The Diatek Arkive 'Organizer' patient information management system: Experience at a university hospital

To install and successfully use early commercial automatic anesthesia recordkeepers, the Diatek Arkive `Organizer' units, in the operating rooms at a major university medical center. Because of the history of previous academic attempts at automatic anesthesia record-keeping, the units were installed on a `surprise' basis, with hardly any discussion of the devices beforehand. The devices themselves had a number of minor difficulties at the start, most of which were promptly corrected. Eventually the units were in use in all non-cardiac general operating rooms. At one point, usage reached over 90% of possible cases. Continued opposition to the device on the part of certain individuals, coupled with the obsolescence of the present devices in light of new technology, led to the eventual abandonment of the system and removal of the devices from service. Total resistance to the new devices on the part of a few vocal faculty members was a major factor in the ultimate downfall of the system. The method of introduction, and especially the lack of involvement of faculty, residents, surgeons, operating room personnel, hospital computer personnel, and the hospital administration in the installation also played a role in the failure of the system. Lack of a workable training mechanism for new residents prevented that user group from rapidly gaining comfort with the systems.