11 ms·

I was recently hospitlized. The EMT took my id card and entered my name incorrectly (YUEK as opposed to YEUK). I told the nurse and she said there is nothing sh

by yeukhon 10y ago

I was recently hospitlized. The EMT took my id card and entered my name incorrectly (YUEK as opposed to YEUK). I told the nurse and she said there is nothing she can do about it until I check out the hospital. I waited until I checked out the hospital, and the nurse took my information down. For my situation, I have to follow up with specialist. The clinic received my medical information and the referral from the hospital. The clinic also got the typo from the hospital, plus the wrong insurance information, as well as the wrong cell phone number. I was amazed at the wrong insurance (hospital gave them my dental insurance, but I received a notice from my health insurance regarding my hospital admission before I visited the clinic). How funny. When I went back to confirm my appointment a few days later, the clinic said no one correct my name (wtf?). What a joke. While I was getting admitted into the hospital for a few nights, the nurses had to pair up in order to figure out how to enter data into the system. The program looks like Excel except it isn't. In some cases you have to enter the data in a different column, in some cases you have to enter 0, in some cases you leave it out. The nurses kept saying "oh I remember you have to do this to get around this issue, oh I think you can ignore this option." When I met with the nurse practitioner the next day, he couldn't log into his system. I told him I work as a DevOps and he was curious about my role. Then he said he has to call the IT support (managed solution) somewhere in Tennessee and all the vendor would say is try again later). Yeah, after meeting 30 minutes he was able to login. Here is the thing - typo can ruin life, typo can take away money and time for fixing error, can cause divorce and all sorts of other bad things. Insurance, Social Security, government IDs, Diploma, etc. There is no reason, in my funny but pretty frustrating anecdote, for hospital to run so inefficient, relying on systems built by incompetent people, product dedicated by policy makers or administrators who really are out of touch with real life (they don't use the system). You know, I am angry, I want to reform hospital software system.

