Is approximately 4 doctors, large group practice uses most electronic records system. In the majority of doctors for small offices, doctors provide most Americans patient illness and tracks, pen and paper and other issues.
Thousands Institute research 1999 in aggregate is life-threatening medical mistakes according to the report of the New England Journal of medicine recently North Carolina hospital in still all too common. Electronic records system itself attracts more and more computer errors, design flaws or failure of communication with patients to expose risk concerns.
For example, where the patient's electronic medical records disappeared or so wrong food and Drug Administration of patient files are stored. Incorrect entries sometimes drug allergies and blood pressure readings, agency says is provided.
These concerns a fresh look at the Institute of medicine, Committee run study came to patient safety and health information technology, and created a problem of the recommendations. 16 Member Panel on Tuesday in Washington for the first time meet has.
February, F D A... you had 260 received reports of malfunctions related health information technology "of the possibility of patient harm" to 44 contains six reported injuries and deaths reported 2008 and 2009, and is called. Malfunction their authority was reported primarily in the hospital.
May represent the tip of the iceberg because these reports are purely voluntary only, and Dr. Jeffrey Shuren, senior F... D... A... policies and enforcement official.
, Congress of show interest from Iowa, ranking, and Senate Finance Committee Republican party Senator Charles E. Grassley is to the health information industry Catherine Sebelius to was done to determine the Health Secretary, wrote the F D A..., the system checks the being was monitoring the patient safety concerns and what role, welfare, health information technology regulation to play are.
Proposed to consider the new safety requirements under the authority of the Agency to ensure the quality, such as Dr. Shuren F D A... regulator a set of safety, effectiveness, medical equipment, and software device.
"All the options to ensure the safety of the table to the" Dr. David Blumenthal, Obama administration National Coordinator of health information technology. Office Medical Institute Gail L. his the warden, gave the patient safety Panel, $ 989 k that Chief Executives rate in the health system President and Henry Ford Detroit.
Dr. Blumenthal Dr. Donald M / Berwick, Medicare and Medicaid administrators and Dr. Brent James, Intermountain Healthcare, Salt Lake City-based experts "agree to improve safety of care electronic health record" health information "
"The create, at any time to change the world risk at the same time," said Dr. Blumenthal, phone interview last weekend. We can implement to it, to realize the benefits of the safety of all, even if it is you want to see it, it is safe.
Institute of medicine "is ends if to ensure the safety regulations is an important part of this fabric we in all markets, the balance of regulation and innovation" and said
Was against the makers, system of long products Government regulations.
"Of by design agency, or any third party only after Shimo-subjects of policing are likely innovations suppression growth and development, now the Suppression of electronic medical records" and includes Charles Dvorak mentioned, Executive Vice President of epic and electronic record systems Permanente emperors and other large-scale medical and hospital group.
Recently avoided industry role and put it in the F... D... A..., statement for this article came in the healthcare information and management systems society, Washington industrial group, only ", on this complex issue of the Institute research and report back the future ask the medicine in the 12 months to the Government decision support that" said
Last month, one common way of protests in the American Medical Informatics Association "hold harmless" clause in many purchase contract unethical said. Clause usually allows the responsible for the manufacturers errors or misuse.
"We we said innovation, is worth more than safety and value of no" associated with Kenneth W., Goodman, said the Miami University bioethicist toward the Safety Advisory Group patients.
"We are in good data medical errors, not what the cause is" named Arthur A. Levin, new medicine Research Institute Committee members. -Mr. Levin, Director of New York, healthcare consumer Center 1999 report is, "in message that man," may 98, 000 preventable deaths, warned in hospitals each year were members of the Group of the Institute.
, Will be available may be electronic records is becoming without noticing the paper chart for more information about refers to the potential risk of the medical journal of New England last month's article, medical malpractice liability. Health care providers, a substantial initial costs and might quite the long-term benefits of uncertainty, Dr. Sandeep S / must weigh the risks to the Medical Center, New York University Langone Mangalmurti, physician, and his colleagues wrote.
