted locations to continuously capture specific clinical processes, such as observing handwashing and hand-sanitizing stations. [Using video] fed through a Web-based link, independent, third-party observers audit the recordings and provider reports on safety incidents.Did you ever doubt this was coming? Virtually every other industry with compliance standards has long used video to monitor compliance and to goose workers into following the rules. If video surveillance is good enough for Vegas croupiers and Kansas meat packers, why wouldn’t it be good enough for neonatal nurses and ER docs?Consider hand hygiene. Until a few…

Why the Medical Record Needs to Become More Like Facebook

The explosive growth of Facebook and MySpace illustrates the market for electronic tools to enhance communication and collaboration. Could there possibly be another workplace more in need of social networking tools than the modern hospital?If you are not familiar with Facebook, find yourself a teenager and take a look over his shoulder while he is using it (mine are available for rent if you get desperate; the best time to catch them is when they should be doing homework). In one thrilling, chaotic electronic e-universe, the site allows users to exchange instant messages with dozens of friends, to post pictures and videos, and to link to virtually everything on the Web – all at the same time. John McCain would be flabbergasted.Now, take a look at today’s medical record, and ask yourself whether – if we could start fresh – this is the tool you would have constructed if your…

Will Knols and Blogs Upend the Cozy World of Medical Publishing?

Yesterday, Google launched Knol, immediately branded as Google’s answer to Wikipedia. As healthcare advisor to the project, I’ll say a few words about Knol, but focus on how it – and other forms of electronic self-publishing – may signal the end of medical publishing as we have known it.First, a word about Knol (the name is short for “a unit of knowledge”). Google’s vision is that providing a tool for people to write about “things that they know” will make the world a better place. Unlike Wikipedia’s anonymous, collaborative writing/editing process, Knols have authors, with names, faces, and reputations. (Authors can choose to have their identity verified, through a cross-check on their credit card or phone records.) Google provides Knolers a tool; authors enter their content and click “publish.” And poof, there it is, on the Web. Users can rate and comment on Knols, send them to friends, and suggest…

Why Diagnostic Errors Don’t Get Any Respect… And What Can Be Done About It

I gave a keynote yesterday to the first-ever meeting on “Diagnostic Error in Medicine.” I hope the confab helps put diagnostic errors on the safety map. But, as Ricky Ricardo would say, the experts and advocates in the audience have some ‘splainin’ to do. I date the origin of the patient safety field to the publication of the IOM report on medical errors (To Err is Human) – it is the field’s equivalent of the Birth of Christ (as in, there was before, and there is after). But from the get-go, diagnostic errors were the ugly stepchild of the safety family. I searched the text of To Err… and found that the term “medication errors” is mentioned 70 times, while “diagnostic errors” appears twice. This is interesting, since diagnostic errors comprised 17% of the adverse events in the Harvard Medical Practice Study (from which the IOM’s 44,000-98,000 deaths numbers were…

The Funniest Satire on Interoperability You’ve Ever Seen (Trust Me)

There is nothing better than a good satire to capture certain (uncomfortable) truths – just ask any of the presidential candidates after an episode of Saturday Night Live. So check out this hilarious spoof on information technology interoperability.As Captain Kirk said to Bones, “have you lost your mind?” Hilarious? Interoperability? But really, check it out. It is very funny.Now for those deep truths. When my friend David Brailer became the first federal IT czar, I think most people expected him to focus his attention and bully pulpit on promoting CPOE and EMR implementation – a “chicken in every pot, a computer in every office” strategy using incentives, regulations, and more. Yet David, who is one of the smartest and savviest people I know, focused much of his energy on the seemingly arcane and stultifyingly boring topic of interoperability – creating a common language so that the computers of different vendors…
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