Texas Health Resources modifies EHR despite assurances no flaw existed

Texas Health Presbyterian Hospital Dallas has made changes to its electronic health-record system, a hospital spokesman confirmed Monday. The announcement comes two days after the hospital's parent system rescinded a previous statement that an issue in its EHR system caused the hospital to release an Ebola patient the first time he came to its emergency department in late September.

The hospital system has changed its EHR software to move a question concerning travel history earlier in the process of inputting patient data for both nurses and doctors. The change was done quickly, though the spokesman could not confirm whether additional help from its vendor, Epic Systems Corp., was necessary.

Additionally, the hospital is conducting an analysis of all of its processes including information technology, the spokesman said.

The hospital is a part of the Texas Health Resources system, which has held itself out as a leader in successfully adopting EHRs.

Last year, Texas Health Resources won the Healthcare Information and Management Systems Society's 2013 Nicholas E. Davies Award of Excellence, which recognizes “outstanding achievement in the implementation and value from health information technology, specifically EHRs,” the group's website states.

Indeed, HIMSS touted Texas Health's return on investment, a claimed $152.8 million return over five years, according to a case study submitted with the award.

System officials also have touted the benefit the meaningful-use program has given the system. CEO Doug Hawthorne, in a 2010 radio spot, said that the investments were “putting us far ahead” of other local hospitals

Texas Health Presbyterian Hospital Dallas initially said a communication breakdown was responsible for clinicians releasing Thomas Eric Duncan after he came to the ED on the evening of Sept. 25 showing symptoms of Ebola, only to be admitted and placed in isolation on Sept. 28 after his symptoms worsened.

But then in a statement issued last Thursday, Texas Health Resources had cited a workflow issue with its EHR system as the reason doctors didn't know the patient had been in Liberia. “Protocols were followed by both the physician and the nurses,” the statement read. “However, we have identified a flaw in the way the physician and nursing portions of our electronic health records interacted in this specific case.”

THR then retracted that in a statement last Friday night. “As a standard part of the nursing process, the patient's travel history was documented and available to the full care team in the electronic health record (EHR), including within the physician's workflow,” the statement read. “There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event.”

Verona, Wis.-based Epic Systems has declined to comment on the events at the hospital or on any changes it may be suggesting for its EHR system. A competitor, Athenahealth, has added three very specific Ebola-related questions to its online EHR system.

Follow Darius Tahir on Twitter: @dariustahir