Carl Dvorak, president of Epic Systems Corporation, is standing behind his company’s electronic health records system installed in the emergency department at Texas Health Presbyterian Hospital in Dallas.

Earlier this month, the hospital that initially misdiagnosed the nation’s first Ebola patient—Thomas Duncan—blamed a flaw in the Epic EHR, specifically a problem in the workflow between nurses and physicians at Texas Health Presbyterian. However, just a day later, the healthcare facility retracted their statement absolving Epic of any responsibility for the misdiagnosis.    

“In the Texas situation, a native African man told a nurse he had just come into the country from Liberia—which is ground zero—and had a 103-degree fever while he was there and he still got sent home,” Dvorak told Health Data Management. “And, then secondarily, the physician—maybe they didn’t read the nursing note, I don’t know—but obviously it was on the opening screen of the physician’s workflow.”

“So, it got missed by the nurse who actually documented that the patient came from Liberia—that’s a knowledge gap,” he said. “And, it got missed by a physician.”

Consequently, Duncan was treated and released, only to return to the hospital where he was admitted for treatment of Ebola and later died from the disease. In testimony Oct. 16 before a congressional hearing, Daniel Varga, M.D., chief clinical officer at Texas Health Resources conceded that mistakes were made and that Texas Health Presbyterian Hospital has since made changes to its Ebola screening process and to its EHR to increase the visibility and documentation of information.

As part of those changes, the hospital now asks questions about a patient’s travel history earlier in the triage process as they first enter the emergency department.

“What they did is they reconfigured the outer triage person—the waiting room triage person—who now has to do the travel screening, in addition to the back room triage nurse,” according to Dvorak. “They have also made it into a hard-stop pop up alert [when there’s a positive travel history and flu-like symptoms], whereas before it was simply document and communicate. And, they’ve actually added a few more questions. In particular, they want to know if you handled dead animals or touched a person that was sick with Ebola—they specifically ask that.”

“I’m not sure that the whole world thinks that’s the right way to do it, but it’s certainly appropriate for them at this time,” he says.  

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access