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Comment by dsclough | Hacker News Reader

A nurse was unable to give my wife medication while in labor because the barcode on the bag of drugs wouldn’t scan. Fortunately we just had to wait another 20 minutes to get a new bag from the pharmacy but I can easily imagine a world where doctors are unable to perform procedures they are physically capable of doing because of liability surrounding not using the computer systems as intended. Epic particularly has really done a number on the healthcare system.

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I really, sincerely don't understand that. How does an unscannable barcode prevent a doctor/nurse from administering medicine they are holding in their hands?

Because they’re accepting the liability of it going wrong if they make an unusual choice to disregard the error

So the problem really isn't CrowdStrike or any computer at all, but dumb policy or regulation?

I think a good remedy would be to completely remove "normal procedure" as a defense against liability. Our legal standard should defend people who break protocols if they know they will result in harm, and prosecute people who don't, or prosecute the people who make the protocols in those cases. Law should supercede corporate policy, not treat it as a form of law

That's not how liability works. There is no "I followed some written procedure when it didn't make sense to do so" defense to malpractice claims.

It doesn't. We do this all this time in rapid responses and cardiac arrest scenarios, when we can't wait for an order in the EHR; someone keeps track of the medications, doses and rough times of administration, and it's entered into the EHR later.

Because the law doesn't want to do its job anymore, so it created useless bureaucracy to make their lives easier and human life hell

An awful lots of apparently useless bureaucracy exists because many people, left to themselves, are often very, very stupid.

Bureaucracy certainly stops smart people from doing the right thing, but more often, it stops stupid people from doing the wrong thing. Hack away at bureaucracy at your peril.

Well said.

It also stops smart people from doing stupid things.

The other commenter already said it: Liability. What if the scan is part of a procedure that ensures that the right drug is given to the right patient? Giving someone the wrong drug or even the wrong dose can cause serious harm. Imagine they kill someone that way and then during the investigation it turns out the they didn't scan the meds. It doesn't matter why they didn't scan it (lazy, forgetful, computer problem), it is en enormous legal risk for every party involved. Thousands of people die each year because of medical errors, so trying to prevent doctors from killing people by using strict procedures is very important. Even if it means that in extreme situations like this the procedure can cause harm as well. Overall it will save many, many more people than it will kill.

What if it turns out they harmed the patient by insisting on following the standard procedure during a worldwide outage? Isn't that the same kind of liability risk, and is the regulation really going to protect them in this case? If so, isn't that a hugely problematic regulation?

Yes, and yes. Welcome to our messed up society.

In that case the nurse or doctor has a strong defense of "I was following policy" for their insurance and boss.

The people writing hospital policies or regulations aren't thinking about individual patient outcomes unless some notable news story came out recently, and even then it's maybe the third or fourth priority on a list a hundred items long.

We don't know that this is what actually happened in OP's case. I was referring to the comment you replied to and there it is pretty obvious that the regulation is exists to prevent harm from being done. But even if there is a clear justification, you would expose yourself to a lawsuit and need argue all this in court. I can totally understand why people don't want that, especially in the US. So if anything, you should blame the legal system.

I doubt refusing to treat patients when the computer is down insulates you from malpractice claims.

It probably also automates the chart entry and billing to insurance/patient, at least to an extent. I wouldn’t rest sole responsibility for this system on legal compliance or risk mitigation. Under normal circumstances, there’s also an efficiency improvement. The problem arises when there either is no workaround when the system doesn’t work, or workers aren’t trained well enough to know how to do things manually (or don’t have enough time under the less efficient mode of operating).

If the barcode wouldn't scan there it might also have not scanned correctly when that bag was being filled which could have led to it being filled incorrectly.

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