Comments on: An HIT Moment With … Leah Binder http://histalk2.com/2008/10/13/an-hit-moment-with-leah-binder/ Healthcare IT News and Opinion Thu, 18 Mar 2010 16:21:54 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: A. Scott Holmes http://histalk2.com/2008/10/13/an-hit-moment-with-leah-binder/comment-page-1/#comment-2458 A. Scott Holmes Tue, 14 Oct 2008 19:20:22 +0000 http://histalk2.com/2008/10/13/an-hit-moment-with-leah-binder/#comment-2458 Leah's article is classic "PYA." there are many things wrong, but I will focus on 2. 1. Why was so much emphasis placed on CPOE where the software was immature, it was difficult to install, and it was represented as a panacea. Somebody should review how the decision was made. 2. Think of the safety outcomes that would have occurred if the same money had been invested in systems that reduce hospital acquired infections, reduce Labor and Delivery mistakes, stream line functions in operating rooms, automate nurse charting, etc. No matter what you say, although Leapfrog may have raised expectations, they created a wild goose chase and they still have the gall to defend their actions. Leah’s article is classic “PYA.” there are many things wrong, but I will focus on 2.

1. Why was so much emphasis placed on CPOE where the software was immature, it was difficult to install, and it was represented as a panacea. Somebody should review how the decision was made.

2. Think of the safety outcomes that would have occurred if the same money had been invested in systems that reduce hospital acquired infections, reduce Labor and Delivery mistakes, stream line functions in operating rooms, automate nurse charting, etc.

No matter what you say, although Leapfrog may have raised expectations, they created a wild goose chase and they still have the gall to defend their actions.

]]> By: Leah Binder http://histalk2.com/2008/10/13/an-hit-moment-with-leah-binder/comment-page-1/#comment-2455 Leah Binder Tue, 14 Oct 2008 13:22:51 +0000 http://histalk2.com/2008/10/13/an-hit-moment-with-leah-binder/#comment-2455 In fact I mentioned in my remarks the studies Dr. Borges cites, pointing out that in both studies CPOE was implemented in 6 days--which is not long enough to safely or effectively implement any system in a hospital, much less one as complex as CPOE. Leapfrog's concern about the importance of proper implementation of CPOE is why we incorporated a CPOE system evaluation tool into our 2008 survey. Here's the direct link to the CPOE background on our website: http://www.leapfroggroup.org/for_hospitals/leapfrog_hospital_survey_copy/leapfrog_safety_practices/cpoe In fact I mentioned in my remarks the studies Dr. Borges cites, pointing out that in both studies CPOE was implemented in 6 days–which is not long enough to safely or effectively implement any system in a hospital, much less one as complex as CPOE. Leapfrog’s concern about the importance of proper implementation of CPOE is why we incorporated a CPOE system evaluation tool into our 2008 survey. Here’s the direct link to the CPOE background on our website: http://www.leapfroggroup.org/for_hospitals/leapfrog_hospital_survey_copy/leapfrog_safety_practices/cpoe

]]> By: Al Borges, MD http://histalk2.com/2008/10/13/an-hit-moment-with-leah-binder/comment-page-1/#comment-2453 Al Borges, MD Tue, 14 Oct 2008 08:34:41 +0000 http://histalk2.com/2008/10/13/an-hit-moment-with-leah-binder/#comment-2453 >>> at that time, the idea of report cards comparing providers was considered fairly radical and opposed by a wide variety of provider stakeholders. Today, everyone seems to agree it’s a good idea Biased, sweeping statement- if you bring up provider report cards and P4P to physicians you'll get tied and burned at the stake just about anywhere you go. By this statement, you wish to forward your agenda. >>> Among the studies: a study led by David Bates, MD, Chief of General Medicine at Boston’s Brigham and Women’s Hospital, demonstrated that CPOE reduced error rates by 55% — from 10.7 to 4.9 per 1000 patient-days. Rates of serious medication errors fell by 88% in a subsequent study by the same group. Another study conducted by LDS Hospital in Salt Lake City by David Classen, MD, demonstrated a 70% reduction in antibiotic-related ADEs after implementation of decision support for those drugs. All I know is that when I think of CPOE I think of 2 articles that have come out in the past where in one the implementation of CPOE had not gone well in one hospital, and something that is generally detested by physicians, and in the other, babies died. I tried to find your bibliography on your site, but alas, it wasn't there. Let show you what I have: -- http://www.emrupdate.com/forums/p/2648/22685.aspx#22685, "Cedars-Sinai Doctors Cling to Pen and Paper", 3/21/2005 -- http://pediatrics.aappublications.org/cgi/content/abstract/116/6/1506, in this URL you will find a study done at a tertiary level children's hospital where the findings were eye opening- CPOE was associated with an INCREASED mortality among its patients! Al >>> at that time, the idea of report cards comparing providers was considered fairly radical and opposed by a wide variety of provider stakeholders. Today, everyone seems to agree it’s a good idea

Biased, sweeping statement- if you bring up provider report cards and P4P to physicians you’ll get tied and burned at the stake just about anywhere you go. By this statement, you wish to forward your agenda.

>>> Among the studies: a study led by David Bates, MD, Chief of General Medicine at Boston’s Brigham and Women’s Hospital, demonstrated that CPOE reduced error rates by 55% — from 10.7 to 4.9 per 1000 patient-days. Rates of serious medication errors fell by 88% in a subsequent study by the same group. Another study conducted by LDS Hospital in Salt Lake City by David Classen, MD, demonstrated a 70% reduction in antibiotic-related ADEs after implementation of decision support for those drugs.

All I know is that when I think of CPOE I think of 2 articles that have come out in the past where in one the implementation of CPOE had not gone well in one hospital, and something that is generally detested by physicians, and in the other, babies died.

I tried to find your bibliography on your site, but alas, it wasn’t there. Let show you what I have:

– http://www.emrupdate.com/forums/p/2648/22685.aspx#22685, “Cedars-Sinai Doctors Cling to Pen and Paper”, 3/21/2005

– http://pediatrics.aappublications.org/cgi/content/abstract/116/6/1506, in this URL you will find a study done at a tertiary level children’s hospital where the findings were eye opening- CPOE was associated with an INCREASED mortality among its patients!

Al

]]>