pragone 10y ago
I've seen all of these situations thousands of times, and I don't even work in a hospital (yet). There has not existed a single EMR I've ever seen that makes any sense whatsoever to the individuals using it. I understand it from the bigger picture, but when things are directly impacting patient care, something needs to be done. I've likewise been extremely interested in reforming EMRs. It's a precarious field to get into, but I am definitely very interested in pursuing it (perhaps after medical school, though).
- yeukhon 10y ago
  I have some ideas, hit me up on my email if you want. Most of the information repeat every time you visit a doctor or a hospital, it doesn't need to be that me.
- tyingq 10y ago
  Part of the issue in healthcare is the "who gets to decide what software to buy". The culture seems to be that individual departments get to decide their own software, based only on their needs. Interoperability is not on their list. So radiology buys what they want, admissions buys what they want, and so forth. Then, the department that has the least clout and direct funding (IT) has to tie it all together. There are some actual standards like HL7, and some generally accepted non-standards like Orsos, but they are all too loose to solve the problem completely. Changing a name is hard partially because it is one of the identifiers that tie the mess together.
  - pragone 10y ago
    You 100% hit the nail on the head. It's really, really amazing to see how absolutely disconnected the buyers and the users are. I was doing training at one hospital where, when they admitted a patient to the floor from the ED, had to print out the entire EMR, because the EMR in the ED and the floor was not compatible. Insanity.
    - tim333 10y ago
      That kind of thing's not so rare though. Hospitals have lots of systems and paper works quite well.
  - flukus 10y ago
    > The culture seems to be that individual departments get to decide their own software, based only on their needs. I think that's a good thing by itself, various parts of a hospital are incredibly specialized and a one size fits all solution will never work. The alternative is some much higher level of management deciding what everyone buys. HL7 needs to be scrapped though, it does nothing to achieve inter-operability, it's just there to make hospital managers think that it exists and keep smaller players out of the market.
cyberferret 10y ago
I am amazed that a lot of systems don't allow changing of information once entered. I signed up with a new ISP a couple of years ago - one of the biggest ISPs in Australia, and during the phone conversation to set up my plan, the operator heard my first name wrong, substituting a 'v' with a 'b'. I didn't realise during the call (because, well, it IS hard to pick up that nuance audibly) until they sent me my sign on links which of course had the typo in my username. Billing information is also all wrong. When I told them about it, their response was pretty much "Oh, too bad - once that username is created, it is there for life. You will have to shut down that account and create a new one", meaning I lose all the benefits I got from the promotional transfer. So I just put up with a wrong first name whenever I sign on or ask for support from them. I still think it is strange that some second or third level support engineer can't just change that info in the database for me, after the proper authentication. I can't believe that something so easy to create over the phone can be so hard to change over the phone.
- Mtinie 10y ago
  Immutability of names may be a perceived benefit and a feature, vs. simply poor UX. Regulatory, perhaps?
  - yeukhon 10y ago
    Regulatory is a process, so if there's a process... we can correct name on a typo on our passport, why not in this case? Either the regulatory is really really stupid (we never thought of it!), or the company bought a bad system.
    - okket 10y ago
      Amazing that in the age of git and Merkle trees it is still hard to change something plus keeping an immutable history of the changes for documentation/accountability purposes. This should be a basic requirement for any sane system nowadays.
      - sly010 10y ago
Udik 10y ago
Typos in ID codes are usually prevented by appending a checksum. But what about reforming names? We could append a checksum to them also :)
- icebraining 10y ago
  In some European countries, you could already just ask the user to insert his national ID smartcard into a reader and get a digital file with basic info (essentially what's printed on the front).
  - emodendroket 10y ago
    No reason you couldn't do something similar with licenses.
    - amorphid 10y ago
      It is interesting to me that we don't have a national ID card in the USA. I don't appreciate strong arguments against them. Like on this list by the ACLU... https://www.aclu.org/other/5-problems-national-id-cards https://www.aclu.org/other/5-problems-national-id-cards >> Reason #2: An ID card system will lead to a slippery slope of surveillance and monitoring of citizens. I think "they" are already monitoring everything I do. Maybe this would have mattered more to me before I had a smartphone, passport, bank account, social media accounts, etc. If I wanted to live off the grid with no electricity & only using trained ninja squirrels to buy things with unmarked bills on my behalf, I would certainly not want to be forced to into having a national ID card. I'm not advocating monitoring. I just feel a national ID card wouldn't be much different than my current situation.
