CPOE vs. CAPTCHA vs. Diabetes.

You must be wondering what is CAPTCHA? This is an acronym which stands for “Completely Automated Public Turing test to tell Computers and Humans Apart". This is a combination of different letterers and numbers you see at websites for security and prevents spam.

Regardless of how fail-safe our security is; you will always need a human interface. Or maybe it is my intrinsic desire to be superior to computers.

I have been a strong supporter of CPOE (Computerized Physician Order Entry) as you may have read it in my previous post “I Stole A Cow”. Recently I came across a Leapfrog study. Leapfrog group partakes in reducing medical mistakes and try to improve quality of care. There has been several studies in the past regarding safety and reduction of medication errors. However, a recent study conducted at 214 hospitals using a simulation tool missed one half of non fatal appropriate warnings and missed one third of fatal  order errors. Now this is something to think about.

I was attending a physician staff meeting last night. The speaker pointed out how there is a degradation of clinical protocols with time as new data emerges every year. One prime example is Leuvin Belgium study regarding Intensive Insulin therapy for hyperglycemia. We all jumped and started to mimic these results. However, later we realized that intensive glucose control can lead to increase mortality as shown by NICE-SUGAR and VISEP protocols. Since then we have changed our target numbers for normoglycemia.

My point is, that though we see a significant benefit from utilizing all new protocols, devices and systems. But we should not loose our skepticism. In my heart I am a skeptic, not so much to ask God for an ID card but enough. I believe in this analogy that if one person calls you an ass, don’t worry about it, if two call you an ass, step back and think about it. If three does, get rid of the tail!