Monday, July 11, 2011

Contingencies

* Bzzzzzaaaaapp *

Suddenly, the light went out. There was complete and utter darkness. Then, about 3 seconds later, the lights returned. My computer with its flat screen poised before me, remained dark. I hesitated a moment, then pushed the power button. Within a few more moments, the computer restarted. All seemed intact.

But what if it wasn't?

Today with our myriad of computer systems, electronic medical records, e-mail messages, paging systems, digital xray machines, blood chemistry analyzers, automated blood pressure cuffs, etc., etc., etc., what would happen if we had no power or functional electronic medical record, just for a week?

Could our health system function?

We have entered the era when our medical students and residents have never entered a written order and "flagged it." Our unit secretaries wouldn't have a clue how to take off an order from a "flagged" chart. How would we order a stat portable chest xray without a computer? And what about our written notes. Would they include the date and time in the lefthand column, or would that be forgotten in our hurry to write our manual progress notes? Would our digital phone systems work? How about our pagers? Doctors can no longer find manual blood pressure cuffs on our wards since hospitals have moved to automated blood pressure cuffs that upload their readings into the electronic medical record automatically. have our nurses and medical assistants lost the art of taking a manual blood pressure?

I wonder about our contingency plans. Hospitals say they have them, but do the personnel know how to function under this challenging constraint?

It is hard to say. I suspect most things would come to a standstill until power was restored. But there might be some things that would be benefitted. Length of stay times would be relaxed. So would performance measures. Even better than that, though...

..our written progress notes and consults would become a whole lot shorter.

Who knows?

Maybe a little power outage would force us all to evaluate what we're currently doing in medicine so we could do improve our efficiencies and skills until the power gets restored.

-Wes

4 comments:

  1. When I was much younger I read a Sci-fi story about all the worlds knowledge stored on servers on the moon... safe keeping. People on earth could access information instantly via satellite. Then one day we went to war and the satellites were destroyed. Thirty days later we were on our way back to the stone age as there were no books or any other information available... Seems to me that 'clouds' are so fragile.

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  2. What a shame! We might have to spend more time with patients instead of the computer!

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  3. At our hospital it was discovered that during the the shift to automated pt BP and temp measurement and input about 4 years ago no one thought to include those instruments on the regular inspection and validation schedule unlike the older, manual equipment. Some atuomated BP cuffs and thermometers were off by over 20% and the problem was not discovered until many nurses said "wait a minute! Those reading san't be real" and blew the whistle after noticing none of the newfangled machines had ih-house inspection & validation stickers.

    This is someting all health care providers should take note of.

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  4. Twice I've received phone calls cancelling my appointment because the power was out. No power = no computer = no patients.

    Generators just aren't that expensive. Buy one and have it available when needed, or rent one for a few hours. The cost is a drop in the bucket compared to lost revenue from cancelling all those appointments.

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