Podcast #220 – Dr. Bob Wachter, Lean & The Digital Doctor
My guest for episode #220 is somebody I've wanted to interview for a long time, Dr. Robert Wachter, one of the leading voices in the modern patient safety movement. He's most recently author of a brand-new book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age. His book was excerpted in this New York Times Op-Ed piece, “Why Health Care Tech Is Still So Bad.”
In this episode, we cover topics including:
- How Bob got into the patient safety field
- Of all of the estimates of patient harm and death caused by medical errors, which does he find most valid?
- His perspectives on the interface between Lean principles and practices and the modern patient safety movement
- What were some of the pros and cons of the $30 billion in federal government incentives for EMR/EHR adoption?
- Is it fair to say that EHR systems solve some patient safety problems while solving others?
- Some of the new waste introduced by new “meaningful use” regulations
- The story of a preventable medication error that harmed a child – a combination of technology problems, human factors, and bad process
- Finding the balance between “system problems” and personal accountability (see this article)
Disclosure: I received an advance copy of The Digital Doctor from the publisher. I highly recommend the book for its balanced presentation of the promise, successes, and challenges of healthcare IT. The book discusses why electronic medical records haven't been adopted more quickly, why government incentives were introduced, and EMR/EHR systems are not the panacea that some had promised.
Previously, Dr. Wachter has written books on patient safety (that I've read and recommend) including Understanding Patient Safety and Internal Bleeding. He received one of the 2004 John M. Eisenberg Awards, the nation's top honor in patient safety and quality. He has been selected as one of the 50 most influential physician-executives in the U.S. by Modern Healthcare magazine for the past seven years, the only academic physician to achieve this distinction. I was honored when Dr. Wachter recently interviewed me about Lean and patient safety for his AHRQ “Web M&M” series.
Dr. Wachter is Professor and Associate Chairman of the Department of Medicine at the University of California, San Francisco, where he holds the Lynne and Marc Benioff Endowed Chair in Hospital Medicine. He is also Chief of the Division of Hospital Medicine, and Chief of the Medical Service at UCSF Medical Center. He has published 250 articles and 6 books in the fields of quality, safety, and health policy. He coined the term “hospitalist” in a 1996 New England Journal of Medicine article and is past-president of the Society of Hospital Medicine. He is generally considered the academic leader of the hospitalist movement, the fastest growing specialty in the history of modern medicine.
You can see his full bio here.
For a link to this episode, refer people to www.leanblog.org/220.
For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also subscribe and listen via Stitcher.
Videos of Bob Wachter:
On Waste — Safety, Quality, and Cost… including some comments I particularly agree with that an over-reliance on financial incentives and penalties can cause problems and Lean/TPS can help focus, in a systematic way, on what hospitalists really care about: the patient.
A longer keynote address on patient safety:
Feedback & Comments:
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[…] Update: Here is the podcast. […]
I highly recommend this excerpt from Bob’s book… the story about the 39-fold overdose and some mentions of Toyota, Lean, and the andon process:
How Medical Tech Gave a Patient a Massive Overdose