Comments on: Report: CPOE Technology is Not a Silver Bullet (No Surprise?) http://www.leanblog.org/2010/07/report-cpoe-technology-is-not-a-silver-bullet-no-surprise/ Mark Graban's leanblog.org - Lean Healthcare, Lean Thinking, Lean Manufacturing, Toyota Production System Fri, 10 Feb 2012 10:01:31 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Announcement on My Future Professional Direction — Lean Blog http://www.leanblog.org/2010/07/report-cpoe-technology-is-not-a-silver-bullet-no-surprise/#comment-21805 Announcement on My Future Professional Direction — Lean Blog Tue, 14 Jun 2011 11:38:17 +0000 http://www.leanblog.org/?p=7213#comment-21805 [...] reason I’m getting involved is that Greg and Matt are keenly aware that software is not a silver bullet. An effective kaizen system requires building the right leadership style and culture. While [...] [...] reason I’m getting involved is that Greg and Matt are keenly aware that software is not a silver bullet. An effective kaizen system requires building the right leadership style and culture. While [...]

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]]> By: Report: CPOE Technology is Not a Silver Bullet (No Surprise … | Win Cricket NOW ! http://www.leanblog.org/2010/07/report-cpoe-technology-is-not-a-silver-bullet-no-surprise/#comment-19764 Report: CPOE Technology is Not a Silver Bullet (No Surprise … | Win Cricket NOW ! Thu, 24 Mar 2011 01:32:12 +0000 http://www.leanblog.org/?p=7213#comment-19764 [...] Continue reading here: Report: CPOE Technology is Not a Silver Bullet (No Surprise … [...] [...] Continue reading here: Report: CPOE Technology is Not a Silver Bullet (No Surprise … [...]

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]]> By: Mark Graban http://www.leanblog.org/2010/07/report-cpoe-technology-is-not-a-silver-bullet-no-surprise/#comment-12341 Mark Graban Sun, 22 Aug 2010 18:23:02 +0000 http://www.leanblog.org/?p=7213#comment-12341 Thanks, Regina, for your comment. I'm not suggesting that we shouldn't move forward with EHR and CPOE. There are clearly benefits if we can do it right. Thankfully, not everyone views the technology as a silver bullet and some organizations are wisely integrating process improvements with technology. I'm concerned about the idea that we perhaps have to wait for the next generation. If (and there are conflicting studies) CPOE leads to more errors today (in the short-term), but will be better in the future, we should do we can to mitigate those today problems today... rather than waiting for the next generation, let's do all we can to help today's generation improve (or maybe we should slow down on the technology a bit then if we think today's people can't learn and adapt, or won't). As a patient myself, I don't want to be harmed tomorrow by a technology that has outstripped people's ability and/or willingness to use it effectively. I'm not willing to take one for the team in that regard. Thanks for sharing your thoughts. Thanks, Regina, for your comment. I’m not suggesting that we shouldn’t move forward with EHR and CPOE. There are clearly benefits if we can do it right. Thankfully, not everyone views the technology as a silver bullet and some organizations are wisely integrating process improvements with technology.

I’m concerned about the idea that we perhaps have to wait for the next generation. If (and there are conflicting studies) CPOE leads to more errors today (in the short-term), but will be better in the future, we should do we can to mitigate those today problems today… rather than waiting for the next generation, let’s do all we can to help today’s generation improve (or maybe we should slow down on the technology a bit then if we think today’s people can’t learn and adapt, or won’t).

As a patient myself, I don’t want to be harmed tomorrow by a technology that has outstripped people’s ability and/or willingness to use it effectively. I’m not willing to take one for the team in that regard.

Thanks for sharing your thoughts.

