Smartphones have made their first appearance on annual top 10 list of health technology hazards produced by the Philadelphia-based ECRI Institute. Although the usual suspects of alarms, radiation dosages and medication errors associated with infusion pumps were on the list, the appearances of smartphones (at number nine) reflects their increased usage (and increased problems).
Top 10 Health Technology Hazards for 2013
- Alarm hazards
- Medication administration errors using infusion pumps
- Unnecessary exposures and radiation burns from diagnostic radiology procedures
- Patient/data mismatches in EHRs and other health IT systems
- Interoperability failures with medical devices and health IT systems
- Air embolism hazards
- Inattention to the needs of pediatric patients when using “adult” technologies
- Inadequate reprocessing of endoscopic devices and surgical instruments
- Caregiver distractions from smartphones and other mobile devices
- Surgical fires
To illustrate its point, the report cites an oft-cited case by Beth Israel Deaconess Medical Center CIO Dr. John Halamka:
A resident physician (at an unnamed facility) was using her smartphone to enter an order in the facility’s CPOE system. The order, as requested by the attending physician, was to stop anticoagulation therapy for a patient. Before completing the order, however, the resident received a personal text message. The resident responded to the message by text, but never went back to complete the order in the CPOE system. As a result, anticoagulation therapy continued unnoticed for several days, and the patient developed conditions that necessitated emergency open-heart surgery.
The report also makes mention of a survey of perfusionists who operate heart-lung machines during surgery. In 2010 survey, half admitted that they sent text messages during surgery. About 15 percent said they used their devices to access the Internet and 3 percent visited social networking sites.
Healthcare professionals have always had to cope with distractions from pagers and the kind of sudden changes to their work schedule that are typical of a workplace prone to emergencies and unforeseen events. The report makes the point that the distractions offered by a pocket-sized device that can access Internet and e-mails ramp up the distraction factor in a big way.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Smartphones and devices have been welcomed as tools that can make healthcare more efficient and reduce medical errors by helping clinical teams stay on top of patient alerts to delivering handy reference information. But there’s also the risk that the immediacy they offer for work-related issues means there’s a certain instant gratification they offer for personal uses too.
The report notes that industry associations are looking at developing best practices for how smartphones should be used — the American Academy of Nurse Anesthetists drafted a position statement in June.
