Computers and Patient Safety

While there is no question that computers have been of great value in improving the ability to deliver medical care, they are anything but an unalloyed blessing.  Among the problems they bring computer systems and automated devices are expensive and add to the spiraling cost of healthcare.  Hospitals are struggling to adopt and efficiently use Electronic Medical Records (“EMR’s”).  Small errors in data entry can cause big problems.  Computer use at the hospital is also tied to increases in the incidence of carpal tunnel syndrome, computer vision syndrome and musculoskeletal problems.  Now we learn of another downside which may lead to medical malpractice: Alert Fatigue.

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Like me you may never have heard of alert fatigue before.  It describes the effect on nurses, doctors and other healthcare providers of a constant barrage of electronic warnings and alerts.  As in the story of the boy who cried “Wolf,” repeated warnings tend to dull the senses and over time become far less effective.  For many years, the ability of computers to monitor patient well-being and warn of developing problems has been promoted as a great advance in patient safety.  The irony appears to be that too many warnings have made patients less safe.

Today, computers in the hospital do more and more.  There are heart monitors, blood pressure monitors, IV monitors, pump monitors, oxygen saturation monitors, respiration monitors, systems that monitor doctor orders and so on and so on.  A study conducted in 2014 found that in an academic hospital with 66 ICU beds, there were more than 2,000,000 alerts generated in a month.  This worked out to about 187 warnings per patient per day.  The problem is compounded by the fact that the majority of these warnings are not related to significant problems.  The flood of insignificant warnings drowns out the warnings that signal the presence of a true emergency.  Anyone who has spent any time in a hospital has heard an alarm sound and seen a nurse come in, turn off the alarm, and immediately leave the room.

Alert fatigue presents a significant patient safety problem.  Studies have shown that alerts themselves are only modestly effective in preventing harm.  Doctors and nurses tend to discount them or override them because of their frequency and the frequency with which they are calling attention to insignificant problems.  And the problem is only getting worse as more and more computerized systems with more and more alarm features come on line.  While medical device manufacturers, hospital administrators, physicians and government agencies all recognize the problem, there is little agreement about how to address it and reduce the threat it poses to patient safety.

The best you can do if you are a patient in the hospital or sitting with a loved one or friend is to ask about any alarms that sound and make sure that the alarm did not signal a significant problem.  Don’t let a nurse just come in and turn off the alarm without asking questions.  Hospitals can be a dangerous place so be alert and you have the best chance of a good recovery for you or your loved one.

Posted in Doctors, electronic medical records, Health Care Costs, Hospital Negligence, Hospitals, medical charts, Medical Costs, medical errors, Medical Malpractice, medical mistakes, Medical Negligence, Nurses |