By Dave Harrington, PhD
Recently, I got to experience the other side of healthcare technology—as a patient—and see firsthand what is working and what needs to be updated, reconfigured, or re-educated. Since the vast majority of technical hospital personnel know what works and what doesn’t, I won’t spend too much space on this; however, I urge you to discuss your concerns with your equipment vendors.
After all, if enough of us speak out, maybe the vendors will start to listen. Unfortunately, that is a huge “maybe.”
Here’s what I would tell the suppliers: “Listen to what your customers say is needed—instead of a group of people who have probably never performed patient care.” Because if enough of us speak with the equipment manufacturers, maybe they will start to send technical personnel to our regional shows—not just salespeople with questionable attention spans.
When I was a product manager, I attended many biomed shows to get input from current and potential customers. Over the past 10 years, however, I don’t recall seeing any product managers at regional shows. And it’s a shame since they should be talking to us.
Regarding hospital staff, though: I believe we should talk to them—particularly nurses—about alarm management. Think about it: If caregivers had fewer alarms to respond to, they could provide more consistent patient care.
Personally, I believe the quickest fix for alarm fatigue is to shut off all the alarms that don’t measure potentially life-threatening data. Two key alarms? The pulse oximeter, followed by the temperature alarm. Although the temperature alarm is not a common one, it can be very important if a patient runs a 105 ° fever like I did at the hospital. ECG alarms, however, offer limited clinical value, in my opinion.
During my time as a patient, another item that concerned me was how the medical staff paid more attention to their tablets than the patients. Despite the fact that all the rooms had hand sanitizers at the door, as well as signs encouraging their use upon entering and leaving the room, more than 90% of those who came into my room never touched me. Instead, they just looked at their tablets and asked me a few questions—often without making eye contact.
So, here’s my question: What has changed in healthcare that providers no longer have to look at or touch a patient?
Technological Concerns
This brings me to computers, which often miss information that we get billed for. In 1991, I published an article in the Journal of Clinical Engineering stating that all medical equipment would be interconnected within five years. Well, here we are 26 years later and, thanks to higher powers, this is not happening. It’s one of the few times that being wrong was actually correct and in the best interest of patients and staff.
Why do I say that? Well, consider all the recent headlines regarding the hacking of health records. This sensitive information is no longer confidential—and hackers are playing with data to make patients appear healthier or sicker. Not only are others seeing our medical records, they may be seeing our financial data, too.
Remember when people claimed how gathering all the healthcare data would improve healthcare and reduce costs? Well, to steal a line from the old TV show, “Get Smart,”: “Would you believe?” I’m unware of any media outlet that cited data from multi computer databases showing how the influx of data has improved healthcare or reduced costs. Another classic line from “Get Smart”: “Missed me by this much”—and it still is missing, at least to me.
So, to IT professionals, I have one request: Come up with better ways to halt the hacking of healthcare data. Ideally, IT professionals would develop a program that would trace the hack back to the originating computer—and fry it, on the spot. Those in-house, however, can help the cause by changing computer passwords on a regular basis. (But they need to make sure that everyone needing access knows the correct password!)
If you do not think that this is needed, just ask my colleague and fellow 24×7 Magazine editorial board member Steve Grimes about his experience with somebody changing an IP address and not telling the right personnel about it. (Editor’s note: Grimes details his experience in September’s cover story, “Come Together, Right Now.” Access it here.)
Just like we did during the Y2K fiasco, we have to bail out the IT people from the problems they created or missed seeing. That way, healthcare can improve and costs can come down.
Dave Harrington, PhD, is a healthcare consultant in Medway, Mass. For more information, contact chief editor Keri Forsythe-Stephens at [email protected]
Dave, you asked a great question: “What has changed in healthcare that providers no longer have to have to look at or touch a patient?”
As far as I am concerned, it started long ago when electronic thermometers were introduced on Nursing Floors. With the old glass thermometers, a nurse would enter your room and place a thermometer in your mouth. While they waited the three minutes for the thermometer to give results, they would take your pulse and blood pressure, check your coloring, look you in the eye, and ask how you were feeling or chat briefly about whatever came to their mind? Maybe they would also plump up your pillow or adjust the curtains in your room. After the introduction of electronic thermometers, nurses only had to be in your room for thirty seconds. I remember debating with our VP of nursing that introduction of the thermometers would tend to de-personalize nursing care and while she agreed about de-personalization, she was under pressure to improve productivity because of cost measures and a shortage of trained nurses.
I know there were distinct hazards associated with the mercury thermometers, and blood pressure manometers, but I also know that this was one of the first steps in creating an environment where, as you state: “that providers no longer have to have to look at or touch a patient” After the introduction of electronic thermometers, technology progressed to where vital signs are now taken by machines operated by “healthcare assistants” and nurses don’t even have to enter the room.
Each new device and technological development has reduced or dehumanized patient care and I would suggest that we, who support all of this technology, were and are part of the problem. To some extent, we and the users of technology have forgotten that our primary business is taking care of human beings (also known as patients) who need kindness and compassion.