Cloud Healthcare Appliance Real-Time Solution as a Service (CHARTSaaS): IT-enabled Cognitive Support for Healthcare Practice Transformation

The following excerpt from an article entitled Medical error—the third leading cause of death in the US in a recent issue of The British Medical Journal (a.k.a. the BMJ, Martin A Makary professor, Michael Daniel research fellow; BMJ 2016;353:i2139 doi: 10.1136/bmj.i2139, 3 May 2016; Copyright BMJ Publishing Group Limited, all rights reserved) bemoans the absence of systems and strategies for documenting medical mistakes as a means to the end of recognizing and reducing the resultant  patient morbidity and mortality rates.

“Medical error has been defined as an unintended act (either of omission or commission) or one that does not achieve its intended outcome, the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning), or a deviation from the process of care that may or may not cause harm to the patient. Patient harm from medical error can occur at the individual or system level. The taxonomy of errors is expanding to better categorize preventable factors and events. We focus on preventable lethal events to highlight the scale of potential for improvement …

“A literature review by James estimated preventable adverse events using a weighted analysis and described an incidence range of 210 000-400 000 deaths a year associated with medical errors among hospital patients.16 We calculated a mean rate of death from medical error of 251 454 a year using the studies reported since the 1999 IOM report and extrapolating to the total number of US hospital admissions in 2013. We believe this understates the true incidence of death due to medical error because the studies cited rely on errors extractable in documented health records and include only inpatient deaths. Although the assumptions made in extrapolating study data to the broader US population may limit the accuracy of our figure, the absence of national data highlights the need for systematic measurement of the problem. Comparing our estimate to CDC rankings suggests that medical error is the third most common cause of death in the US …

“Human error is inevitable. Although we cannot eliminate human error, we can better measure the problem to design safer systems mitigating its frequency, visibility, and consequences. Strategies to reduce death from medical care should include three steps: making errors more visible when they occur so their effects can be intercepted; having remedies at hand to rescue patients; and making errors less frequent by following principles that take human limitations into account.”

The following excerpt from a Perspective article entitled Meaning and the Nature of Physician’s Work in a recent issue of the New England Journal of Medicine (David I. Rosenthal, M.D., and Abraham Verghese, M.D.; N Engl J Med 375;19, November 10, 2016; Copyright 2016 Massachusetts Medical Society, all rights reserved) bemoans the current situation of medical practice vis a vis information technology in general and electronic health record systems (a.k.a. hospital information systems) in particular.

“In a past era, the work of the hospital physician was done primarily at the bedside or in the adjacent wet laboratory. Residents had the opportunity to witness the unfolding of diseases (for which we may now have cures) and to come to know their patients over
the course of lengthy hospitalizations …

“The skills learned early by today’s medical students and house staff — because they are critical to getting the work done — are not those needed to perform a good physical exam or take a history, but rather the arts of efficient ‘chart biopsy,’ order entry, documentation, and sign-out in the electronic age …

“In addition, we believe that in the coming years, the U.S. medical community will have to rethink the human–computer interface and more thoughtfully merge the real patient with the iPatient. We have an opportunity to radically redesign electronic health record systems, initially created for fee-for-service billing, as our organizations shift toward bundled payments, capitation, and risk sharing. Perhaps virtual scribes and artificial intelligence will eventually reduce our documentation burden.”

The foregoing two complaints have at least one element in common: the urgent need to improve medical practice and healthcare delivery by revisiting and revising the manner in which information is managed and utilized by healthcare providers. The purpose of this blog is to explore the need for and application of state-of-the-art information technology for the positive transformation of medical practice and healthcare delivery, all aspects of which are subsumed under this blog’s banner and URL of CHARTSaaS.wordpress.cocm — Cloud Healthcare Appliance Real-Time Solution as a Service. You, the reader, through your review and comment contributions to this blog will be a critical success factor in the realization of CHARTSaaS goals and objectives; the realization of which will result in medical mistake mitigation and practice transformation. Thank you for your active interest on behalf of healthcare provider and their patients — all of us!

One thought on “Cloud Healthcare Appliance Real-Time Solution as a Service (CHARTSaaS): IT-enabled Cognitive Support for Healthcare Practice Transformation”

  1. Pete, Your article does really highlight the large number of deaths caused by medical errors and a good start for ongoing discussion of the topic and the potential solutions

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