Technology is taking over our healthcare systems
Technology continues to expand and infiltrate every aspect of our lives today. Screen time is at an all time high for most Americans and the idea of not having a computer to do the most mundane tasks has become foreign to most especially anyone born after 1985. One of the industries that has benefited greatly by the utilization of technology is definitely healthcare.
It is almost unheard of in today’s society to go to a simple doctor’s appointment and not have the doctors and nurses utilizing a computer to look up medical records, past prescriptions, or to access x-rays and other test results from another medical facility. Although extremely convenient in most aspects, the use of technology in regard to prescriptions has had a few dangerous if not deadly consequences.
Recently a juvenile patient with a rare genetic disease known as NEMO that leads to a lot of rare infections and bowel issues was given an antibiotic 38 times the normal dosage by a nurse at the renown San Francisco Medical Center’s Benioff Children’s Hospital. How did this happen? Was it an error by the admitting doctor who typed in the script? No, it was the error of the system itself when it was set up.
It is a matter of complexity
Setting up systems in hospitals and doctors offices are extremely extensive and should be as people’s lives are at risk by the processes put in place with these highly technical systems. In the case of the young boy at
Benioff’s Children’s Hospital the mistake was made because of the weight-based prescription policy that was selected when the entire interface was installed. The computer system was set up to utilize weight-based prescription dosing for children weighing under 40 kilograms which equates to approximately 88 pounds. The problem arose because medication is prescribed in milligrams. So, the mistake occurred in the translation from the computer when it forced the doctor to order the medication in milligrams per kilogram.
The computer then prompted the doctor to check the dose size and since this particular patient was on a double dose of this medication, that is what the doctor prescribed. This child weighed 38 Kilograms so the computer multiplied the weight by 5 milligrams and produced a dosage of 193 milligrams, now the highest dosage of this particular medication was 160 milligrams so the computer then asked the doctor to accept the 160 milligrams which was below the 5% threshold (which is considered acceptable in regards to medication) so she did, but this in reality was 39% higher than the required dosage. There was nothing that could be done except to sit and wait as poison control had never seen such an overdose and therefore had no protocol in place to assist. Complications arouse during the waiting period and on several occasions, they felt as though the child would die. Luckily for all involved he did survive but many lessons were learned on how to properly utilize modern technology in regard to healthcare. Precautionary measures have since been put in place to assure that something like this does not happen to another patient.