The power to heal and the power to harm
Doctors are repeatedly reminded they have the power to cause great harm or even death if they make a mistake. Every time they pay their malpractice bills, they get another reminder of the daily risk involved.
People who provide software and hardware need to be held to the same standards. Microsoft, in particular, can be totally evil and cause great harm.
Yesterday was an example.
The day started normally. Suddenly, our receptionist’s main computer popped up with a Blue Screen of Death. BSOD is the acronym. It was actually catastrophic and the computer would briefly reboot and then crash again with the same BSOD.
Moving quickly, I replaced her computer with a new machine. I keep such things on standby. It took about 20 minutes and it did not have a lot of the functionality we usually need. The correct printer drivers had not been installed, so the machine would not print.
Our other receptionist soon needed to print an updated doctor schedule. BOOM! BSOD!!.
What is a BSOD? It is a sudden blue screen with strange information printed which basically says you have hit a catastrophic event. A countdown appears before you can reboot. Then, you need to reboot and this can take a lot of time for the computer to get itself together, again. Any unsaved work is totally gone. Sometimes, it is so abrupt, it wrecks critical operating system files and the computer will not restart. In other words, short of having a meteor crash into your computer, it is the worst thing that can happen to your computer. It is a show-stopper. Your work stops for many minutes. In the case of our receptionist’s computer, it stopped totally on that particular machine.
Meanwhile, in one of our exam rooms, the doctor went to print patient instructions. BOOM! BSOD. The visit froze until the system could unfreeze and reboot and then slowly grind back into the EMR.
What happened? Was it a dreaded Russian or Chinese virus? Pretty soon, the common issue became evident: As long as you did not attempt to print anything, everything was okay, with the exception of the first computer which seemed DEAD, DEAD, DEAD!
Who do you call for such a thing? Did I not update Windows 10 appropriately? Was this a bunch of bad drivers?
Our big network printer is leased. I called the company. The first call proved unhelpful: “Call your IT person.” I’m the IT person.
Hours later, as the common thread became evident, I called them again with specific examples. This time, the result was different. An avalanche of phone calls describing the same event was arriving at the company. A later call from an IT person clarified the problem: On March 10, Microsoft pushed out two security updates which could not be refused. The updates destroyed network printers, especially from Kycocera. The only way to fix the issue was to manually remove the updates. It sounds great in theory, but in practice, this is not easy. Microsoft deemed these updates so critical, it blocks removal, even with elevated privileges. The other option is to do a system restore to an earlier date, before March 10. This seems to work, but the process ties up the machine for an hour or two.
When you impair information retrieval and recording at a healthcare office, you impair care. You put patients at risk. People can get hurt and people can die.
Has Microsoft acknowledged the risk openly? Eventually, yes. Is there a fix? Nope! This is kind of a big deal. This essentially took out a whole fleet of healthy computers in our office. The majority of them still need to be system restored or reset. We are temporizing by using other printers. It was also incredibly time intensive. Such an event is a catastrophe. Microsoft should have “all hands on deck,” working through the night with frequent updates. Is that happening? I doubt it! Microsoft has incredible power and incredible wealth. It would be nice if they could use these superpowers for good rather than evil.
EHR is the absolute bane of primary care medicine. Before I retired, I could see and take care of so many more patients, document appropriately by dictation and get home at a reasonable time. Am retired now but at the end the “computerwork” got so bad I’m glad I hit age 64 and was able to get COBRA insurance to back out and retire. May God condemn to Hades anyone who tells students primary care medicine is a rewarding career. In the computer age it sucks and best to stay away. I was so glad I was able to retire.
Don’t get me wrong. I loved being able to use a modem to login to my local hospital and to check on current inpatients, their labs and x-rays from home. (Now it’s DSL or fiber.) That was great and I will call it “computer assistance”. In that case computerization/electronification really helped me. Turning me into a secretary was the biggest waste of time EHR forced upon me/docs. Though I was able to dictate my notes, it was a PITA to have to input orders into a computer screen. Unit clerks became unemployed then. That was a travesty to them.
I highly recommend one save their pennies and retire from primary care medicine as soon as they can. Don’t have a large number of kids to send through college so you can get out as soon as possible.
Kurt Savegnago