Missed Ebola diagnosis leads to debate

Missed Ebola diagnosis leads to debate

A statement from the 25-hospital Texas Health Resources explaining why critical travel information was not communicated regarding the nation’s first Ebola patient has left many wondering where the problem occurred. And, more importantly, how to fix it.

On Oct. 1, THR issued a statement, which appeared to point fingers at THR’s Epic electronic health record system versus potential human error, saying that a flaw in the interaction between the physician and nursing portion of the EHR caused the patient’s travel history to not appear in the physician’s standard workflow. Epic contacted Healthcare IT News to highlight that Texas Health Resources had issued an Oct. 3 correction to their initial statement. They declined to comment on anything further.

In its Oct. 3 statement, THR officials said there actually was “no flaw in the EHR in the way the physician and nursing portions interacted related to this event” and that the patient’s travel history “was available to the full care team” in the EHR including the physician’s workflow.

The controversy and contradictions started when Thomas Eric Duncan, diagnosed with the Ebola virus Sept. 29 at Texas Health Presbyterian Hospital in Dallas, told his nurse he had been in Liberia prior to his arrival in the U.S. The information, THR officials say, was entered into the EHR. But the information somehow did not reach the appropriate clinicians. Duncan was then discharged from the EHR. THR declined to comment further.

Clinicians and IT professionals who have commented on the statements have debated over whose mistake caused the failure to communicate Duncan’s critical travel history to physicians.

Outspoken patient privacy advocate Deborah Peel, MD, weighed in on THR’s initial statement. “Paper records and electronic records both have errors, that’s why the physician has always been responsible for making his/her own independent assessment – which means talking with the patient,” she said. “EHRs can’t replace the patient-physician relationship.”

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