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Hospital’s failure with electronic medical records a caution for others

Patient Safety Monitor Alert, March 24, 2005

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While government officials are making a push for electronic medical record systems and citing patient safety improvements, the experience of one hospital known for pioneering new techniques and technologies serves as a cautionary tale for other hospitals, reports the Washington Post.

In 2002, Cedars-Sinai Medical Center in Los Angeles installed a $34 million computer system. After just three months of use, frustrated staff discovered too many problems and rebelled, forcing the hospital to shelve the system.

Doctors and nurses cited problems including inadequate training, time consumption, and that the hospital implemented the system all at once, rather than one ward at a time.

Hospital officials admitted to certain flaws in the system, but said many of the tensions were cultural. Officials are waiting for the technology to improve and possibly for younger doctors who are more familiar with computers to arrive before trying again. In the interim, the hospital relies on extra layers of staff to double and triple-check its procedures, said Neil Romanoff, a physician who oversees safety procedures.

"Most industries in America have used information technology to make their businesses more cost-effective, more efficient, and more productive," President George W. Bush said recently at a visit to the Cleveland Clinic. "The truth of the matter is, healthcare hasn't."

But the failure at Cedars-Sinai demonstrates how difficult the transition can be.

"The most important lesson of the Cedars-Sinai case is that electronic health record implementation is risky," said David J. Brailer, national coordinator for health information technology. "Up to 30% fail."

About 6% of hospitals nationwide have computerized systems for doctors' orders. Yet, the reason for using information technology is also one of the reasons the transition is so difficult, he said. "You are moving from a freewheeling environment-which is why there are a lot of errors-to very controlled processes" that often do not account for creativity, instinct, and judgment. "It changes the way everyone interacts."

To read the complete Washington Post article, click here.

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