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]]> By: Regina Holliday http://www.leanblog.org/2010/07/report-cpoe-technology-is-not-a-silver-bullet-no-surprise/#comment-12340 Regina Holliday Sun, 22 Aug 2010 14:13:42 +0000 http://www.leanblog.org/?p=7213#comment-12340 Dear Mark, Thank you for writing this and since you asked for the patient perspective here it is. As a patient rights advocate I promote the use of CPOE within the Meaningful Use rule. It is by no means a silver bullet. We are not looking for one "magical solution" to solve a host of problems with the United States medical system. CPOE does need to double checked by programs like Leapfrog but also patients and caregivers need access to the record themselves and provide another set eyes to catch errors within the record. As you point at the US does lag behind in adoption and implementation of these systems, as we get more people on board some of the early problems will work out by use. As more and more Doctors graduate with an expectation that data entry is part of good medicine we will get more and improvement. As cutting edge technology venders come on board to create better systems we will see even more improvement. Most importantly as patients become empowered and take ownership of their personal medical state we will get more positive outcomes. We are in a phase of real change within medicine, and CPOE is part of that change. Thanks, Regina Dear Mark,
Thank you for writing this and since you asked for the patient perspective here it is. As a patient rights advocate I promote the use of CPOE within the Meaningful Use rule. It is by no means a silver bullet. We are not looking for one “magical solution” to solve a host of problems with the United States medical system. CPOE does need to double checked by programs like Leapfrog but also patients and caregivers need access to the record themselves and provide another set eyes to catch errors within the record. As you point at the US does lag behind in adoption and implementation of these systems, as we get more people on board some of the early problems will work out by use. As more and more Doctors graduate with an expectation that data entry is part of good medicine we will get more and improvement. As cutting edge technology venders come on board to create better systems we will see even more improvement. Most importantly as patients become empowered and take ownership of their personal medical state we will get more positive outcomes.

We are in a phase of real change within medicine, and CPOE is part of that change.

Thanks, Regina

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]]> By: Brian Buck http://www.leanblog.org/2010/07/report-cpoe-technology-is-not-a-silver-bullet-no-surprise/#comment-11587 Brian Buck Tue, 20 Jul 2010 15:35:49 +0000 http://www.leanblog.org/?p=7213#comment-11587 We use CPOE in my organization. It is amazing how much time logging on adds to process time. As we get more teams together caring for the patient, each role has to log off and then log on. For HIPPA reasons, a provider can't leave the computer if he needs to leave the room for a short time (some lean work there!) and needs to lock/unlock the screen. This is very frustrating for providers. The other barrier is making changes to CPOE. It forces the need for IS to make the change and they have long queues and priorities. When they do make the change, it is more implentation mindset and not experimental since someone doesn't know how quickly they can get another change. It is not a nimble system. Lastly, the system gives some ALERT FATIGUE. There are so many pop-ups or "REMINDER" or "ARE YOU SURE" that it is easy to click through them and not really read anymore. This is akin to how signs are not effective counter-measures. We use CPOE in my organization. It is amazing how much time logging on adds to process time. As we get more teams together caring for the patient, each role has to log off and then log on. For HIPPA reasons, a provider can’t leave the computer if he needs to leave the room for a short time (some lean work there!) and needs to lock/unlock the screen. This is very frustrating for providers.

The other barrier is making changes to CPOE. It forces the need for IS to make the change and they have long queues and priorities. When they do make the change, it is more implentation mindset and not experimental since someone doesn’t know how quickly they can get another change. It is not a nimble system.

Lastly, the system gives some ALERT FATIGUE. There are so many pop-ups or “REMINDER” or “ARE YOU SURE” that it is easy to click through them and not really read anymore. This is akin to how signs are not effective counter-measures.

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]]> By: Glenn Whitfield http://www.leanblog.org/2010/07/report-cpoe-technology-is-not-a-silver-bullet-no-surprise/#comment-11586 Glenn Whitfield Tue, 20 Jul 2010 13:32:16 +0000 http://www.leanblog.org/?p=7213#comment-11586 Mark, Excellent point! You need to fix the process / system first with the involvement of the people before installing the technology. We have seen this in manufacturing (ERP) for years - just put in the new IT system and it will solve your problems. It appears we are heading down the same path in healthcare. Let's hope we can change the direction before its too late. I talk about this in "EHR and the Ghost of Technologies Past" here: http://piadvice.wordpress.com/2009/11/23/ehr-the-ghost-of-technologies-past/ There are no Silver Bullets, there's just hard work! Glenn Mark,

Excellent point! You need to fix the process / system first with the involvement of the people before installing the technology. We have seen this in manufacturing (ERP) for years – just put in the new IT system and it will solve your problems. It appears we are heading down the same path in healthcare. Let’s hope we can change the direction before its too late. I talk about this in “EHR and the Ghost of Technologies Past” here: http://piadvice.wordpress.com/2009/11/23/ehr-the-ghost-of-technologies-past/

There are no Silver Bullets, there’s just hard work!

Glenn

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