Story number three is a case that I wrote about Mount Auburn Hospital, here in the Boston area. You might remember that Mount Auburn was in the news a little while back because one of the surgeons left the operating room to go cash a check. This place had people problems. They thought a little technology might come in handy. And in particular, the technology they wanted to put in place was called the physician order entry system (POE).
What these things do is just automate the process of physicians saying, “Oh, we’ve got to give this person some penicillin. We’ve got to get some medication from the pharmacy and get that to the patient in room 203,” or whatever. And the way that process worked before: the technology that came around was, as you can imagine, a physician scribbles something on a piece of paper, hands it to a nurse, and walks away. The nurse faxes it to a pharmacy; a pharmacist can maybe read it. If they can’t, they try to call up the doctor who’s somewhere in the hospital and figure out what’s going on. There is no immediate checking for drug-drug interaction, there’s no immediate checking for dosages that might be off. It is a very manual, very kind of broken, messed-up process. And there has been research done in other hospitals that says, “Look, if you put one of these physician order entry systems in place, you have a much more uniform process. It’s much more automated. The handwriting problems go away. We can put in rules behind it so that we can automatically check to see if the drugs don’t get along. Or if you’re giving an eight-month-old a dosage that’s appropriate for a 200-pound person, we can just do all of this.” So Mount Auburn Hospital says, “Oh, fantastic, we should probably do that.” By the way, healthcare errors in the United States kill somewhere in the neighborhood of 100,000 people a year. The single largest category of error is a medication error inside a hospital. This is a very serious problem. Here is a technology that can help fix it So they put in place this technology. And all it did was kind of standardize the flow for ordering medications from the internal hospital pharmacy, and ask physicians to use their user names and passwords to do it. How do you think that went over? It was just a nightmare, from start to finish. They couldn’t figure out where in the hospital to start it,
because no one wanted it in their part of the shop first. They tried to figure out if they should make it mandatory or if they should make it optional. And the whole thing was just one long series of fits and starts—just a slog, month after month, year after year. I was talking to a guy at a party a while back, who happened to be a resident at Mount Auburn in the part of the hospital where this system went in. I say, “Oh, fantastic. How’s that working out?” He goes, “I scribble my prescriptions on a piece of paper and hand it to a nurse, and she enters it into the system.” So with that kind of technology, there was clearly some potential there. And there was a problem that needed to get fixed. The technology had been demonstrated to do some good. And it ran into this organizational brick wall, and something just about the opposite of what we see with the Wikipedia was going on at Mount Auburn Hospital.
เรื่องสามเป็นกรณีที่ผมเขียนเกี่ยวกับพยาบาลเมาท์ออเบิร์น ที่นี่ในพื้นที่บอสตัน คุณอาจจำว่า เมาท์ออเบิร์นคือข่าวน้อยขณะที่กลับมา เพราะ surgeons หนึ่งซ้ายห้องปฏิบัติไปเงินสดเช็ค สถานที่แห่งนี้มีปัญหาคน พวกเขาคิดว่า เทคโนโลยีเพียงเล็กน้อยอาจเป็นประโยชน์ และโดยเฉพาะอย่างยิ่ง เทคโนโลยีที่พวกเขาต้องการเก็บไว้เรียกระบบรายการใบสั่งแพทย์ (ท่าโพธิ์)What these things do is just automate the process of physicians saying, “Oh, we’ve got to give this person some penicillin. We’ve got to get some medication from the pharmacy and get that to the patient in room 203,” or whatever. And the way that process worked before: the technology that came around was, as you can imagine, a physician scribbles something on a piece of paper, hands it to a nurse, and walks away. The nurse faxes it to a pharmacy; a pharmacist can maybe read it. If they can’t, they try to call up the doctor who’s somewhere in the hospital and figure out what’s going on. There is no immediate checking for drug-drug interaction, there’s no immediate checking for dosages that might be off. It is a very manual, very kind of broken, messed-up process. And there has been research done in other hospitals that says, “Look, if you put one of these physician order entry systems in place, you have a much more uniform process. It’s much more automated. The handwriting problems go away. We can put in rules behind it so that we can automatically check to see if the drugs don’t get along. Or if you’re giving an eight-month-old a dosage that’s appropriate for a 200-pound person, we can just do all of this.” So Mount Auburn Hospital says, “Oh, fantastic, we should probably do that.” By the way, healthcare errors in the United States kill somewhere in the neighborhood of 100,000 people a year. The single largest category of error is a medication error inside a hospital. This is a very serious problem. Here is a technology that can help fix it So they put in place this technology. And all it did was kind of standardize the flow for ordering medications from the internal hospital pharmacy, and ask physicians to use their user names and passwords to do it. How do you think that went over? It was just a nightmare, from start to finish. They couldn’t figure out where in the hospital to start it,เพราะไม่ต้องในส่วนที่หนึ่งของร้านก่อน พวกเขาพยายามคิดออก ถ้าพวกเขาควรทำมันบังคับ หรือ ถ้าพวกเขาควรทำให้มันไม่จำเป็น สิ่งทั้งหมดได้ เพียงหนึ่งชุดยาวพอดีกับและเริ่มต้น — เพียงการหวด ปี เดือนหลังจากเดือนนั้น ผมพูดกับคนในพรรคขณะที่กลับมา ที่เกิดขึ้นต้อง อาศัยที่เมาท์ออเบิร์นในส่วนของโรงพยาบาลซึ่งระบบนี้ไปใน การ ฉันพูด "Oh ยอดเยี่ยม วิธีที่ทำออกมา" เขาไป "ฉันเขียนแผนของฉันบนกระดาษ และมือกับพยาบาล และเธอป้อนเข้าสู่ระบบ" ดังนั้น ด้วยแบบเทคโนโลยี มีศักยภาพบางอย่างชัดเจน และมีปัญหาที่ต้องได้รับการแก้ไข มีการสาธิตเทคโนโลยีการทำดีบาง มันวิ่งมาตักนี้องค์กร และบางเพียงตรงข้ามของสิ่งที่เราเห็นด้วยวิกิพีเดียภาษาเกิดขึ้นที่โรงพยาบาลเมาท์ออเบิร์น
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