April 7, 2008

1. Quaid To Cedars-Sinai: Barcoding is The Right Stuff

Facts and Background

Actor Dennis Quaid, whose newborn twins were nearly killed by an accidental blood thinner overdose at Cedars-Sinai Medical Center in Los Angeles, says on his foundation's web site that he may sue the hospital if it doesn't "do the right thing" and implement bedside barcode verification of medications.

Opinion

This would be a great public advocacy statement for bedside verification, other than the fact that currently available systems are generally primitive, hellishly difficult to implement, and badly designed from a nurse workflow perspective (not to mention that drug manufacturer barcoding practices have been less than enthusiastic and consistent). Deaths have occurred in similar situations even in hospitals with barcoding systems because their quirks encourage nurses to find productivity-saving workarounds.

Musings

• If barcoding was as easy to implement as Quaid thinks, it wouldn't take a near miss or a vocal movie actor to convince hospitals. Unfortunate, but true, grocery scanning analogy aside.
• Cedars is among the 80% or so of hospitals that haven't implemented barcoding.
• Quaid is already suing Baxter for making hard-to-read heparin vials.
• The babies are fine, thankfully. While the incident is regrettable, what's there to sue for?
• One memorably stupid comment from Quaid: "They recall dog food that came from China last year, but they don't recall medicine that kills people if you give it in the wrong dosage." That would be all drugs, Dennis.
• Ambulance chasing attorneys were all over Baxter's heparin anyway after contaminants were identified in some lot numbers.
• Baxter's heparin and its labeling were approved by FDA, which evaluates both for safety. Why isn't Quaid naming them as the overseer?
• One thing that Baxter and Cedars-Sinai can't do: make a nurse read the label. At what point does individual negligence come into play when a healthcare worker doesn't follow hospital policy, especially with a known high risk drug?
• It's time to go back to the barcoding table with more consistent drug barcoding, better software, and wider adoption. That's a message that somebody needs to hear, so Dennis Quaid may be the right guy for the job.

2.  Admitted John's Sidekick Makes it Rain for RHIOs

Facts and Background

New York state has awarded $105 million in grants for regional health information organizations, Governor David Paterson announced last Monday.

Opinion

Given the disproportionate healthcare spending and waste that has been identified in New York, maybe this isn't the worst way to spend state (and federal) money.

Musings

• Most of the RHIOs that received money were already operating. What were they planning to do without a state bailout?
• The state's RHIOs at least have agreed to share information and technology.
• If you like the idea of government using tax money for healthcare data sharing, New York actually seems to have good programs with support and visibility, although their business plans may be shaky.

3. UCLA Belatedly Admits Fawcett Leak

Facts and Background

UCLA Medical Center fired an employee for selling information from actress Farrah Fawcett's chart to a tabloid, it was reported last Wednesday. The incident occurred before the hospital fired or disciplined several employees for inappropriately reviewing the medical records of Britney Spears.

Opinion

There is no way that celebrity records will ever be safe from prying employee eyes, no matter how much technical or physical security is employed. The temptation is too great and too many hospital employees are involved in the average patient's care.

Musings

• The Enquirer ran an exclusive story headlined "Farrah's Cancer is Back!" last May, before she could even tell her son. They need to be sued, badly.
• The Enquirer's parent company, when challenged by Fawcett's attorneys, bragged that their stories were based on "exceptional sources directly in a position to know the information reported," according to a Los Angeles Times report.
• UCLA says it was monitoring for breaches of her file but found none, but when she complained, the hospital tracked down multiple instances where an unauthorized employee accessed her records. Even that retrospective security auditing capability is beyond many hospitals and information systems.
• Fawcett was registered under an alias, which didn't stop the breach.

Subscriber Name: %%Name%%
Subscriber E-Mail: %%emailaddress%%
Subscribe Date: %%subscribedate%%
Unsubscribe

© 2008 HIStalk. All rights reserved.