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Did the person survive?
by plonk 2y ago
Did the person survive?
- jmcgough 2y agoWe have limited visibility into this in the emergency department. You stabilize the patient and admit them to the hospital, then they become internal medicine or ICU's patient. Thankfully most of the work was done and consults were called prior to the outage, but they were in critical condition.
- perfectstorm 2y agoi'll admit i have no idea what i'm talking about but isn't there some Plan B options? something that's more manual? or are surgeons too reliant on computers?
- nubinetwork 2y agoI don't know about surgeons, but nursing and labs have paper fallback policies... they can backload the data later.
- regularfry 2y agoIt's often the case that the paper fallbacks can't handle anywhere near the throughput required. Yes, there's a mechanism there, but it's not usable beyond a certain load.
- Bjartr 2y agoI think it's eventually manageable for some subset of medical procedures, but the transition to that from business as usual is a frantic nightmare. Like there's probably a whole manual for dealing with different levels of system failure, but they're unlikely to be well practiced. Or maybe I'm giving these institutions too much credit?
- zamadatix 2y agoThere are plan B options like paper charting, downtime procedures, alternative communication methods and so on. So while you can write down a prescription and cut a person open you can't manually do things pull up the patient's medical history for the last 10 years in a few seconds, have an image read remotely when there isn't a radiologist available on site, or electronically file for the meds to just show up instantly (all depending on what the outage issue is affecting of course). For short outages some of these problems are more "it caused a short rush on limited staff" than "things were falling apart". For longer outages it gets to be quite dangerous and that's where you hope it's just your system that's having issues and not everyone in the region so you can divert. If the alternatives/plan b's were as good or better than the plan a's then they wouldn't be the alternatives. Nobody is going to have half a hospital's care capacity sit as backup when they could use that year round to better treat patients all the time, they just have plans of last resort to use when what they'd like to use isn't working. (worked healthcare IT infrastructure for a decade)
- sqeaky 2y agoI am talking out my ass, but... Seems like a possible plan would be duplicate computer systems that are using last week's backup and not set to auto-update. Doesn't cover you if the databases and servers go down (unless you can have spares of those too), but if there is a bad update, a crypto-locker, or just a normal IT failure each department can switch to some backups and switch to a slightly stale computer instead of very stale paper.
- regularfry 2y agoCan only speak for the UK here, but having one computer system that is sufficiently functional for day-to-day operations is often a challenge, let alone two.
- mehrau 2y agoYes buy the more high available you do the more it costs and it's not like this happens every week.
- jmcgough 2y agoI will say - the way we typically find out really sends a shiver down your spine. You come in for you next shift and are finishing charting from your prior shift. You open one of your partially finished charts and a little popup tells you "you are editing the chart for a deceased patient".
- plonk 2y agoSounds like this is hugely emotionally taxing, do you just get used to it after a while, or is it a constant weight? This is why I'm impressed by anyone who works in a hospital, especially the more urgent/intensive care