I realize it's been quite a while since I taught - or was in school myself - but I'm distressed…
Morning Headlines 10/3/14
HealthCare.gov Delays Web Host Switch
CMS misses its opportunity to switch web hosts for Healthcare.gov, and will now have to stay with Verizon through the remainder of the 2014/2015 enrollment period. Verizon’s hosting platform was cited as one of the problems that caused outages during last years failed launch.
Update on VA’s scheduling software system
VA CIO Stephen Warren clarifies that a new scheduling system will be installed across the organization’s 163 facilities by 2017, contradicting reports earlier this week that the system may not be live until 2020.
How Much? A Glaxo Goof Remains in the Sunshine Database
CMS’s new Open Payments may be live, but much of the data populating it is reportedly either missing important details, or outright erroneous.
The ONC posts a job opening for a new Chief Medical Officer to replace Jacob Reider, MD who vacated the position to take over as the deputy national coordinator.
Another big headline for today are the reports on the Ebola patient at Texas Health Presbyterian Hospital: “Officials with Texas Health Presbyterian Hospital in Dallas said its emergency room staff followed protocol by obtaining the required information from Thomas Eric Duncan, including the fact that he had recently been in Ebola-ravaged West Africa. But the hospital’s electronic health-records system has two workflows: one for nurses and another for doctors. ‘As designed, the travel history would not automatically appear in the physician’s standard workflow,’ Wendell Watson, the hospital’s public relations director, said in a written statement. Watson said the problem has been corrected.'” Texas Health Resources uses Epic.
Re: Just a Nurse Analyst’s remarks – this one bothered me too, but maybe for different reasons. I’m scratching my head and wondering why a physician wouldn’t be reading the notes documented by the nurse who initially triaged this patient. Is the software the problem or the workflow that doesn’t support an interdisciplinary approach to patient care? Hard to say with the details given, but I’d sure like to believe doctors and nurses see the value in reviewing each others notes! Perhaps Dr. Jayne can throw in on this one.
http://www.texashealth.org/body.cfm?id=1629&action=detail&ref=1872
An ED doc who treats an African man with high fever, vomiting, and diarrhea while the Ebola outbreak is national news and obviously recognized as a global crisis and does not ask about recent travel themselves is negligent will be found guilty of malpractice lawsuits from the patient as well as civil suits from anyone who contracts Ebola from that person.
This hospital was deflecting blame.
No matter what, this is the responsibility we accept as physicians. It’s our job to figure this out.
Technology can’t be a replacement (yet) for the thoughtful approach of a doctor. Even when it is convenient to blame technology.
What would the world look like if technology could blame people?
Texas Health Resources published a clarification:
“We would like to clarify a point made in the statement released earlier in the week. As a standard part of the nursing process, 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.
There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event.”
http://www.texashealth.org/body.cfm?id=1629&action=detail&ref=1872
Clarification posted by THR
http://texashealth.org/body.cfm?id=1629&action=detail&ref=1872
Josie….it’s the software AND the workflow. Magic is to have a system to ‘allow’ nurse charting to flow to the to other disciplines (physicians, et al) and the depth of the vendor to KNOW you need to do that and already have options to put it in place. Real magic is a company who ‘gets it’ about the clinicals and puts their money where their mouth is, and uses a lot of savvy IT clinicians.
Josie – hard truth – MDs are in their own world. They have a ton of work to do. No time to review possibly irrelevant comments by a nurse. If only they could weed out the important notes nurses make. It is a team. Systems need to make that transparent. They can do that, with the help of the local IT staff, for sure. Takes a lot of work and hours. Astonishing and unbelievable but many will read this problem of Ebola hitting the USA as a result of a nurse who didn’t share info verbally, and a computer system that did not properly alert physicians based on nurse notes.
Why isnt a fever and positive travel history to western africa considered a critical result that must be communicated to the MD with documented readback?
Kudos for calling out the uninformed knee-jerk reaction from arm-chair journalists who don’t know IT or healthcare (i.e. the Atlantic article). However, it is embarrassing when an industry “professional” decides to exploit this situation, hopefully a U.S. public health pandemic wake-up call/firedrill, for his own highly questionable agenda. Shamelss but predictible move by Jonathan Bush. Athena is also contacting trade journalists indicating that Athena is tackling this Ebola thing via the super duper healthcare cloud. Bravo, what a guy.