Friday, October 03, 2014

eBola? In my day we had to make do with Bola

(Not my joke, but I don't remember where I heard it.)

This is a follow up to the last post on the CDC's comedy attempt to stop Ebola from spreading in the US.  USA Today has a nice summary which I've excerpted here.

The apartment of the Ebola patient is finally being cleaned, so his partner does not have to continue to live with possibly infectious linen and other soiled items. (In case you've forgotten, she's cooped up in there because she's at gunpoint. You could argue that it would be more humane to take her to a nice clean quarantined hospital room, but no such luck. This is the USA.)
County officials say they had trouble finding a cleaning crew willing to sanitize the residence, but late Thursday night, a crew was seen entering the apartment.
One of the kids went to school on Wednesday, but the county has issued an "order" and the armed guard outside is enforcing it, so no more school until October 19th. No more visitors, either.
If someone else falls ill with a suspected case of Ebola, officials confirm they will likely be taken to Texas Health Presbyterian Hospital in Dallas by ambulance. Protocols have been put in place, though health officials declined to elaborate on the specifics of the protocols.
Let's see. If I remember HIPAA correctly, health officials aren't allowed to talk about general public health....No, wait, they ARE allowed to talk about public health protocols. It's individual patients' health records they are forbidden to discuss. Silence on this subject suggests they don't have any "protocols", or that they are so threadbare that they daren't expose them to scrutiny.

In the last blog entry, I wondered why the nurse had not flagged up the fact the patient had been to Liberia. Apparently the nurse did flag it, but there was a "flaw" and the information was not passed to doctors.
In their electronic records, physician and nursing workflows were kept separate, and the documentation of travel history was located only in the nursing workflow portion of the records. Since the flaw was discovered, the travel history documentation was relocated to a portion of the records that appears in both workflows, and has also been modified to specifically reference Ebola-endemic regions in Africa, hospital spokesman Wendell Watson said.
Sadly, I've worked in healthcare most of my working life, and I can totally believe this "flaw". It's entirely likely that some portion of the initial exam didn't get to the doctors.

Since nearly every hospital in the US has a different home-grown (and mostly incompatible with others) IT system, and they all have similar but interestingly different "flaws", good luck in not getting Ebola!

Update 10/04/14: There was no "flaw" in the IT system. The nurse didn't think to tell the doctor and the doctor didn't think to ask or to look in the IT system.

I've worked with infectious disease people, public health people and the CDC (a bit) for years and this is just hopeless behavior. I despair.

No comments:


Blog Widget by LinkWithin
I sometimes mention a product on this blog, and I give a URL to Amazon or similar sites. Just to reassure you, I don't get paid to advertise anything here and I don't get any money from your clicks. Everything I say here is because I feel like saying it.