When the Mission Really Is Critical

The language of IT tends toward the dramatic. Missions are critical. Exceptions are fatal. Implementations are painful. Systems crash. And staffing is always in crisis.

Perhaps this tilt toward the purple is one of the ways in which we compensate for the relative bloodlessness of the IT discipline. Managing networks and vendors, searching for the right application or system to do the job, and balancing budgets and enterprise demands aren’t exactly the stuff out of which action-adventure novels—or, to be frank, sexy magazine stories—are made. This is not to say that what IS people do is not important. IT is often the difference between business success and failure. But it’s rarely a matter of life and death.

Then again, sometimes it is.

In this issue, Senior Writer Susannah Patton’s cover story, “The Rx Files” (Page 104), describes one of those rare instances in which the passion practitioners profess is truly earned.

Patton’s article begins with the sad story of Betsy Lehman, a Boston Globe health columnist, who in 1994 entered Boston’s world famous Dana-Farber Cancer Institute for treatment. Because a doctor made a prescription error, and because that error was not caught, the 39-year-old mother of two died—not from cancer, but from a mistake.

An awful tale, and awfully common. Last year, the Institute of Medicine of the National Academy of Sciences published a report on the prevalence and consequence of medical errors. According to the report, medical mistakes kill between 44,000 and 98,000 a year. Seven thousand of those deaths were because a patient received the wrong medicine or the wrong dose of the right medicine. This happens when a nurse misreads a doctor’s prescription, or a pharmacist sees 20 mg instead of 2.0 mg, or a doctor just gets it wrong. All of which is easy to do when you’re overtired, overworked or overstressed.

To anyone with a technological bent or experience with any one of a number of business processes, the way to fix the problem of prescription error is obvious: You create a smart order-entry system; you install pharmaceutical software and integrate that with electronic medical records. If proper drug protocols are programmed into the system, the system will flag or reject prescriptions that don’t meet the parameters.

Since Lehman’s death, Dana-Farber has installed an automated system that checks prescriptions against protocols, and pharmacists double-check them against a patient’s electronic records. Unfortunately, although one-third of hospitals nationwide have computerized order-entry systems, only 1 percent require their physicians to use them.

Vendors must be pushed to build better off-the-shelf systems, and IT leaders must market the benefits of those systems to the users—the health-care providers on whom our lives, and the lives of our friends and families, inevitably depend.

After all, in this arena, the IT mission truly is critical.