Ebola And EHRs: An Unfortunate And Critical Reminder

Lara Cartwright-Smith, Jane Hyatt Thorpe, and Sara Rosenbaum | Health Affairs Blog | October 28, 2014

The Dallas hospital communication lapse that led to the discharge of a Liberian man with Ebola symptoms is an example of the failure of the American health care system to effectively share health information, even within single institutions. It is not possible to know whether a faster response would have saved Thomas Eric Duncan’s life or reduced risk to the community and health workers.

What is clear is that rapid sharing of information is one of the elements critical to halting the spread of Ebola. Had all members of the initial care team known of the patient’s recent arrival from an Ebola-stricken country and acted appropriately to quarantine Mr. Duncan, this would have limited the chance of exposing the public and enabled faster preventive protocols for treating personnel.

In the search for answers as to what went wrong at Texas Health Presbyterian Hospital, a long list of things certainly went wrong. One is the way in which information was (or was not in this case) used at a critical point in the episode – when Mr. Duncan was transferred from the initial intake nurse to the examining physician.  Early reports indicated that the EHR system was flawed; according to hospital officials, the “documentation of the travel history was located in the nursing workflow portion of the EHR … [and therefore] the travel history would not automatically appear in the physician’s standard workflow.” The hospital subsequently retracted this statement, saying that “the patient’s travel history was documented and available to the full care team in the electronic health record (EHR), including within the physician’s workflow.”...