Recalls get issued with reasonable frequency. The crazy part is that clinics have no way of identifying exposures (patients) or inventory impacted by recalls because US hospitals do not capture unique device identifiers (UDIs) in electronic health records or their supply chain systems.
Honestly depends on how tight of a ship a hospital is run. I've seen plenty of Hospital systems that have their own asset tags so they can manage preventative maintenance routines and separate tags for finding the damn things. Mostly because doing that allows them to build a paper trail. I've also seen a couple hospital systems trade some very common equipment like infusion pumps though I'm not privy to the finer details of that.
Clinics get a little dicey, since they often do not have the same resources at their disposal that hospitals do, but you are unlikely to find anything much more advanced than an ECG in there.
The problems are pretty much getting the device to cooperate with the EHR (which is hard enough already) and attaching that information consistently to every patient (even John Does that paramedics drag in). And between those two, I can't really see equipment realistically being attached to every patient in a way that's consistent enough for a court to use as evidence. There's way too much room for nurses to just screw up between all of their different responsibilities.
No they don’t. I helped lead a failed effort to implement UDI capture at a major academic research hospital. To date only Duke and Mercy health systems have implemented UDI capture in a limited capacity.
The big problem is that implementation requires significant up front capital investment and operational changes; for nebulous / speculative ROI in terms of dollars. So organizational incentives are just not there.
Ultimately this is the type of problem that will require government intervention to solve. And that intervention will require the creation of incentives for organizations to implement UDI capture - similar to how it took an act of congress (Obamacare) to incentivize healthcare systems to adopt electronic health care records and protocols for communicating / sharing health care information.
UDIs of devices are typically tracked in the patients medical records.
What you are talking about is a central database with all of it. Yes, that would be good, but it doesn't mean that each patients UDIs of devices implanted or used isn't tracked (or supposed to be) within their medical records.
> The big problem is that implementation requires significant up front capital investment and operational changes; for nebulous / speculative ROI in terms of dollars.
This sounds like something like one field in a database?
It is. FDA requires manufactures to display UDIs in packaging (or devices themselves) in human and machine readable format. But hospital IT systems are not set up to capture this information and they have no compelling (i.e. financial) incentive to invest in the IT system upgrades and operational changes needed to capture this information. You would think better inventory management would be enough of a selling point, but apparently not. I am convinced that it will take government interventions - like CMS requiring UDIs on reimbursement forms - to get it done.
> Please don't complain about tangential annoyances—e.g. article or website formats, name collisions, or back-button breakage. They're too common to be interesting.
They might be too common to be interesting, but if we can't call them out they will never stop. And the fact that people still do this ridicilous stuff is newsworthy of it's own don't you think?
There should be a special place in hell for devs that do this. Trying to rank it in dev hell for ad tech/tracking devs and user hostile JS devs, and I think they are just two ballrooms on the same floor
I wish I had been on the committee when this change the browser API was proposed. I would obviously gotten kicked out for asking "just what the hell do you think people are going to do with this?". But at least I'd be somewhat infamous for asking the question when seemingly no one else was willing to.
I used it once for an SPA doing highly dynamic user surveys, users really wanted the back button to push them one question back, and depending on the path through the question graph back wasn't always "back".
Equating a frustrating anti-pattern of websites with medical equipment failure is extremely disingenuous. An infusion pump failure can harm a person, and according to the article, has seriously injured at least on person. Hijacking the back button isn't going to physically harm someone.
Well excuse me for being extremely disingenuous then. But the no harm argument is arguable incorrect, I myself might get a heart attack some day because of a dark pattern given how infuriating those things can be.
Presumably someone thought it was something that 1- met the standards for submission and 2- they wanted to discuss.
Dang has a post about submission standards if you're curious. Did you have a specific reason why it shouldn't be here? I've seen articles about everything from beluga whales to jelly beans posted, not everything needs to be about an emerging framework or IPO.
Recalls get issued with reasonable frequency. The crazy part is that clinics have no way of identifying exposures (patients) or inventory impacted by recalls because US hospitals do not capture unique device identifiers (UDIs) in electronic health records or their supply chain systems.
Honestly depends on how tight of a ship a hospital is run. I've seen plenty of Hospital systems that have their own asset tags so they can manage preventative maintenance routines and separate tags for finding the damn things. Mostly because doing that allows them to build a paper trail. I've also seen a couple hospital systems trade some very common equipment like infusion pumps though I'm not privy to the finer details of that.
