1.) What problems are hospitals and physicians encountering in diagnosing diseases and prescribing medications? What management, organization, and technology factors are responsible for these problems?It is impossible for any doctor to know the WHOLE story about a patient. As many forms and information they require before prescribing a medication or diagnosing and ailment, there is always information that is left out. This 'missed' info can lead to a misdiagnosis or a prescription for a medicine that may react poorly. This critical info can fall into the cracks by way of "poor handwriting, memory lapses, fatigue, and distractions" (pg. 505). Due to the massive volume of patients served, this can amount to a staggering sum of miscalls.
Management factors: many doctors must be kept up to date on different prescription medications and different diagnoses. With insufficient training, doctors may be unaware of potential side effects or medical guidelines.
Technology factors: Most hospitals do not have adequate information systems to help guide doctors towards a more educated decision. With software to use as a reference or 'second opinion' doctors would be more capable of fulfilling their duties successfully.
Organizational factors: Because of limited health care for some patients, some doctors can only spend about ten minutes with their patients. In many cases this is not adequate time to allow for a thorough analysis and diagnosis. More time would be needed to conduct a more robust analysis.
2.) Are CPOE and DDS systems appropriate solutions? Why or why not? What management, technology and organization issues are involved in the use of these systems?The programs themselves are not sufficient solutions. But the successful integration of the software into the hospital environment is definitely a step in the right direction. As the programs specify, the doctors opinion should always be the deciding factor, but CPOE and DDS programs can be useful in helping the doctor reach a conclusion. From my limited knowledge of the software, I think hospitals should be required to have and utilize these programs as a way to double check the doctor'r prognosis. A successful implementation could result in drastic decreases in malpractices costs and not to mention many spared lives.
Management: the implementation and forced use of the software would be a lofty hurdle to pass. With many doctors set in their old ways it could be difficult to convert them to use a confirm opinions with a machine after decades of being the sole decider.
Technology: The software would take a long time to setup and begin to utilize effectively. Their would need to be massive IT support to ensure the safety of information stored within the software. It would also be critical to make sure nonauthorized personeel does not change or delete any of the information as well.
Organization: Because most patients are only alloted about 10 minutes with their doctor, it would be hard for any doctor to input a patient's information. This would be another hurdle needed to pass before these systems could effectively be implemented.
3.) What obstacles prevent computer systems from improving the medical industry? How can these obstacles be removed?One major obstacle would be to get all doctors to use the systems. It would be difficult to get many of them to change the way they have been doing things for years or even decades. Some HMO allow doctors only 10.5 minutes to see a patient which would definitly not allow them time to utilize the software.
In order to get doctors to be more openminded about the system, hospitals would need to phase it in slowly. Make sure new hires are trained on the effective utilization of the program and slowly trickle it up to the doctors who have been their longer. Once they see the benefit it would hopefully be easier to persuade them. In order to solve the time issue their is really only one option: increase medical funding. Ten minutes is not enough time to make a thorough assessment of a patients health. Increased medical funding would allow for more time per patient and hopefully a more robust medical evaluation. Included in the evaluation could be the use of CPOE and DDS systems.