"We probably about 2% of errors of prescription drugs, catch" Ross Koppel, Pennsylvania University sociologist and investigator RAND Corporation, Santa Monica, California, based on research organization "98% has got the error"
This article has been revised to reflect the following fix.
Correction: 12 / 15 / 2010
The previous version of this article is imprecisely Ross Koppel RAND Corporation quotes. In the prescription drug was approximately 2% of errors not all medical mistakes ??? said 2%.
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But one afternoon a month after his treatment, the patient was shocked to see, red collect urine in the urinal. After his doctors a series of tests and bladder irrigation run by a pencil size catheter, he learned that the bleeding was a complication of radiation treatment.
He recalled, hearing about this side effect three months earlier, but none of the reports he has given or collected it and once he mentioned by the fear of the emergency room and the doctor's office visits and discomfort had recovered from the clinical Arbeit-Up, he had more thoughts - be it until a few weeks later, when he started bleeding again.
By the time I met him, he was in the middle of his third visit to the hospital."I feel like I'm bound to this place," said er.Er showed me a plastic jug partially urine color of the fruit punch filled with, and he described a post-treatment life marked by fear to discover before going to the toilet and blood. "If I knew that my life would be after radiation like this," he sighed, "I would have decided the surgery."
Performed in a laboratory bench or in clinical trials has medical research long by a priority - driven the need, to finden.In of usually a cure to more modest than a search for "the most effective treatment" known, has this standard as a barometer of success and an important criterion for funding serviert.Die of most published studies are characterised by a preponderance of data to document small points of light in the laboratory values or changes to the size of spots from cancer or area of of heart muscle damage on specialized X-rays. Some studies strengthen the apparent success of their results with additional data on social effects such as treatment or number of workdays missed.
Few studies, however focus on patients experience.
The result was an almost embarrassing wealth of choice for patients with diabetes, heart disease, donated milk all this emphasis on healing infections and even some types of cancer.The increasingly demanding treatment regimens of medicine's armamentarium, that now make cast, as soon as life-threatening diseases in chronic ones, but in the process to have led a group of people that caught in the unenviable position of living with an illness that never quite goes weg.Nicht longer forced to make unique Existentialist treatment decisions, fight instead every day with the side effects of very treatments to keep you alive.
For many of these patients the most important question is "What treatment can I life?" not "what treatment allow me the longest life?", but rather
Now, the patient-centered outcomes research offer Institute, a new initiative that federal health care responsible overhaul, published a paper last month in the policy journal Health Affairs, a chance to change the prevailing winds of medical research so that the needs of this growing segment of the patient population are addressed. With a 21-member Board of individuals from public and private sector it adopted a mandate comparing treatments for common diseases on the agenda for research and to finance the most important studies.But according to paper authors, the potential of such enterprises is fully realized only if it supports initiatives and that experience strategies, the patient only front and Center in research but also in the middle of the medical mainstream smack.
""In a sense, we have conquered death,", said Dr. Albert W. Wu lead author and a general internist and Professor of health policy and management at Johns Hopkins Bloomberg School of public health in Baltimore.""Now we have people with chronic illnesses and experience quality of life every day is an important part of how to do and whether the treatments become worth."
Effectively to gather the patient perspective, Dr. Wu and his co-authors suggested where patients reported results more routine part of clinical studies and practice and administrative data collection in some cases, who need the information for the refund.For several months now have integration data about patients experience in routine medical practice at the Johns Hopkins University was.A dedicated portal called PatientViewpoint.org, can use, patients completing surveys on your energy levels, social functioning, mental health, nausea and pain at the suggestion of their doctors.The information is then treated like more traditional clinical trial; access is reserved for the patients and their doctors.
Currently, the site is only for patients with breast or prostate cancer diagnosed Wu but Dr. and his colleagues hope that all doctors who are able to order patient surveys that measure experiences such as levels of pain, physical work or depression, proactive identification then check the results results which are high or low, with patients.And overloaded despite initial concerns that patients could feel the questionnaires, most are thrilled.
