The news this week that Thomas Eric Duncan succumbed to the Ebola virus while being treated at Texas Health Presbyterian was a stark reminder of the ephemeral quality of life, the everyday courage of hospital-based healthcare providers and the importance of communications in that endeavor.
Hospitals are big, complex organisms with multiple systems and workflows, and significant hope—and $25 billion in taxpayer dollars—has been invested in recent years in the potential of information technology to improve the quality of healthcare in the U.S. The announcement by Texas Health Presbyterian that a procedural flaw in its electronic health record (EHR) was responsible for Duncan being released from the emergency room on the night of September 25 was disappointing. It should not, however, have surprised anyone in healthcare.
“In our electronic health records, there are separate physician and nursing workflows,” the health system acknowledged in a prepared statement. Without workflows attuned to individual healthcare providers, EHRs would be gathering dust in hospitals.
This statement was prepared for an anxious public (and media) looking for reassurance that the virus would not be coming to their community anytime soon. For healthcare, it simply is a reminder that while the technology must serve the workflow, the information must serve the patient.
Duncan, who concealed the fact that he had been exposed to the Ebola virus in Liberia, returned to the emergency room at Texas Health and was admitted on September 28. After a valiant effort to save him failed, the first Ebola patient in the U.S. died on October 8.
America is well advised to keep in mind that it is not a lack of EHRs in Liberia that gave rise to the epidemic. The unavailability of plastic gloves is the greater culprit.