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Alumni Dispatches

Intensive Technology

Marcelo Cardarelli, MD, MPH ’06

Marcello Cardarelli Barren is the word that would best describe the technology of the first intensive care units (ICUs) at the dawn of the specialty. Signs, symptoms, the initial attempts to measure blood gases and an embryonic mechanical ventilation, were as sophisticated as things got.

Today, displays and screens saturate our senses with data and imagery and the use of electronic medical records (EMR) has seized the stage. While the use of EMR has potential to reduce the occurrence of pharmacological adverse events, other hypothetical advantages of their use in the ICU, at least as currently designed, have failed to materialize.

While EMR may eliminate the logistic problems of the paper ones, they have not completely replaced the use of paper. Healthcare personnel in ICU environments, still use paper-based workarounds (small lists) for efficiency, risking error in transcription and defeating one of the guiding principles behind the push for universal adoption of electronic medical records, which is data soundness.

The incentive behind the use of unsafe shortcuts is not necessarily rooted in the legendary notion of resistance to change on the part of clinicians but rather the levy, unintentionally imposed, by a medical record system designed from the perspective of a software engineer while having a general practitioner in mind.

Throughout history, as innovative technologies from the wheel to the computer, disrupted the status quo of civilization, our very human response has fluctuated between the norm and the exception. The norm has been the spontaneous embracement of those tools that allowed us to carry out complex tasks with ease. The exception has been the unenthusiastic resignation to accept poor fit-to-use technology due to the lack of anything better or simply because we are mandated to use it. On the subject of electronic medical records in the ICU environment, the exception seems to be the norm.

Marcello Cardarelli, formerly an assistant professor of surgery at the University of Maryland, serves as Scientific Advisor at Blnk Medical Technologies.

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