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    Backstage at the Medical Revolution

    Behind-the-scenes technologies are transforming medicine -- but who's gonna pay?

    Digital Imagery continued...

    Big deal, you say? It is if you're the one trying to clutch an envelope full of X-rays while maneuvering hospital corridors balanced on crutches.

    Not too long ago, only Superman had X-ray vision, but now every Dr. Tom, Dr. Dick, or Dr. Harriet with a computer terminal, the right software, and security authorization can peer into the inner workings of his or her patients to see whether the hip bone's connected to the thigh bone.

    It's the flashy stuff in medicine -- the latest miracle surgery or wonder drug -- that gets all the rave notices these days, but what goes on behind the scenes is also making subtle but important changes in how doctors practice medicine and how patients and physicians communicate.

    Barring Drug Errors

    Everybody makes mistakes, but when mistakes come in the form of the wrong drug or the wrong dose, they can be very costly indeed. In 1994, a mistake in the dosing of a chemotherapy drug for treatment of breast cancer cost Boston Globe health reporter Betsy Lehman her life.

    According to a 1999 report from the Institute of Medicine, an independent organization associated with the National Academy of Science, medication errors account for more than 7,000 deaths in the United States each year; another study estimates that "adverse drug reactions" (such as breathing failure caused by narcotics or anesthesia drugs) cause more than 100,000 patient deaths annually.

    The Institute of Medicine report, titled "To Err is Human: Building a Safer Health System" says that in most cases medical errors aren't the fault of a single person or group, but instead are caused by system failures.

    "[T]his is not a 'bad apple' problem," the IOM report says. "More commonly, errors are caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them. For example, stocking patient-care units in hospitals with certain full-strength drugs, even though they are toxic unless diluted, has resulted in deadly mistakes."

    To reduce the chance of fatal or harmful drug errors, the FDA in March 2003 proposed widespread adoption of a barcode scanning system for use with all prescription drugs and select over-the-counter medications as well.

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