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Like Clockwork: How Daylight Saving Time Stumps Hospital Record Keeping

This story additionally ran on USA Today. This story might be republished at no cost (details).

Modern expertise has helped medical professionals do robot-assisted surgical procedures and sequence complete genomes, however hospital software program nonetheless can’t deal with daylight saving time.

One of the preferred digital well being data software program programs utilized by hospitals, Epic Systems, can delete data or require cumbersome workarounds when clocks are set again for an hour, prompting many hospitals to go for paper data for a part of the night time shift.

And it occurs yearly.

“It’s mind-boggling,” stated Dr. Mark Friedberg, a senior doctor coverage researcher at RAND, including that in 2018, “we expect electronics to handle something as simple as a time change. “Nobody is surprised by daylight savings time. They have years to prep. Only, surprise, it hasn’t been fixed.”

Dr. Steven Stack, a previous president of the American Medical Association, referred to as the glitches “perplexing” and “unacceptable,” contemplating that hospitals spend tens of millions of on these programs, and Apple and Google appear to have handled seasonal time adjustments way back. Epic was based in 1979, however some hospitals have used these digital programs longer than others.

Carol Hawthorne-Johnson, an ICU nurse in California, stated her hospital doesn’t shut down the Epic system through the fall time change. But she’s come to count on that the vitals she enters into the system from 1 a.m. to 2 a.m. will likely be deleted when the clock falls again to 1 a.m. One hour’s value of digital record-keeping “is gone,” she stated.

Hospital workers have realized to take care of it by taking additional chart notes by hand, however it’s nonetheless a burden, she stated, particularly if vitals change, or a affected person wants one thing like a blood transfusion.

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Although hospitals usually keep away from the software program glitches by turning the software program off and switching to paper charts, it’s removed from superb as a result of hospitals have developed to grow to be more and more reliant on digital programs, stated Stack, an emergency doctor in Kentucky.

“When [electronic medical records] work, it’s wonderful,” he stated, however when the system is turned off, medical doctors can’t use it to entry affected person data or order exams. Whiteboards are a factor of the previous, and a few workers members aren’t as snug with paper data as a result of they’ve relied on digital data their whole careers.

“It’s an hour where you’re flying sort of blind,” Friedberg stated.

The one-hour pause slows all the things down, which may trigger sufferers to spend extra time in emergency division ready rooms, prompting some to go dwelling earlier than seeing a well being care supplier. That’s harmful, Stack stated.

Not all hospitals flip Epic off, nevertheless. At Johns Hopkins Hospital, suppliers who have to examine sufferers periodically by way of the night time use a workaround. They enter vitals at 1 a.m. after which when the clock falls again an hour later and so they should enter new vitals, they record them at 1:01 a.m. They depart a observe that it’s an hour later, not a minute later. That’s how the Cleveland Clinic does it, too.

“I don’t disagree with the sentiment that we would like health IT systems to be much more sophisticated,” stated Dr. Peter Greene, Johns Hopkins chief medical info officer. But there are many different issues he’d prefer to see mounted first. “This particular aspect is not one that has caused us a lot of trouble.”

Other digital medical data programs might require comparable workarounds, stated Jennifer Carpenter, vice chairman of IT medical programs at University Hospitals in Cleveland, which makes use of a number of digital medical data programs. Cerner, one other main digital medical data firm, was unavailable for remark, however many hospitals plan for Cerner to be down through the time change, too.

When requested to touch upon the glitches and workarounds, Epic spokeswoman Meghan Roh supplied the next assertion:

“Daylight savings time is inherently nuanced for healthcare organizations, which is why we work closely with customers to provide guidance on how to most effectively use their system to care for their patients during this time period. We’re constantly making improvements and looking for opportunities to enhance the system.”

But Friedberg identified that hospitals are locked into their digital medical document programs as a result of they’ve invested a lot cash in them. And it might value much more to transform and switch the data into a brand new system. As a end result, there’s little incentive for software program corporations to enhance their merchandise, he stated.

“I shudder to think … what does it do with leap years?” Friedberg puzzled.

This story additionally ran on USA Today. This story might be republished at no cost (details).

Sydney Lupkin: slupkin@kff.org”>slupkin@kff.org, @slupkin

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