For years we’ve been told that electronic health records are going to save health care in America, making it less expensive and ensuring that patients get the right, medically-appropriate care. I have no doubt there’s a role for electronic health records, although it’s an extremely dubious proposition that the federal government is the right entity to be leading the charge in their adoption and implementation.
Today we learn that one of the reasons Thomas Eric Duncan, the patient with ebola in a Dallas hospital that has caused such concern, was sent home on Friday after complaining of ebola-like symptoms (and to be fair, also flu-like symptoms) even though the nurses knew he had recently arrived from Liberia was that the information about his travel was not available in the electronic health record to the doctor who saw him. The Huffington Post reports:
Dallas Ebola patient Thomas Eric Duncan did tell a hospital nurse that he had been in Africa when he first visited the hospital with a fever and other symptoms, but due to a flaw in the hospital’s electronic health record workflows, that travel history was not communicated to physicians at the hospital, according to newly released information…
When asked about his travel history over the last four weeks, he said he had traveled to Africa. This information was entered into his electronic health record by the nurse.
According to the statement, doctors and nurses all followed the necessary protocols when administering to a patient with suspected communicable disease. However, the way the electronic health records at the hospital are set up, if a nurse enters travel history into the nursing workflow portion of the electronic health record, that information doesn’t automatically show up in the doctor workflow portion of the record…
The Obama administration and Congress has poured $30 billion or so into medical practices and hospitals to subsidize adoption of electronic health records, and will soon start penalizing providers who don’t use them the way the federal government wants by reducing their Medicare reimbursements.
In a sane world, we’d have the bugs worked out before the government starts penalizing people for not adopting their preferred system (in a really sane world, we’d let doctors and hospitals themselves figure out whether they want them and how to adopt them, instead of having government dictate to them). Alas, that is not the case.