Excluscive Article at EMRIndustry.com
Ebola has been disrupting the medical community, academia, transportation, security, government, media and the lives of people across the globe. The finger-pointing itself has has been infectious with the medical community itself being hit the hardest. There has been a great deal of wrong information spread.
Now that a bit of the smoke is clearing, we have identified a few facts. If you stand next to a medical professional, particularly one using an EHR, chances are you will not be infected by Ebola. What you can catch is disease spread by misinformation.
What causes a patient to sent home with 103 degree fever are gaps in EMR communications. The right medical professionals are not receiving the right information at the right time. Passive data and lack of push technology are the major causes. We can prevent these issues with technology available today.
Article in Detailed :
By Donald M. Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room, Assistant Professor of Anesthesiology, Case Western Reserve University and Northeast Ohio Medical University.
A board-certified anesthesiologist, researcher, medical educator, and entrepreneur. With more than 15 years of experience in healthcare, Dr. Voltz has been involved with many facets of medicine. He has performed basic science and clinical research and has experience in the translation of ideas into viable medical systems and devices.
Thanh Tran, CEO of Zoeticx, Inc. also contributed.
The recent Ebola outbreak has highlighted new healthcare challenges and finger-pointing has started very quickly. First at the EHR system as it fails to highlight the previously recorded data about the patient’s recent travel history. The failure to bring these details to the emergency physicians leads to a discharge of patient Eric Duncan. A Recent article by Jeff Riggins in EMR Industry.com has correctly pointed out that it is miscommunication among care providers and not an EHR system problem (in this case, Epic). It should be classified as a preventable medical error due to a miscommunication/omission.
Not long ago, we had a similar case with a patient in New York – Rory Staunton. This 12 year old boy died because of another preventable medical error due to miscommunication. Rory was sent home with a diagnosis of upset stomach and dehydration. Meanwhile, the missing data about a septic shock was recorded with his increased fever and lab test results in the EMR system, but once again, not brought to the attention of the physician quickly enough to remedy the situation.
There is even one yet-to-be-published case in Ohio where a patient died from a simple hernia operation. The case is quite similar to the above where an EKG was ordered prep and was posted to the EHR about 10 minutes before a patient was taken to the operating room. No one read the EKG as the patient had just had a normal EKG a few days earlier as part of a prep screen. However, the EKG taken right before the surgery showed acute ischemia. The patient died in the recovery room. Again, all the data was recorded in the EMR system, but failed to be communicated to the physician.
These preventable medical errors may appear under different forms, cases, healthcare institutes, and different impacts, but there is one common denominator–miscommunication or omission of critical patient medical information to care providers. The video ‘Life almost lost’ by Zoeticx summarizes the missing components in healthcare – communication and collaboration among care providers. Jeff Riggins has identified that it is the miscommunication leading to the discharge of patient Eric Duncan and not an EHR system problem.
An EHR system is a recording system where care providers search relevant patient medical data for their patient’s diagnosis. Misdiagnosis in this case is not about missing data, but the fact that the data fails to present to physicians the correct diagnosis outcome. Would this particular Ebola case differ from Rory Staunton, the recent Ohio case, or the theoretical case of Billy White?
EHR Systems – Recording Patient Medical Data
The issue is about recognizing that any current EHR is a passive database component. As any other passive database components in other industries (finance, manufacturing, etc.), they do not address the challenge of presenting information to the decision maker, let alone being timely. The issue is about understanding that there must be applications designed in healthcare to bring information forward to physicians in order to prevent such medical errors. None of the EHR systems perform that task because it is a passive database component. Most of the tasks to bring such information to physicians have been located on the ‘customized solutions’ built specifically for each healthcare institute, addressing some of the basic needs for physicians.
The medical industry is falling into the expectation that EHR systems, once deployed, would address all the needs of care providers. The flaw in our healthcare system is to accept that assumption, also incorrectly supported by EHR vendors.
The reality is that US healthcare needs to inspire a next set of innovative solutions, focusing on supporting care providers. In order to achieve such inspiration, the healthcare industry must figure out how to address EHR interoperability and EHR agnostics. This will free up independent developers from draining their resources in addressing the infrastructure challenges created by EHR vendors and considering those offering options such as Open APIs. These types of solutions are being offered by next generation EHR connectivity providers such as Zoeticx.
Healthcare Challenges – How to Improve Patient Outcomes!
Eric Duncan and Rory Staunton have the same outcome from the same characteristics of preventable medical errors. Both cases raise the attention of our nation, and then are soon forgotten when the media switches its focus on other news. The difference is that the Eric Duncan case is an epidemic one and Rory Staunton is an individual patient outcome.
However, from the standpoint of patient outcome, both are preventable medical errors that claim 400,000 US lives per year. It is time to get the innovation going in healthcare, starting with addressing EHR interoperability and EHR agnostics and the acceptance that EHR systems are simply a data component in the whole equation.
We need to stop blaming EHR systems and begin recognizing that the journey ahead needs more than EHR systems!
