Ebola or Epic: Which do US hospitals fear more?

How's that for workflow?

How’s that for workflow?

I don’t laugh easily, but I did chuckle when I heard that a Texas hospital was blaming its electronic medical record for the hospital’s mishandling of the first Ebola case in the US –a patient who had flown in from Liberia. According to the hospital, the patient told the nurse he’d been in Liberia, she documented it, but somehow that information didn’t make it to the doctor due to a workflow problem. The patient was released, got sicker, may have exposed others in the community, and then returned to the hospital. Somehow I knew this explanation wouldn’t be the end of the story.

Sure enough, a few days later the hospital issued a “clarification,” stating that “there was no flaw in the way the physician and nursing [workflows] interacted.” But there was still no word on why the patient was discharged.

iHealthBeat (Dallas Hospital Issues ‘Correction,’ Says ‘No Flaw’ in EHR System) does a very nice job of summarizing the situation and speculating on what really occurred. Here’s my guess at the truth, in order of likelihood. I’ll also note that all of these factors may be true:

  • Doctors stumbled through an awkward EHR workflow. Responsibility for the mess-up is shared by the EHR vendor (Epic) and whoever supervised and trained the physicians using the system
  • Epic –big gorilla that it is– put pressure on the hospital to issue a retraction. (Epic denies this but I’m skeptical)
  • Doctors tend to ignore nurses’ notes. “They ignored them when they were on paper, and now they ignore them on the computer,” according to a Biomedical Informatics professor

It’s worth mentioning that cloud-based athenahealth adjusted its workflow right away to emphasize Ebola-related questions, something that would be a lot harder to do with Epic.

photo credit: Keoki Seu via photopin cc

By healthcare business consultant David E. Williams of the Health Business Group

3 thoughts on “Ebola or Epic: Which do US hospitals fear more?

  1. Jon Kamp

    Ebola in USA – I Agree with Judge Jeanine Pirro about what to do!

    Help Do Something – Sign the Petition Now! And Spread the Word Not The Virus!

    https://petitions.whitehouse.gov/petition/have-faa-ban-all-incoming-and-outgoing-flights-ebola-stricken-countries-until-ebola-outbreak/FFJHH9yX

    The 1918 Flu Virus Pandemic infected over 500 million people across the world, including the USA, remote Pacific islands and the Arctic, and killed 50 to 100 million of them, that’s a 10 to 20 percent death rate.

    A large factor in the worldwide occurrence of this flu was increased travel. Modern transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease.

    Now we have Jumbo Jets and the Ebola Virus….. With a 70 to 90 percent death rate!

    Help Do Something – Sign the Petition Now! And Spread the Word Not The Virus!

    Reply
  2. Pingback: Ebola and the bigger patient safety issue | Health Business Blog

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s