Falling Back

Twice a year we warp time... and frustrate clinical time keeping. Yes, tonight the clocks fall back an hour as daylight saving time retires for another year.

The DST experiment started about 100 years ago to see if energy consumption (principally coal) would be reduced by bringing more work into daylight. We've learned that the opposite happens. Worker productivity suffers as well.

Whatever our gripes about gaining or losing an hour's sleep, serious information management problems confront those caring for patients when 02:00 becomes 01:00. For example, whether a change in blood glucose occurs over an hour, or a minute, can radically affect insulin drip protocols.

With a clinical information system in play, time distortions also distort medication administration records, clinical decision supports, and countless other digital details; especially if interoperating and interfaced systems handle DST-adjusted timestamps differently.

The biannual DST challenge is not handled consistently by health information systems. We'll need to plan and train for how Connect Care will cope (and vote against DST anytime the opportunity arises!).