"" Patients want to have further discussions with their doctors and other providers on these types of questions,"said Dr. Wu.""Sometimes it is difficult to all to cover this information during the medical encounter, and these surveys may be another opportunity that do."
"Not all clinicians and researchers strive however, patients reported results to umarmen.Viele have never was involved in the research methods and are skeptical, what is the value of a discipline or drill who are not familiar."This is stuff squishy, soft, ", said Dr. Wu."It is still not something can be ordered on a lab slip."
"Dr. Wu is confident however that the new patient-centered outcomes Research Institute more towards all researchers will provide while new and more comprehensive standards requiring results patients reported and quality of life.""I think we have a real chance right now and this Institute has great potential for a positive force in understanding how treatments and what effective and for whom is to be," he said.
But he also pointed out: "we have to remember, to patients umfassen.Wir want your perspective to consider when we come with evidence you can really use to better decisions about treatment and care."
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I was having lunch with an another nurse outside the hospital when I discovered a former patient of mine.
I jumped up to hug him, and wondered that he had hair. Jeff is a British Professor and we have mutual friends, lessons at a nearby University. Long before he became a patient in my hospital, I was lucky the first meeting Jeff at a dinner party.The next time I had seen him, was in the Krankenhaus.Er had been diagnosed with lymphoma and treatment was.
Jeff Swensen for the New York Times Theresa Brown, r.n.
"Hey, Theresa," he called to walk in the Hall holds his I.V. pole, baldness, dressed in a hospital gown. "It's Jeff."
I could not put it and it reminded me how we had met. I realized that the discomfort I felt that, because I try to separate my work from my "real" life.Even more, I like to think that keep these worlds separate helps keep influenced cancer anyone I know.
Jeff stayed for only 19 days. while I was his nurse for a short time during his stay, I was often close to his room.We would talk about cancer or his transplantation, but about a literature class he prepared and some write that he had done for a magazine. for me it was refreshing, jumping back in the life of the mind I had left the University. I it was thought, a way to feel like a person, rather than only a patient.
And then some months later, it was he, lunch at the same restaurant where I was with my friend restaurants.
It happens sometimes - I see that after treatment in hospital a patient out and about in the real world. Every time you seem like a mythical being, someone new human created from clay.
See Jeff from the resulting short flight of stairs, how did he gebracht.In restaurant the story of Orpheus and Eurydice in memory this well-known tale was Orpheus musician, deeply in love with Eurydice, who died after used by a snake gebissen.Mit heartbroken, Orpheus his work on his way into the underworld charm and convince Hades to bring Eurydice back to life.Orpheus was not warned, to review Eurydice to both climbed up the steps from the underworld, but Orpheus could not resist a look back.After the rules broken, he looked helplessly how you resolved and disappeared.
I always thought that this is one of the stories was cruel in Greek mythology.Certainly some sympathy for Orpheus's sense of disbelief could have the gods who his lost love had come back to life.
That was the feeling I had when I Jeff, saw full sound, with hair on his head, food in a restaurant, looked like a Professor instead of a patient.As he and I talked, I kept touching his elbow, want me assure that he really was.
I told him, he looked great, which meant really, that he look more like a patient.
A few weeks later I saw him again, in the public Bibliothek.Diesmal I needed not to his elbow to touch, to keep; two sightings had convinced me he would we resolve. talked about his health, but most of our conversation focused on books, his writing and teaching.
Jeff has given me permission to his story to say the things only as a reminder of patients has some lung problems better werden.Er, by his immune system is over reactive verursacht.Ein relapse of his illness is a larger Sorge.Aber is teaching, writing, reading and rerun for exercise if his lungs verlangsamen.Er loves him Prince, so that his daughter tickets for a concert in Madison Square Garden this December gekauft.Die option to a concert to visit only one more character his life normally returned - is no longer immune suppressed and fragile, it is safe for him part of such a large crowd.
There is no denying that cancer is still on his mind, but his journey the stairs up successfully done, the rest of his life is, too.
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