The Ebola debacle at Texas Health Resources, and the possible role of the hospital's electronic health record system in the misdiagnosis of patient Thomas Eric Duncan, has spurred questions and action regarding how to improve EHRs in screening for the disease.
For instance, the Centers for Disease Control and Prevention (CDC) and the Office of the National Coordinator for Health IT held a webinar Oct. 16, soliciting industry feedback on increasing the ability of EHRs to screen for Ebola. An initiative launched in 2013, called the Public Health EHR Vendors Collaboration, is now focused on getting vendors to configure their systems to support Ebola screening protocols.
And, in an opinion article published in the Journal of the American Medical Association (JAMA) this week, Kenneth Mandl, M.D., of Boston Children's Hospital and Harvard Medical School, pointed out that Texas Health's EHR performed "exactly as expected" but as a one-size-fits-all technology, the system is designed for typical patients, where travel history is not especially relevant. In contrast, for patients such as Duncan, travel history was the "single most important aspect" of his screening.
Mandl recommended that changes relating to EHRs need to be made to combat Ebola, such as the use of applications for more clinical decision support and greater access to public health information.
EHRs have been found to be effective in screening for a multitude of conditions--if the EHR is set up to provide the screening. Workflow and communication issues have been cited as the cause of Texas Health Resource's failure to adequately treat the U.S.'s first Ebola patient. Texas Health Chief Clinical Officer Daniel Varga testified to Congress last week that the hospital has made design changes to its EHR to better screen for Ebola patients, including the use of pop ups and addition of more screening questions regarding patients' travel history.