This is one of his examples of IT failure
‘Mother referred for delivery
and management of a fetus in utero with diagnosis of hypoplastic left heart – baby born, middle of night,
terribly sick, unexpectedly more wrong than expected, and with truly ambiguous
genitalia. Can’t get an xray, prostaglandin-E (a
lifesaving medication used in babies born with functionally absent, or
obstructed, blood flow out of the heart), or any medical test, until there is a
“Medical Record Number” in the computer. Can’t get one of those until we tell the computer whether the baby is a
boy or a girl. And there is
no way to bypass that and get on with delivering emergency care. (Unimaginable
- ed.)
Not the way one wants to
break the news of an intersex (gender not definite)
problem to a new young mom, of a very sick baby…. So I ran back to Labor &
Delivery, sat down face to face with the mom, still groggy from meds and
caesarian section surgery – and said something like, “Your baby is very sick,
and we don’t know precisely why. And we can’t tell for sure right now whether
your baby is a boy or a girl. In order to get x-rays and medications, we need to tell our computer whether your
baby is a boy or a girl. Which do you want the baby to be?
The 18 year old new mom
looked me right in the eye, nodded her understanding, and said, “I want a
girl.” So I said, “OK, she’s a girl. I’ll come back and talk to you as soon as we
get her stabilized.”’
....
Never since have I ever
designed a database with gender as a binary part of the primary key. Out in the business world, people are still
doing that. And I’m sure some of those people are still trying to sell their
business stuff to healthcare. Babies aren’t the only ones who might need a
bypass (intersex is actually quite common), and
consider the roadside bomb victims in Iraq – or any other explosive,
burning trauma – is gender your first concern?
Now I don't really understand why the doc here couldn't decide himself and then change the gender later on if it were incorrect. Or would that then have lead to two patient ids because the gender were part of the key creating the id?
Graham
http://www.synapsedirect.com/
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