Looking to prevent future mishaps, Texas Health said it has upgraded the hospital's EHR with a screening tool that prompts emergency room triage staff to take a detailed travel history. The system highlights that information in a large, red box at the top of the record. The hospital's EHR vendor, Epic Systems Corp., touts the flexibility of its systems to be configured to a hospital's needs.
Texas Health initially blamed the EHR system for its initial misdiagnosis of Duncan, but later retracted that statement.
The hospital has also put an increased emphasis on face-to-face communication between physicians and nurses to ensure that they don't rely solely on the technology.
In addition, new protocols dictate that patients should be asked about their travel history and their reason for coming to the ER within five minutes of walking in. Patients believed to be at high risk will be taken to an isolation unit by a nurse wearing full personal protective equipment or immediately taken to another hospital with an isolation unit.
Upon discharge of patients who've been cleared for Ebola, vital signs will be rechecked—if anything is abnormal, a physician is notified.
At a news conference Thursday night, New York Gov. Andrew Cuomo said that health officials are prepared to contain the virus because of the lessons learned from Texas Health Presbyterian.
“We are as ready as one could be for this circumstance. What happened in Dallas was the opposite. Dallas, unfortunately, was caught before they could handle what they were dealing with,” Cuomo said.
New York health officials reiterated Friday that they've learned what it takes to keep staff and other patients safe as they watched how events unfolded in Texas. Dr. Mary Bassett, the city's health commissioner, maintained that Bellevue's staff will be protected if they wear personal protective equipment properly.
“The doctor used personal protective gear” in Guinea, Bassett said. “We don't know what happened so that he became infected, and we may never know what happened.”
Only staff who have trained with protective gear for the last 2½ months will be allowed to treat Spencer, said Dr. Ram Raju, president and CEO of the New York City Health and Hospitals Corp., the agency that operates Bellevue.
“The people who have been trained to take care of this patient right now are highly skilled and well-trained nurses,” Raju said. “They've been training putting on the PPEs and taking them off and making sure what needs to be done.”
New York officials also said Spencer's girlfriend is in isolation at Bellevue and two of Spencer's friends who had close contact with him have been placed under quarantine.
Follow Adam Rubenfire on Twitter: @arubenfire
