I conducted a fairly extensive web search, combining such terms as “healthcare,” “IT,” “medical errors,” “technology,” “fat-fingering,” etc. While the number of search results ranged from 25,000-95,000, depending on the combination of terms (and I admit I didn’t look at more than the first few dozen with each search combination), I found no relevant articles linking fat-fingering with medical errors. In fact several of my healthcare searches brought up stories about the May 6 stock market incident, no doubt because that incident affected the healthcare of thousands of Americans.
In spite of a dearth of reported incidents of fat-fingering or other user-caused medical errors caused by or delivered through electronic data entry devices, the possibility definitely exists. A mistyped entry on a lab result, a prescription or any one of a number of parameters, could have dire consequences. Perhaps that is another underlying reason why healthcare is so far behind virtually every other industry in America in adoption of technology. Whereas all other industries — transportation, hospitality, financial services, manufacturing — are highly automated and are implementing fourth- and fifth-generation systems, healthcare has around 20-25 percent adoption of technology, and those who have implemented technology are on their first or second systems. Could it be that physicians and other players are afraid that technology could somehow accelerate or exacerbate medical errors by making more of them faster?
If so, that is an opinion with no basis of facts to back it up. On the other hand, there are plenty of facts that the lack of technology and automation in healthcare leads to fatal medical errors.
So while some providers may fear that technology could lead to issues like the stock market meltdown, the irony is that there are reports of thousands of deaths per year caused by one of the most manual of processes — poor physician handwriting. Time Magazine quotes a 2006 report from the National Academies of Science that claims 7,000 deaths and 1.5 million injuries per year blamed largely on doctors’ bad handwriting. The adoption of technology, which would relieve other care givers of the added burden of interpreting doctors’ written notes, instructions and prescriptions, would no doubt reduce this issue. And with built-in rules engines and decision support algorithms, the adoption of technology would reduce those numbers even further by automatically detecting such things as wrong dosages, wrong medication formulations, and inappropriate drug interactions.
When you buy a computer or laptop online, if you specify a combination of hard drive, mother board, operating system and memory that will not work, the rules engine built into the configurator will not let you proceed. If you have even a fairly simple medical condition like a skin rash that requires a prescription there is nothing to prevent or warn the physician that the oral medication may interfere — perhaps catastrophically — with other medications that you might be taking.
So the answer to the question, “could fat-fingering happen in healthcare?” is, technically, that it could. But the good news is, with so little technology adoption in healthcare, it would likely have limited effect.
But that is actually bad news.
Reduction and elimination of medical errors is just one more reason that healthcare needs to get with the program. An errant keystroke at a burger joint may require a happy meal to get sent back to the kitchen. An errant keystroke by a trader may cause havoc in the stock market. The lack of keystrokes in healthcare is killing people.
Marion K. Jenkins, PhD, is founder and CEO of QSE Technologies, which provides IT consulting and implementation services for ASCs and other medical facilities nationwide. Learn more about QSE Technologies at www.qsetech.com.
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