      - emodendroket 10y ago
        Especially when the SSN is used as a stand-in but has no security whatever.
      - realusername 10y ago
Spooky23 10y ago
I got sued by a hospital because their systems couldn't distinguish between the dependent version of me (from my Parents health insurance 3 years prior) and the current version of me. (I share a name with my dad and had the same insurance plan) They kept billing my defunct account, despite dozens of attempts to correct.
- chris_wot 10y ago
  Counter sue for fraud.
  - Spooky23 10y ago
    They ultimately settled it and fixed it when I got my State Senator involved. My small claims suit for my expenses was dismissed due to a binding arbritration clause. As a then 22 year old, that was about all I had the time to do.
RcouF1uZ4gsC 10y ago
This is surprising to me. At the hospital where I worked, everybody was assigned a medical record number. It was possible (in fact, I saw it done several times) to change the name of the patient, and even combine multiple patients into one (useful for drug seeking patients who claim to be multiple people on different visits). A common case was with newborn/pediatric patients. A newborn was listed with a system name of <Mother's last name>/Baby <Boy|Girl> with an optional A/B/C for twins/triplets/etc. If that patient was later admitted in follow-up (for example heart defects which required multiple surgeries over time to fix) their actual name was then used. I guess the issue is that the future is not evenly distributed.
- zxexz 10y ago
  Out of curiousity, do you remember the vendor of the software at the hospital you worked?
MaysonL 10y ago
35 years ago my name was entered incorrectly into a data base. I'm still getting mail with the incorrect spelling.
Benjammer 10y ago
> I want to reform hospital software system. Join the club: https://angel.co/electronic-health-records-1 https://angel.co/electronic-health-records-1 http://www.builtinnyc.com/blog/healthcare-startups-nyc http://www.builtinnyc.com/blog/healthcare-startups-nyc
brokenmachine 10y ago
I am acutely familiar with hospital systems and in every one I have seen so far, you can modify demographic information. Maybe the nurses didn't know how to do it, but it can definitely be done. Not saying there aren't other glaring inefficiencies (outsourced useless IT helpdesk especially), but changing patient demographic info is not one of them.
- kagamine 10y ago
  As a UX guy "Maybe the nurses didn't know how to do it, but it can definitely be done." is absolutely no excuse. It still screams 'poor design' and 'couldn't be bothered to test'.
  - brokenmachine 10y ago
    As a UX guy, you would surely vomit or run away if you saw most of the health programs I've seen. Please help fix them, there are so many examples of shocking UI in health. So many of them look like first year uni projects by middling level programmers. Also, sometimes only particular people (probably Admissions Dept) would have the permissions/knowledge necessary to edit that info. So maybe the nurses couldn't fix it but surely there would have been people in that hospital that could have fixed an incorrect name, had they been notified. They were probably who made the error in the first place!
kevin_thibedeau 10y ago
I had to stop handwriting the letter "u" in my name with a tail because it was being entered as an "n" too often.
- mjevans 10y ago
  Fancy is for the places they don't ask you to print for clarity... (which is everywhere except the 'signature' area).
frik 10y ago
The program looks like Excel except it isn't. In some cases you have to enter the data in a different column, in some cases you have to enter 0, in some cases you leave it out. It could be SAP or some other old fashion ERP system. Or some old Java/C# application built for the hospital. These have usually in common a very crude old fashion UI and things like changing a record is overly complex. Often also the workers don't know the program good enough. So they only know the standard use case. If you fall out of the 95% use case, you get into a lot of trouble because of their inexperience with the application. If they try new things put to mitigate the issue, it's better to ask for their boss or things can go worse.
- rows 10y ago
  Yes this sounds like SAP with insufficient training. Clients have been asking for years to get browser-like functionalities, getting a form with only the fields they really need and nothing that can be determined automatically. But SAP has been improving for years, and now they are offering jQuery in disguise https://sapui5.hana.ondemand.com/ https://sapui5.hana.ondemand.com/ It's hard to blame bad UI on SAP when they are pushing for the opposite.
sobkas 10y ago
>There is no reason, in my funny but pretty frustrating anecdote, for hospital to run so inefficient, There is one reason why it is so. When they make such error, you must take effort, time and money to fix it. So if hospital can spend "their" money on system that can fix and/or catch such errors (+staff that can efficiently use it), but on the other hand they can just "outscore" it to you, guess what choice they will make?
leni536 10y ago
http://health.gnu.org/ http://health.gnu.org/
marme 10y ago
just realize that the type or wrong cell phone number could have been an extra 0 in you medicine dosage that have killed patients before. The leading cause of death in hospitals is error not any actual disease. Doctors amputate the wrong limb, give the wrong medication, all sort of stupid mistakes that should be easily preventable

