Remember to take care of those who take care of us in a crisis, and other letters

Modern Healthcare's recent cover story “The other victims of gun violence” calls attention to the important fact that, in the wake of disaster, trauma workers often need support and counseling just as much as the patients they treat. In our 35 years of providing employee assistance program services and crisis support in response to hundreds of events, we've been called on to fill an increasing need to help first responders, trauma workers and even members of the media cope with the emotional toll of daily exposure to violence and trauma.

It's refreshing to read that, according to Dr. Leslie Zun, chair of emergency medicine at Chicago's Mount Sinai Hospital, the culture is changing and it's no longer considered a sign of weakness to reach out for help. We applaud employers that provide assistance for their employees. We also encourage businesses and employees to remember that the effects of trauma reach beyond direct victims. Resources and support should be available for all those affected, especially the individuals we rely on most to take care of us in a crisis.

Ted Uczen

FEI Behavioral Health

Milwaukee

The recent article “EHR safety goes to court” included this quote: “It looks like it's a round of litigation that's about to happen as the inevitable human errors in dispensing healthcare are now being traced back to negligent use of the computer technology,” said Robert Fuller, a partner at Nelson Hardiman and former chief operating officer at Downey (Calif.) Regional Medical Center.

This statement blames users, ignoring the reality of bad design. Based on reports now proliferating from some of the most reputable medical organizations, e.g., ECRI, the Joint Commission, the Institute of Medicine, National Institute of Standards and Technology and others, it's negligent design and negligent implementation that are far more a cause of a phenomenon called “use error,” as opposed to the “user error” described.

This is not simply a play on words.

“Use error” is a term used specifically to refer to user interface designs that will engender users to make errors of commission or omission. It is true that users do make errors, but many mistakes are due not to user error per se but due to designs that are flawed, such as poorly written messaging (or lack of messaging—no warnings of potentially dangerous actions), misuse of color-coding conventions, omission of information, etc.

Blaming the user is part of the problem that perpetuates bad health IT.

Adjunct professor of healthcare informatics

Drexel University

Philadelphia