The Verona, Wis.-based firm has not made any direct modifications to its EHR software because travel history was already an element in the standard package, an Epic spokesman said. But, he continued, “We did recommend that every organization carefully review its triage and communication processes.” The company also has established a standing call to share best practices with its clients around communicable diseases.
Some EHR vendors tweak systems to cope with Ebola
That was one development in the health IT community's mobilization to better identify potential U.S. patients with the often-fatal Ebola virus, following the alarm last week when a Dallas hospital mistakenly released Thomas Eric Duncan, the first patient diagnosed with Ebola in the U.S. Texas Health Resources Presbyterian Hospital Dallas, which has an Epic EHR system, initially blamed the mistaken release of Duncan, who died Wednesday of Ebola, on a flaw with the EHR. The hospital later retracted that statement.
Dr. Brian Anderson, senior manager of clinical content at EHR vendor Athenahealth, said his company's cloud-based technology allows for quick adoption of communicable disease protocols. The company was alerted by the Centers for Disease Control and Prevention and a client about the need for Ebola screening questions mid-afternoon on Oct. 3. Within one hour, he said, Athenahealth had updated its EHR with recommended CDC questions to screen for Ebola risk, including travel and residence history, contact with animals from a geographic area facing high risk of Ebola, and contact with people known or suspected to have the virus.
“It's not something providers have to do on their own,” he said.
Other EHR vendors are taking varying approaches. A spokeswoman for Allscripts said her company's approach was “open” and therefore allowed for configuration by the clients themselves. “Our clients have the capacity to implement rules and alerts based on patient history, such as travel,” she said, adding that AllScripts would communicate best practices throughout its network.
A spokesman for GE Healthcare said in a written statement that its EHRs “enable customers to collect and act on patient information, such as recent travel history, presenting signs and symptoms, and lab tests. These capabilities can be used by healthcare providers to help manage infectious diseases like Ebola, as well as other conditions.”
Russ Branzell, CEO of the College of Healthcare Information Management Executives, said he's hearing from health system chief information officers around the country that they are making EHR tweaks rather than major changes in their record systems to address the issue.
He noted that when outbreaks of communicable diseases occur, the CDC typically recommends that providers follow standard procedures to identify potential patients with the disease. In response, CIOs typically tweak the documentation process in their EHRs, then make sure their healthcare providers are working in harmony with the changes. “The real key is to make sure everyone's doing them the same way, and that people are entering data appropriately in the record,” he said.
Despite the initial furor over the claimed EHR glitch in Dallas, Branzell argued that electronic records actually improve the healthcare system's effectiveness at identifying patients with infectious diseases. Under the old paper-based records system, he said, “You're trusting human beings 100% to follow processes.” In contrast, now the CDC can put out an alert and a health system can tweak its EHR to comply, meaning that all users in the system will follow the same processes.
Branzell cites his own recent experience as an example. After traveling to Abu Dhabi, he developed a respiratory cold that he was worried was Middle East respiratory syndrome. On his return to the U.S., he was pleased to find out that his doctor's office had an intake system that had been modified to ask about travel history because of a CDC alert on MERS.
Follow Darius Tahir on Twitter: @dariustahir
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