I finally figured out why hospital administrators (1) don’t care that their computer systems go down, and (2) refuse to admit that they go down. It’s been driving me nuts. When the systems are down, patient health and lives are put at risk! Why the lack of concern and the secrecy?
The answer is simple: people die in hospitals all the time! And on top of the people who would have died anyway, hospitals kill people all the time! Yes, “kill” – either through negligence (such as failure to sterilize) or positive error (wrong treatment). In fact, medical error is the fourth leading cause of death in the US! And how often do you hear about that?! In that context, a few more people dying because of an unavailable computer system is a drop in the bucket. And refusing to talk about it fits the pattern.
Hospital Computer Failures
Hospitals know they have to have computers. They know computers are complicated and they know software is hard. So nearly all use a couple simple, common-sense strategies:
- Give high salaries to the top IT people to make sure they’re getting the best
- Spend lots of money on computing for the same reason
- Buy only what the best places are buying to reduce risk
Sounds good, right? Sure, if you don’t know the facts. The result of these common strategies is consistent: most hospitals use incredibly expensive, generations-old technology that regularly fails. Comforted by the fact that they’re no worse than most of their peers, the hospital big-wigs nonetheless keep a solid lid on the problems and outages that are so severe, they would cripple any other business.
Here are details about disastrous computer systems decisions in hospitals. Here is the story of my personal encounter with outages and keeping the problems secret. Since hospitals know they can’t count on their computers, in practice they’re all about the paper.
BUT … when real people are dying, the “death” or severe crippling of a piece of electronics is, like, who cares?
Causes of Death: the Public Information
Tracking causes of death makes perfect sense. It’s something we want to know for each person who dies; it’s recorded on the death certificate. Here is the relevant section from my great-grandfather’s death certificate in 1923:
It’s something we want tracked, so we can see trends and know where to put our efforts to reduce the causes of death. Here is recent data from the CDC, the US government agency that is supposed to track these things:
Heart disease and cancer are the biggies, right?
Unfortunately, that’s not the whole picture. Hospital executives and government bureaucrats go to great lengths to make sure we don’t know the full story. People might get upset if they knew how many of them had relatives who died in the hospitals as a direct result of negligence and/or medical error! Important people could conceivably lose their jobs!!
Causes of Death: the Information they try to Hide
Even hospitals that have great doctors and special experts can have horrible levels of medical error. But the ones that are really bad? They’re really, REALLY bad. Here’s an example of a death-trap masquerading as a hospital in Brooklyn:
Unfortunately, it’s not just a couple of bad eggs that are the problem. We know it’s widespread and big, but unfortunately because of all the secrecy, it’s hard to know exactly how bad it is. We know it’s bad enough that the equivalent of a jumbo jet of people die of medical error every day:
This makes medical error the fourth-leading cause of death, shown here in terms of deaths per 100,000 in 2010:
Because the people in charge are so anxious to keep the facts from us, the only thing we can be confident about is that, whatever the reported data on medical errors is, the actual number is far greater.
Then there are preventable deaths. Even when there are strict rules about reporting problems, hospitals break them. Reuters did some investigating in 2016:
Among other things, they discovered that there was a superbug outbreak in a New Mexico nursing home the January 2014 that was supposed to be reported. There was repeated delay and denial. In the end, here’s what happened:
What about the CDC? The agency that publishes the bogus statistics that ignores all the hospital-caused deaths? They don’t seem to care:
Things are getting worse:
A book has just come out by Dr. Robert Pearl, CEO of the Permanente Medical Group, responsible for the health care of 3.8 million Kaiser Permanente members. He states that medical error is directly responsible for more than 200,000 deaths per year, and another 200,000 preventable deaths as a result of substandard care.
The theme is clear: suppress the information and focus elsewhere.
Conclusion
With so much energy going into suppression and denial of hospital-caused deaths of human beings, it’s finally clear to me why hospital administrators, bureaucrats and most of the “big thinkers” in the medical profession can’t give the time of day to concerns about computer systems. First, they use paper anyway. Second, it’s someone else’s problem. Finally, however bad the computer systems are, they don’t hold a candle to the ongoing death-and-destruction horror show of real human beings dying. Human beings who, except for the incompetence and ineptitude of some doctors, hospital staff and administrators, would be alive today.
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