Clinics get a little dicey, since they often do not have the same resources at their disposal that hospitals do, but you are unlikely to find anything much more advanced than an ECG in there.
The problems are pretty much getting the device to cooperate with the EHR (which is hard enough already) and attaching that information consistently to every patient (even John Does that paramedics drag in). And between those two, I can't really see equipment realistically being attached to every patient in a way that's consistent enough for a court to use as evidence. There's way too much room for nurses to just screw up between all of their different responsibilities.
They do for implants
No they don’t. I helped lead a failed effort to implement UDI capture at a major academic research hospital. To date only Duke and Mercy health systems have implemented UDI capture in a limited capacity.
The big problem is that implementation requires significant up front capital investment and operational changes; for nebulous / speculative ROI in terms of dollars. So organizational incentives are just not there.
Ultimately this is the type of problem that will require government intervention to solve. And that intervention will require the creation of incentives for organizations to implement UDI capture - similar to how it took an act of congress (Obamacare) to incentivize healthcare systems to adopt electronic health care records and protocols for communicating / sharing health care information.
Yes they do (I work in the industry)
It's required by law. Many implants have things in them they don't want put into cremation for example.
https://www.ecfr.gov/current/title-21/chapter-I/subchapter-H...
What is your source?
What you are talking about is different.
UDIs of devices are typically tracked in the patients medical records.
What you are talking about is a central database with all of it. Yes, that would be good, but it doesn't mean that each patients UDIs of devices implanted or used isn't tracked (or supposed to be) within their medical records.
I'm being told breast implants have serial numbers, but I'd readily believe that other kinds of implants don't.
> The big problem is that implementation requires significant up front capital investment and operational changes; for nebulous / speculative ROI in terms of dollars.
This sounds like something like one field in a database?
That seems crazy
It is. FDA requires manufactures to display UDIs in packaging (or devices themselves) in human and machine readable format. But hospital IT systems are not set up to capture this information and they have no compelling (i.e. financial) incentive to invest in the IT system upgrades and operational changes needed to capture this information. You would think better inventory management would be enough of a selling point, but apparently not. I am convinced that it will take government interventions - like CMS requiring UDIs on reimbursement forms - to get it done.
US health care is 1 needle of sanity in a haystack of crazy.
The problem with the devices (missing screws) leads to uncontrolled fluid amounts in IV pumps... which is dangerous.
[dead]
[flagged]
> Please don't complain about tangential annoyances—e.g. article or website formats, name collisions, or back-button breakage. They're too common to be interesting.
(https://news.ycombinator.com/newsguidelines.html)
They might be too common to be interesting, but if we can't call them out they will never stop. And the fact that people still do this ridicilous stuff is newsworthy of it's own don't you think?
There should be a special place in hell for devs that do this. Trying to rank it in dev hell for ad tech/tracking devs and user hostile JS devs, and I think they are just two ballrooms on the same floor
I wish I had been on the committee when this change the browser API was proposed. I would obviously gotten kicked out for asking "just what the hell do you think people are going to do with this?". But at least I'd be somewhat infamous for asking the question when seemingly no one else was willing to.
I used it once for an SPA doing highly dynamic user surveys, users really wanted the back button to push them one question back, and depending on the path through the question graph back wasn't always "back".
Equating a frustrating anti-pattern of websites with medical equipment failure is extremely disingenuous. An infusion pump failure can harm a person, and according to the article, has seriously injured at least on person. Hijacking the back button isn't going to physically harm someone.
Well excuse me for being extremely disingenuous then. But the no harm argument is arguable incorrect, I myself might get a heart attack some day because of a dark pattern given how infuriating those things can be.
How is this HN-related though? How did it even get on the front page?
> Please don't complain that a submission is inappropriate. If a story is spam or off-topic, flag it.
(https://news.ycombinator.com/newsguidelines.html)
A lot of us here work on medical devices. Besides that, it's just interesting to see how technology directly affects people.
Presumably someone thought it was something that 1- met the standards for submission and 2- they wanted to discuss.
Dang has a post about submission standards if you're curious. Did you have a specific reason why it shouldn't be here? I've seen articles about everything from beluga whales to jelly beans posted, not everything needs to be about an emerging framework or IPO.