David Hallberg

When No News Is Bad News

In a recent evaluation of a hospital’s Millennium system, I was surprised at the small number of entries in some of the facility’s message log files. While most of you would salivate at the thought of an empty log – and the promise it held for a relaxing lunch break – I was intrigued and wondered what they had done to the system to correct the longer list of errors and warnings that typically appeared in the log files. My intrigue turned to concern when I discovered that nothing had been done.

As I dug further into this hospital’s system, I discovered the problem: Errors were still occurring, but they were being suppressed instead of logged. Had this suppression continued, the hospital ran the real risk of compromising patient care.

The culprit was Millennium’s messages.suppress file, which stops Millennium from writing out these messages. The file is a legitimate place to define a list of unactionable informational messages that would otherwise clutter your log files and slow down your system. In this instance, however, entries that potentially contained critical information relating to system operation and patient care – such as APPAUTH, ESO and ScriptErrors – were included on the suppression list and disappeared from the system. Without these error messages, there was no record of a problem and therefore no way to research an issue and correct it.

I strongly encourage you to obtain the messages.suppress file ($cer_mgr/messages.suppress or CER_MGR:MESSAGES.SUPPRESS) from the back end of your system and examine it closely. If there are any events defined in the file, you need to determine who put them there and why. When entries are either added or removed from the messages.suppress file, you must cycle all of the appropriate server processes to make the change take effect. If, upon investigation of your messages.suppress file, you have questions about what an entry means, I will be more than happy to discuss it with you.

The bottom line – you don’t want to suppress errors. You want to fix them and ensure that the system does not hamper your clinicians from providing the best care they can deliver. You also don’t want to open your organization to significant liability issues without any mechanism for defense.

Prognosis: We caught this hospital’s suppression problem before any patients were affected. We hope you can say the same.