by yeukhon 10y ago

pragone 10y ago

I've seen all of these situations thousands of times, and I don't even work in a hospital (yet). There has not existed a single EMR I've ever seen that makes any sense whatsoever to the individuals using it. I understand it from the bigger picture, but when things are directly impacting patient care, something needs to be done. I've likewise been extremely interested in reforming EMRs. It's a precarious field to get into, but I am definitely very interested in pursuing it (perhaps after medical school, though).

yeukhon 10y ago
I have some ideas, hit me up on my email if you want. Most of the information repeat every time you visit a doctor or a hospital, it doesn't need to be that me.
tyingq 10y ago
Part of the issue in healthcare is the "who gets to decide what software to buy". The culture seems to be that individual departments get to decide their own software, based only on their needs. Interoperability is not on their list. So radiology buys what they want, admissions buys what they want, and so forth. Then, the department that has the least clout and direct funding (IT) has to tie it all together. There are some actual standards like HL7, and some generally accepted non-standards like Orsos, but they are all too loose to solve the problem completely. Changing a name is hard partially because it is one of the identifiers that tie the mess together.
- pragone 10y ago
  You 100% hit the nail on the head. It's really, really amazing to see how absolutely disconnected the buyers and the users are. I was doing training at one hospital where, when they admitted a patient to the floor from the ED, had to print out the entire EMR, because the EMR in the ED and the floor was not compatible. Insanity.
  - tim333 10y ago
    That kind of thing's not so rare though. Hospitals have lots of systems and paper works quite well.
- flukus 10y ago
  > The culture seems to be that individual departments get to decide their own software, based only on their needs. I think that's a good thing by itself, various parts of a hospital are incredibly specialized and a one size fits all solution will never work. The alternative is some much higher level of management deciding what everyone buys. HL7 needs to be scrapped though, it does nothing to achieve inter-operability, it's just there to make hospital managers think that it exists and keep smaller players out of the market.

cyberferret 10y ago

I am amazed that a lot of systems don't allow changing of information once entered. I signed up with a new ISP a couple of years ago - one of the biggest ISPs in Australia, and during the phone conversation to set up my plan, the operator heard my first name wrong, substituting a 'v' with a 'b'. I didn't realise during the call (because, well, it IS hard to pick up that nuance audibly) until they sent me my sign on links which of course had the typo in my username. Billing information is also all wrong. When I told them about it, their response was pretty much "Oh, too bad - once that username is created, it is there for life. You will have to shut down that account and create a new one", meaning I lose all the benefits I got from the promotional transfer. So I just put up with a wrong first name whenever I sign on or ask for support from them. I still think it is strange that some second or third level support engineer can't just change that info in the database for me, after the proper authentication. I can't believe that something so easy to create over the phone can be so hard to change over the phone.

Mtinie 10y ago
Immutability of names may be a perceived benefit and a feature, vs. simply poor UX. Regulatory, perhaps?
- yeukhon 10y ago
  Regulatory is a process, so if there's a process... we can correct name on a typo on our passport, why not in this case? Either the regulatory is really really stupid (we never thought of it!), or the company bought a bad system.
  - okket 10y ago
    Amazing that in the age of git and Merkle trees it is still hard to change something plus keeping an immutable history of the changes for documentation/accountability purposes. This should be a basic requirement for any sane system nowadays.
    - sly010 10y ago

Udik 10y ago

Typos in ID codes are usually prevented by appending a checksum. But what about reforming names? We could append a checksum to them also :)

icebraining 10y ago
In some European countries, you could already just ask the user to insert his national ID smartcard into a reader and get a digital file with basic info (essentially what's printed on the front).
- emodendroket 10y ago
  No reason you couldn't do something similar with licenses.
  - amorphid 10y ago
    It is interesting to me that we don't have a national ID card in the USA. I don't appreciate strong arguments against them. Like on this list by the ACLU... https://www.aclu.org/other/5-problems-national-id-cards https://www.aclu.org/other/5-problems-national-id-cards >> Reason #2: An ID card system will lead to a slippery slope of surveillance and monitoring of citizens. I think "they" are already monitoring everything I do. Maybe this would have mattered more to me before I had a smartphone, passport, bank account, social media accounts, etc. If I wanted to live off the grid with no electricity & only using trained ninja squirrels to buy things with unmarked bills on my behalf, I would certainly not want to be forced to into having a national ID card. I'm not advocating monitoring. I just feel a national ID card wouldn't be much different than my current situation.
    - emodendroket 10y ago
      Especially when the SSN is used as a stand-in but has no security whatever.
    - realusername 10y ago

Spooky23 10y ago

I got sued by a hospital because their systems couldn't distinguish between the dependent version of me (from my Parents health insurance 3 years prior) and the current version of me. (I share a name with my dad and had the same insurance plan) They kept billing my defunct account, despite dozens of attempts to correct.

chris_wot 10y ago
Counter sue for fraud.
- Spooky23 10y ago
  They ultimately settled it and fixed it when I got my State Senator involved. My small claims suit for my expenses was dismissed due to a binding arbritration clause. As a then 22 year old, that was about all I had the time to do.

