Summer time confuses hospital electronic medical records


Sydney Lupine, Kaiser Health News

Posted at 6:00 am, Wednesday 3 November 2018 | Updated 10:09 am ET 3 November 2018

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Summer time ends at 2:00 am on Sunday, 4 November. Here you need to know.
USA TODAY

Modern technology helped physicians perform robot surgical procedures and follow entire genomes. However, the hospital software can not handle daylight saving time.

Epic Systems, one of the most popular e-medical software systems used by hospitals, can delete files or require tough solutions when watches are returned for an hour – prompting many hospitals to choose cards for part of the night shift.

And this happens every year.

"It's mind-boggling," said Dr. Mark Friedberg, a senior policy scientist at RAND. In 2018, he said, "we expect electronics to handle something as simple as a change of time."

"No one is surprised at the time of daylight saving time, they have years to prepare, only, surprise, has not been determined."

Dr. Steven Stack, a former chairman of the American Medical Association, described malfunctions as "disturbing" and "unacceptable," as hospitals spend millions of dollars on these systems, and Apple and Google appear to have experienced seasonal changes in time for quite some time long.

Epic was founded in 1979. However, some hospitals have used electronic systems more than others.

Carol Hawthorne-Johnson, an intensive care nurse in California, said her hospital did not interrupt the Epic system during the fall. But it has come to expect that the vital signs that enter the system from 1 am. until 2 pm Sunday will be deleted when the clock drops back to 1 pm The time of an electronic log is gone, he said.

The hospital staff has learned to deal with it by taking extra bank notes by hand. But it is still a burden, said Hawthorne-Johnson, especially if clusters change or the patient needs, for example, blood transfusion.

Hospitals often avoid software malfunctions by turning off the software and turning it into paper charts. But it is far from ideal, because hospitals have evolved to increasingly depend on electronic systems, said Stack, an emergency doctor in Kentucky.

"Never [electronic medical records] work is great, "he said, but when the system is turned off, physicians can not use it to access patient records or order trials, whiteboards are a thing of the past, and some staff members do not they are comfortable with papers, since they are based on electronic records throughout their careers.

"It's an hour you fly blindly," said Friedberg.

More: How DST helps affect your sleep and general health

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Stopping an hour slows everything down, which can cause patients to spend more time in the waiting rooms of the emergency department. Some go home before they see a healthcare provider. This is dangerous, Stick said.

Not all hospitals disable Epic. At Johns Hopkins Hospital in Baltimore, providers who need to control their patients overnight use a solution: They input vital data at 1 am. and then when the clock falls back an hour later and must enter new vital elements, 1:01 am. They leave a note that it is an hour later, not a minute later. So do the Cleveland clinic.

"I do not disagree with the feeling that we would like health information systems to be much more sophisticated," said Dr. Peter Greene, head of medical information at Hopkins. But there are many other problems we would like to see first.

"This particular aspect is not what has caused us many problems," he said.

Other electronic medical records systems may require similar solutions, said Jennifer Carpenter, vice president of clinical computer systems at University Hospitals in Cleveland. University Hospitals use various e-medical records systems.

Many hospitals use Cerner, another major electronic medical records company. These hospitals are planning for Cerner to be down during the change of time, too.

Cerner was not available to comment. An epic spokesman, asked to comment on the problems and solutions, delivered a statement.

"Daylight saving time is naturally intense for healthcare organizations and we are working closely with customers to provide guidance on how to use their patient care system more effectively during this time period, "said the representative of Epic Meghan Roh. "We are constantly improving and looking for opportunities to strengthen the system."

Friedberg said that hospitals are often locked in their electronic medical file systems because they have invested so much money in them. It will cost even more to convert and transfer the files to a new system. As a result, he said, there is little incentive for software companies to improve their products.

"I hate to think," he said. "What does it do with jumps?"

Kaiser Health News (KHN) is a non-profit news service covering health issues. This is a drafting independent project of the Kaiser Family Foundation not linked to Kaiser Permanente.

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