Can Amazon Actually Kill People by Steven Mussey MD?

The internet has become life or death to millions. This is not an exaggeration.  Our representatives in the United States Government, paid by Electronic Medical Records (EMR) software companies, mandated doctors participate in this scheme of records management. Doctors must use software, integrally linked into the internet, to provide daily care. (We still can’t share information with each other… but that’s for another rant…..)  Otherwise, Medicare will cut the pay of any doctor who chooses to stay with paper.

What if you are distrustful and want to keep a paper backup in case the EMR dies?  NO! Even my malpractice insurance carrier calls such a backup perilous and confusing.  Such duplication violates “best practices.” Use the safety tools in your computer system! “Trust us! We got your back! Paper is unreliable and gets lost!”

Yet, we do it anyway. Why?

Because the internet is a mess! Computers suddenly act strange. Ransomware predators lurk in the shadows. Sites go down without warning.  “Put your trust in the cloud! It’s the only safe way! Computer prescribing and records will keep patients safer than ever before! Don’t live in the dangerous past!”

Well, yesterday, Amazon Web Services had a huge outage. This was not simply an outage that temporarily slowed your Amazon Prime web browsing.  Companies relied on Amazon Web Services for their day to day function. Unfortunately, one of these companies was our EMR provider.  This means, at mid-day, we were dead in the water. Our schedule and all of our patient notes were inaccessible.  No medical records equals no medical care. Period. End of story. Game over!

You can’t see patients. You can’t even answer the phone! You have no idea who is walking in the door for their scheduled visit.  You might as well close the office and turn off the phones.

But we had our paper backup. This was the same paper backup we maintained despite our malpractice carrier’s warnings that we were tempting epic disasters.

So, yesterday, with my computer sitting like a gigantic paperweight for a couple of hours, I grabbed a pen and a new device called…. “paper”… and went to work.

Nobody died. Nobody got hurt.

We survived.

Amazon failed us. Our EMR failed us. Our trusty pen and paper backup charts saved us.

The time is now to scream: “OUR COMPUTER INTERNET INFRASTRUCTURE IS NOT READY FOR ALL OF THIS! STOP THE INSANITY! IT IS TOO INSECURE AND TOO UNRELIABLE! WAKE UP!!!”

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  9 comments for “Can Amazon Actually Kill People by Steven Mussey MD?

  1. Kathy
    March 10, 2017 at 10:26 am

    “OUR COMPUTER INTERNET INFRASTRUCTURE IS NOT READY FOR ALL OF THIS! STOP THE INSANITY! IT IS TOO INSECURE AND TOO UNRELIABLE! WAKE UP!!!”

    There, I’ve done my part!

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    • Kurt
      March 13, 2017 at 8:52 am

      A little known fact is now a medication error can be propagated by a simple mouse click.
      In the past, at least the brain had to be engaged before moving the pen on the paper!
      (Or when dictating from the crib notes!)

      Pharmacists used to catch errors when nurses called to renew medications and would point
      out changes made by other physicians. Now, push a button and the wrong meds can be renewed.

      A well thought out electronic record assist should have been rigorously pursued instead of this
      bull-hockey.

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  2. Soccerdoc
    March 5, 2017 at 10:38 am

    To Pat’s point about note simplicity, I received a 6 page ER note on a 60 yo woman who slipped on black ice and lacerated her leg. No mention of size or location and no explanation of treatment. Fortunately, she passed the Glasgow Coma Screen, is not being abused at home, and does have an Advanced Directive.

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    • Pat
      March 5, 2017 at 11:15 am

      That’s hilarious…

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  3. Pat
    March 4, 2017 at 10:58 am

    It is incumbent on each business owner to decide what works best for him. If EMR’s are the best way to practice, then doctors would have gone to them en mass long ago. The very fact that they were mandated means they were not the best choice.

    This goes to the larger point: the central government has no appropriate role in the daily provision of health care, and will abuse that role into population control. This is not just political theory – it is practical reality. Primary care notes should be as simple as file cards: “Mrs. Smith – cough – smoker – RT rhonchi – bronchitis – levaquin, prednisone, f/u prn”. Something as tedious as Mrs Smith’s case does not deserve a page of data. The instinct of government is to control Mrs Smith, to control her doctor, and to use each party to control the other. Again not theory, that has already happened. There is nothing noble and nothing honorable about that relationship. Don’t even try to dress it up as “compassionate.”

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    • Non Compos Mentis
      March 5, 2017 at 9:41 am

      Well said.

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  4. drhockey
    March 4, 2017 at 9:20 am

    Dr. Mussey — been there, done that.

    Paper chart hack — break a window to get into my office.
    EMR hack — you can keep your bathrobe on while in your Moldova/China/Russia/etc. apartment.
    Which system seems more secure with less people “eligible” to hack into your patients’ Protected Health Information?

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  5. HJR
    March 4, 2017 at 8:40 am

    Our inpatient EMR often goes down for hours at a time. When it happens, the administrators say “use downtime procedures” which means “fly by the seat of your f-ing pants”. Imagine covering 100 inpatients at night that you’ve never met, and you know nothing about. Mr. X’s BP is 210/110? OK, well what was it earlier today? Oh,… there’s nowhere to find that out because the system is down? Well,… what meds is Mr. X on? There’s nowhere to find that out either,… I see. Well what is Mr. X even doing in the hospital? Oh, that’s right. The H&P only exists in the computer too. Good thing nothing important is in the EMR. What could possibly go wrong?

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  6. Thomas Guastavino
    March 4, 2017 at 8:36 am

    No one has ever hacked a locked up paper chart and a paper chart never crashes. Of course, the government can’t track what you are doing if you use a paper chart so they of course, prefer the computer.

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