RcouF1uZ4gsC 10y ago

This is surprising to me. At the hospital where I worked, everybody was assigned a medical record number. It was possible (in fact, I saw it done several times) to change the name of the patient, and even combine multiple patients into one (useful for drug seeking patients who claim to be multiple people on different visits). A common case was with newborn/pediatric patients. A newborn was listed with a system name of <Mother's last name>/Baby <Boy|Girl> with an optional A/B/C for twins/triplets/etc. If that patient was later admitted in follow-up (for example heart defects which required multiple surgeries over time to fix) their actual name was then used. I guess the issue is that the future is not evenly distributed.

zxexz 10y ago
Out of curiousity, do you remember the vendor of the software at the hospital you worked?

MaysonL 10y ago

35 years ago my name was entered incorrectly into a data base. I'm still getting mail with the incorrect spelling.

Benjammer 10y ago

> I want to reform hospital software system. Join the club: https://angel.co/electronic-health-records-1 https://angel.co/electronic-health-records-1 http://www.builtinnyc.com/blog/healthcare-startups-nyc http://www.builtinnyc.com/blog/healthcare-startups-nyc

brokenmachine 10y ago

I am acutely familiar with hospital systems and in every one I have seen so far, you can modify demographic information. Maybe the nurses didn't know how to do it, but it can definitely be done. Not saying there aren't other glaring inefficiencies (outsourced useless IT helpdesk especially), but changing patient demographic info is not one of them.

kagamine 10y ago
As a UX guy "Maybe the nurses didn't know how to do it, but it can definitely be done." is absolutely no excuse. It still screams 'poor design' and 'couldn't be bothered to test'.
- brokenmachine 10y ago
  As a UX guy, you would surely vomit or run away if you saw most of the health programs I've seen. Please help fix them, there are so many examples of shocking UI in health. So many of them look like first year uni projects by middling level programmers. Also, sometimes only particular people (probably Admissions Dept) would have the permissions/knowledge necessary to edit that info. So maybe the nurses couldn't fix it but surely there would have been people in that hospital that could have fixed an incorrect name, had they been notified. They were probably who made the error in the first place!

kevin_thibedeau 10y ago

I had to stop handwriting the letter "u" in my name with a tail because it was being entered as an "n" too often.

mjevans 10y ago
Fancy is for the places they don't ask you to print for clarity... (which is everywhere except the 'signature' area).

frik 10y ago

The program looks like Excel except it isn't. In some cases you have to enter the data in a different column, in some cases you have to enter 0, in some cases you leave it out. It could be SAP or some other old fashion ERP system. Or some old Java/C# application built for the hospital. These have usually in common a very crude old fashion UI and things like changing a record is overly complex. Often also the workers don't know the program good enough. So they only know the standard use case. If you fall out of the 95% use case, you get into a lot of trouble because of their inexperience with the application. If they try new things put to mitigate the issue, it's better to ask for their boss or things can go worse.

rows 10y ago
Yes this sounds like SAP with insufficient training. Clients have been asking for years to get browser-like functionalities, getting a form with only the fields they really need and nothing that can be determined automatically. But SAP has been improving for years, and now they are offering jQuery in disguise https://sapui5.hana.ondemand.com/ https://sapui5.hana.ondemand.com/ It's hard to blame bad UI on SAP when they are pushing for the opposite.

sobkas 10y ago

>There is no reason, in my funny but pretty frustrating anecdote, for hospital to run so inefficient, There is one reason why it is so. When they make such error, you must take effort, time and money to fix it. So if hospital can spend "their" money on system that can fix and/or catch such errors (+staff that can efficiently use it), but on the other hand they can just "outscore" it to you, guess what choice they will make?

leni536 10y ago

http://health.gnu.org/ http://health.gnu.org/

marme 10y ago

just realize that the type or wrong cell phone number could have been an extra 0 in you medicine dosage that have killed patients before. The leading cause of death in hospitals is error not any actual disease. Doctors amputate the wrong limb, give the wrong medication, all sort of stupid mistakes that should be easily preventable