If you are someone who deals with interfacing digital systems (EMRs, PMS, PACS, etc) in the medical industry or you are about to attempt it, I am sure that you have experienced some of these issues.
I’ve been doing healthcare integrations for quite a few years, and I have prepared a laundry list of troubleshooting questions and techniques based on my experience. When things don’t work as planned (or don’t work at all), having a consistent approach to finding the solution is vital.
The following list is not prioritized in order but should give some very good approaches to dealing with healthcare integration issues.
- Did the components of the system ever work properly? (It’s a surprisingly valid question!)
- See the problem for yourself! Reproduce the problem, if at all possible.
- What was the person doing when it broke?
- Ask very specific questions (Understand the REAL problem!)
- Check out things that YOU have CONTROL OVER first! (When you turn it over to someone else, it will now be done in THEIR time frame, NOT yours.)
- Try the simplest things first. Use the OSI model from the bottom up to find the easiest problems first.
- Prove what it is NOT. (Eliminate what’s not wrong.)
- Is it correctly setup and/or configured?
- Did you reboot? (This might resolve the problem temporarily, but if it is hard to reproduce. Don’t do it unless you absolutely have to.)
- Were things customized? (The impact of system customization must be considered.)
- Does it happen with other users or applications?
- When was the last visitor?
- Don’t make assumptions.
- Understand the workflow.
- Has this happened before?
- When did it happen – in time?
- What happened between when it worked and when it didn’t? (Look for system changes.)
- Was there a power failure?
- Talk to IT or the network admin about anything being done on the network or server.
- Is anything thing else down or not working properly?
- Please get the EXACT error message (the whole thing!).
- Do you know how it is supposed to work? Does the operator only think it is supposed to work a certain way but it is designed to work the way it does.
- Were there other errors before this error (cascading errors). It’s vital to find the root cause, not just the latest or last symptom.
- Is user telling the truth about what they did or didn’t do? No one likes to admit to his or her mistakes. Now is the time for diplomacy and some delicate and clever questions.
- Does it have remote access? Another user might be accessing the system.
- Check with different people about how it is supposed to work.
- Check that all network wiring is plugged into the correct connections.
- Check that the initial setup was done correctly.
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