“Why isn’t it working like the iPhone?” is a complaint Dr. Hanna says he hears all the time.
One answer is that a number of medical software programs are limited in nature and don’t automatically network well with other systems already in place. User errors and other problems crop up regularly; plus, there isn’t a repository for people to measure different systems against each other. Some SHM leaders are considering a plan to create an online resource for IT vendors, but the society is leery of making recommendations because of potential conflicts of interest.
The Joint Commission, which accredits and certifies more than 15,000 healthcare organizations and programs, has been asked—by Dr. Hanna, among others—if it intends to regulate EMR vendors, which would let hospitalists know which systems are most reliable and useful. Commission President Mark Chassin, MD, MPP, MPH, said after his HM09 keynote address that his agency has no intention of doing so.
—Scott Flanders, MD, FHM, SHM president
“We don’t see [that] as a good message for us to give,” Dr. Chassin said.
IT also can be used in creative ways to spur patient-safety improvements. As hospitalists struggle to increase compliance with hand-hygiene standards, several hospitals have resorted to using video cameras above sinks to track whose hands are clean and whose hands are not clean, Robert Wachter, MD, FHM, said during his plenary address to conclude HM09. Real-time tracking runs through a software program and is displayed on a small, LED screen that hangs from the ceiling. Positive results are praised, while low rates of compliance result in pages to HM and hospital leaders to address hygiene issues. Dr. Wachter, professor and associate chairman of the department of medicine at the University of California at San Francisco Medical Center, chief of the division of hospital medicine, former SHM president and author of the blog “Wachter’s World” (www.wachtersworld), said UCSF hospital executives are considering the video system.
Dr. Wachter also says hospitalists can’t lament the rise of QI and the stricter standards that are attached. Nor can HM complain too loudly about the burdens QI places on them. As hospitalists argue that their value is partly defined by their contributions to hospital quality, they have to expect to be accountable to the claim. “We have positioned ourselves as being leaders in quality and safety,” he says. “This is not going out and being branded. We bring this in. We often say we have two sick patients; one is in front of us, the other is our organization.”