I am aware of the use of the word recidivism in the legal system and maybe I am using the wrong word. Throwing away a $250K investment as totally worthless,turning around and spending $375K on a new program to replace the other one. This is a type of buyers remorse that is the equivalent of spending $675K plus having to cost retrain the staff twice, loss of productivity of the practitioners twice. Phillip Longman compares VistA to some proprietary examples in this article.
Longman P. Code Red, how software companies could screw up Obama's health care reform. Washington Monthly July/August 2009.http://www.washingtonmonthly.com/featur ... ngman.html
"Things did not go so smoothly at Children’s Hospital of Pittsburgh, which installed a computerized health system in 2002. Rather than a godsend, the new system turned out to be a disaster, largely because it made it harder for the doctors and nurses to do their jobs in emergency situations. The computer interface, for example, forced doctors to click a mouse ten times to make a simple order. Even when everything worked, a process that once took seconds now took minutes—an enormous difference in an emergency-room environment. The slowdown meant that two doctors were needed to attend to a child in extremis, one to deliver care and the other to work the computer. Nurses also spent less time with patients and more time staring at computer screens. In an emergency, they couldn’t just grab a medication from a nearby dispensary as before—now they had to follow the cumbersome protocols demanded by the computer system. According to a study conducted by the hospital and published in the journal Pediatrics, mortality rates for one vulnerable patient population—those brought by emergency transport from other facilities—more than doubled, from 2.8 percent before the installation to almost 6.6 percent afterward. "
"Among the most notorious examples is Cedars-Sinai Medical Center, in Los Angeles, which in 2003 tore out a "state-of-the-art" $34 million proprietary system after doctors rebelled and refused to use it."
"According to Dr. Scott Shreeve, who is involved in the VistA installations in West Virginia and elsewhere, installing a proprietary system like Epic costs ten times as much as VistA and takes at least three times as long—and that’s if everything goes smoothly, which is often not the case. In 2004, Sutter Health committed $154 million to implementing electronic medical records in all the twenty-seven hospitals it operated in Northern California using Epic software. The project was supposed to be finished by 2006, but things didn’t work out as planned. Sutter pulled the plug on the project in May of this year, having completed only one installation and facing remaining cost estimates of $1 billion for finishing the project. In a letter to employees, Sutter executives explained that they could no long afford to fund employee pensions and also continue with the Epic buildout."
Throwing away a $154 million dollar investment is a dramatically different statement than a lukewarm acceptance rate of less than 50%.
The definition of "recidivism" that I found states: a tendency to relapse into a previous condition or mode of behavior; especially: relapse into criminal behavior .
While this term is most commonly used to describe relapse into criminal behavior my understanding is that it is the technical word to be used to describe buyer's remorse when a consumer takes a product back for exchange or refund. If this is not the correct word, what word should
I be using for the 17% of practice managers who are willing to throw away hundreds of thousands, or hundreds of millions, of dollars, because the software is so bad or completing implementation will bankrupt the facility?
Sam Bowen, MD