Thursday, August 28, 2014

This article in Crain's Detroit Business (originally from Modern Healthcare) notes:

Recent studies have found that rapid implementation of new medical technology — electronic health records, patient monitoring devices, surgical robots and other tools — can lead to adverse patient events when it is not thoughtfully integrated into workflow. The right processes require understanding the devices and the users. Testing in controlled environments often does not adequately consider the “human factor,” or how people interact with technology in high-pressure, real-life situations.

From 2011 to 2013, human-factor issues were the most frequently identified root causes of “never-events,” such as medication errors and treatment delays, according to a Joint Commission report. “It’s the interface of the human with the technology that creates a problem,” said Ana Pujols-McKee, M.D., the commission’s chief medical officer.

Rosemary Gibson explains:

“We have a cascade of gadgets and equipment that’s just raining down on the health care system.” Productivity demands are forcing physicians, nurses and other clinical staff to work faster, and when that directive is coupled with new devices and equipment, “even the most competent people in the world can’t do that safely."

In a private conversation, a colleague who had been involved in the National Transportation Safety Board was shown the article and was asked, "How does aviation handle new stuff in the cockpit?"

The reply:

All of the aircraft manufacturers have human factors teams who participate in the implementation of new technologies. Once developed it's fight simulators and training, training, training.

This article was fascinating to me. It appears that the medical community is about 2 decades behind aviation.

What a relief. Two decades. I had thought medicine might be stuck in the Twentieth Century. Oh, wait. Two decades ago is the Twentieth Century.

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