Tuesday, December 20, 2011

Electronic devices distract doctors. So do other things.

Another hand-wringing piece about the dangers of distraction by electronic devices, this time from The New York Times, prompts these comments.

According to the article, Dr. Peter J. Papadakos, an anesthesiologist and director of critical care at the University of Rochester Medical Center reportedly said he had seen nurses, doctors and other staff members glued to their phones, computers and iPads. It goes on to say the following:

“My gut feeling is lives are in danger,” said Dr. Papadakos, who recently published an article on “electronic distraction” in Anesthesiology News, a journal. [Anesthesiology News, a journal? Since when?]

This is interesting coming from an anesthesiologist, whose colleagues were notorious in the analog age for doing crossword puzzles and reading the [print] Wall Street Journal during cases.

Here, via the AHRQ, is a nice example of an adverse event that occurred because of a distraction. A resident forgot to place an order to stop warfarin because she was interrupted by a text. Curiously, the electronic computer order entry program, while described as being “robust,” did not alert anyone. When his INR reached 8.5 three days later, the patient developed a hemopericardium requiring surgery. It’s a little disingenuous to blame a text for this complication when a team of doctors apparently forgot that a patient was receiving one of the most dangerous drugs around.

The Times article described a malpractice case from Colorado. It involved a neurosurgeon who was making personal phone calls during an operation which left the patient partially paralyzed. Where were the OR staff and the anesthesiologist while all these calls were being made? I doubt that I could even make one personal phone call during a case in my OR without the supervisor, the medical director and risk management being notified.

There is no question that electronic devices can be addicting and distracting if you let them. So can many other things like thinking of sex, which men apparently do at least 19 times a day or so a recent study says.

I will admit that it annoys me when I am talking to a resident or PA and she pulls out her phone to read an incoming text. And I certainly agree that 99.9% of all emails do not need to be viewed immediately.

That does not mean we should electronic devices from hospitals. I think the ability to look up a drug instantly or review management of a problem on UpToDate at a patient’s bedside far outweighs the potential for distraction.

I wonder if the same debate took place when radios were first placed in automobiles?


Anonymous said...

I find that docs text me and want me to text them more often these days. I find it much easier and faster to just do the voice call, that way I can tell if they are "getting it" or not.


Skeptical Scalpel said...

We text a fair amount. We expect some sort of response, even if it's just "K," to confirm that the recipient got it. Phone call can be annoying when one is examining a patient or doing a bedside procedure.

Anonymous said...

But that's the problem. When I get a "K", especially from a male doc, I picture that same typical male response made while staring at a football game on TV, "K". Now, I know when they are in surgery, as I am the master of their worlds, bwahaha!

Then when I reference the texted issue hours later, he will say, "Did I do that stuff?" -- meaning did he do the thing that he responded "K" to earlier. LOL. I don't know, let me check and see if you did. HA.


Lisa said...

Couldn't the same be said for telephones when they were in rooms too or pagers? With every new technology the benefits usually outweigh the negatives. Being able to look up info instantaneously could save lives.

Skeptical Scalpel said...

SCRN-You know how we men are. We don't always listen to you.

Lisa-You are correct. The fact is even a spoken comment from a colleague can be distracting.

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