Computer scare


I don’t know whether to laugh, cry, or scream. Today in my news feed I found a short article from the online site of Health Data Management magazine, Nurses Union Rails Against ‘Unproven’ Medical Technology. About the only thing I can commend it for is that the headline puts ‘unproven’ in quotation marks.

It serves as a PR prop for an advertising campaign of, sad to say, a nurses’ union. Now, mind you, I am not intrinsically opposed to the concept of nurses organized to better their working conditions and to bargain for competitive wages. I am on the board of directors for a district of my state nurses’ association, and the state-wide unit is heavily engaged in representation of working nurses as a collective bargaining unit.

The union’s press release, which is generously parroted by a supposedly respected health IT site, uses a theme that I have no quarrel with, Insist on a Registered Nurse. But the release itself consists of unsubstantiated attacks on all manner of technological advances that touch the patient care workplace. Prominently featured is a three-and-a-half minute “fun new video” titled “Computer Care.” Those in the field will immediately discount it as being 100% parody, from the bean-counting administrator to the computer geek trying to enter data into the system while the patient has a heart attack. But, of course, those in the field are not the target audience. It is the general public, who are being encouraged to rebel against electronic health records (EHRs) and the like, and to equate more technology with fewer nurses.

The press release repeatedly claims that EHR technology is “frighteningly” unsafe and experimental, and that countless lives are endangered on a daily basis by its use. Not one shred of evidence is adduced to support this assertion. It falsely states that EHRs “dictate treatment for patients.” In fact, while they do a decent job of using sophisticated clinical decision support algorithms to suggest best practice guidelines that a clinician might consider, they do not dictate the care provided. Supposedly the systems “too often fail.” No context is provided; how many times is “too often”? In reality, unplanned downtime is rare, and when nurses participate in well-executed planning for such events, patient care can proceed with a minimum of detrimental effect.

It makes a fallacious connection between improved electronic tools in hospitals and the shift from inpatient to ambulatory and population based care. It even tries to tie EHR adoption to the perceived disparity in U.S. health statistics like infant mortality and life expectancy.

I expected better from this outfit, but perhaps I was being overly optimistic. Perhaps they would really like to have nurses robbed of useful, life-saving technology. Think of an inpatient care environment without heart monitors, defibrillators, IV pumps to safely deliver drugs made possible by recombinant DNA techniques, lab tests that are resulted in seconds rather than hours—I could go on and on. Not to mention, we would relegate nurses to go back to writing out all their notes, vital signs, etc. in longhand, as well as deciphering the illegible scribbles of others on the care team. Now, that’s dangerous.

Totally unmentioned in this hit piece is the fact that in the most successful EHR implementations, nurse informaticists and staff nurses are integrally involved in the planning, design, implementation, and training. This is precisely because we know that nurses are the patient’s best advocates and will insist on workflows that improve, not worsen, patient safety.

To sum it up, health IT helps make care safer and more efficient. Are nurses really against that?

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