Bastiat, Electronic Health Record Software, and Healthcare Operations Efficiency, Quality and Patient Safety

Frederic Bastiat, the great French economist who no less than Josef Schumpeter called “the most brilliant economic journalist who ever lived”, was famous for developing the concept of opportunity cost and the well-known  “broken window parable”.

In this classic economic lesson, Bastiat uses the story to explain that events and technology that impact human economy have two sets of consequences:  those that are obvious and easy to determine (“the seen”) and those that without deeper analysis are not obvious (“the unseen”).

Now you might ask what the heck does the healthcare industry patient record software have to do with Bastiat?  Well, if you are in supply chain or operations for a hospital or ambulatory surgery center, or even a patient, quite a bit.  For while  EHR software was rightly implemented in healthcare to provide portable, accessible, and comprehensive patient data (the “seen”) it has had some deleterious impacts in other areas of healthcare.  Two of them are operations efficiency and patient safety with regard to implantation of recalled devices.

A great deal of what a hospital spends for products goes to the operating room. Implants are very expensive, and many surgeries involve them.  As a rule, these implants must be labeled with extensive information such as part numbers, lot numbers, serial numbers, expiration dates, and donor numbers.  In many industries, in fact in most every area of the hospital, scanning at point of use can capture all this data reliably.  Every area, except the operating room, which still relies on manual documentation that leverages scraps of paper, sticky labels, transcription, and manual keying of all this data by nurses into the computer that runs in the OR.  This begs a question…


Why isn’t scanning at point of use (or in the case of healthcare, point of care) prevalent in the OR?

Well, the answer is that the EHR/patient record software is running in the OR.  Due to regulations, this software is VERY carefully guarded and protected, as it contains very sensitive patient data.  And because it is so closely protected and walled off, it has prevented point of care scanning of implant and product documentation in the OR.

For successful point of use/point of care scanning to occur, two things are necessary:  accurate, fast, and complete acquisition of label data (data capture) and then subsequent parsing of that data with clean complete and current data on the back end. (data match).  You cannot have successful point of use/point of care scanning without BOTH complimentary functions.  And unfortunately, both functions are challenges for OR surgical product usage capture.

Data capture is a problem because surgical labels are very complex and have all that information we talked earlier often represented in multiple barcodes on the label.  A traditional laser label scanner can only capture one barcode at a time, and with 3 or 4 barcodes on a label, which code does a nurse you aim the laser at? To capture all the data what order should the barcodes be read?

Typical surgical implant label

Data match is a problem because the EHR/patient record software is so vigorously protected and siloed.  Its product databases are non-dynamic and affected by the errors underlying manual entry of product numbers into the system. 

Parsing incomplete capture data against inaccurate matching data is a losing proposition, with high failure rates. O.R. nurses get frustrated with poor scanning success rates and refuse to use the technology.

As a result, surgical product scanning has not been widely adopted in the healthcare surgical theatre.  Lack of complete, accurate and workflow friendly operative product documentation  increases cost, hampers efficiency, lowers quality, and impacts patient safety for hospitals and ambulatory surgery centers, and healthcare in general. Unseen impacts, if you will, of using the EHR as the point for surgical product documentation.

You wouldn’t use a keyboard and a computer to check out even something as simple as groceries at the market.  Why are we using the same to track perhaps the most sensitive products that impact our healthcare?

It doesn’t make any sense. At all. 

The entire world has adopted point of use/point of sale scanning through specialized hardware and software that completely, accurately, and efficiently automates any kind of transaction.  Point of care scanning has done the same in every area of the hospital, from central supply to the pharmacy to the patient floors.  For the O.R. it would do what it has done everywhere else - improve efficiency and quality, lower costs, and increase patient safety by catching recalled items before they are implanted.

It’s time the healthcare industry adopts new technology and workflows that enables point of care scanning in its biggest cost and profit center:  the operating room. 

It’s time for healthcare and the OR to put Scan in the Plan with Summate Technologies.

For more information to see how Summate will improve healthcare finance, operations, and patient safety please go to www.summate.net.