On death and not dying

April 14, 2006

I was one of the first ones there, a youth football coach who’d never been to the annual meeting of the Wisconsin Football Coaches Association. I’d planned out my conference schedule and listed the room numbers. It made sense to roam the halls early, before the talks began, so I could find out how to get to and from the rooms quickly and efficiently.

I was one of the first ones there, a youth football coach who'd never been to the annual meeting of the Wisconsin Football Coaches Association. I'd planned out my conference schedule and listed the room numbers. It made sense to roam the halls early, before the talks began, so I could find out how to get to and from the rooms quickly and efficiently.

Sooner than I'd thought, however, I'd scoped out the conference center and was looking for something to do. That's when I stumbled on a breakfast featuring a video of Tony Dungy. A few months earlier, Dungy, the coach of the Indianapolis Colts, had lost his son. In this video, Dungy spoke about the strength of his Christian faith and how he felt about the death of James. It was the most powerful video I had ever seen. It gripped us. Some were younger than me, some older, more than a few grizzled and hardened - the kind of men you'd never expect to cry. But they did.

Death has a way of making that happen. Its effects go far beyond the person who dies to family and friends, sometimes even to complete strangers. With so much riding on medical decisions, the people who have chosen to dedicate their lives to fighting death need to be as efficient as they can. Often, they are not. But you can hardly blame them.

It's tough enough communicating between departments. Transfer a patient from a tertiary-care center to a community hospital, and you might as well have parked him on Mars. Exam results can take a week or longer to reach a specialist. Orders to reduce the dosage of a medication no longer needed are lost. Nobody checks to see whether what was supposed to get done actually got done. Why?

An executive from Misys Healthcare believes staff simply can't keep up. They are being asked to do more with fewer people and declining budgets, even though the number of exams is rising.

"Unless we fix this, the errors are going to go up. More patients are going to get hurt or die," Dave Jones, Misys senior product manager, told me.

Misys' solution, due in the third quarter of this year, is a rules-based engine to scrutinize medical orders. These orders may be from a referring physician for a radiology exam. They might come from a nurse for laboratory tests. But they will be looked at, discreetly and efficiently (DI SCAN 4/13/06, Misys promotes efficiency through bilingual IT communications).

This makes a lot of sense. How many times do we, in our daily lives, intend to do something and forget? How many times do we do what we think is right, only to find out we were wrong? Nobody wants a machine telling them what to do, but it wouldn't bother me if I had one to catch mistakes before I made them.

In dealing with something harsh enough to make football coaches cry, we can use all the help we can get.