Sunday, October 05, 2014

Bad Software, Bad!

Inflammatory headline:

The Ebola Patient Was Sent Home Because of Bad Software
The Dallas hospital's debacle highlights the atrociousness of many electronic health records.

Actually, the hospital made an initial claim:

"Protocols were followed by both the physician and the nurses. However, we have identified a flaw in the way the physician and nursing portions of our electronic health records (EHR) interacted in this specific case."

But then, the hospital seemed to take it back:

“We would like to clarify a point made in the statement released earlier in the week. 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, including within the physician’s workflow,” the statement said. “There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event.”

There's a lot of careful wording there, as if people were afraid of lawsuits for some reason.

I think the key word here is "available", as in the travel history was "available" to the physician. Probably (wild guess) that means the doc could have clicked a button that he didn't click. Probably in retrospect it would have been nice if the first thing he saw when he brought up the patient's info was a big blinking red banner that said "African! Feverish!".

It turns out that making that happen is one of those things in you configure in the software package:

"As a result of this discovery, Texas Health Dallas has relocated the travel history documentation to a portion of the EHR that is part of both workflows. It also has been modified to specifically reference Ebola-endemic regions in Africa. We have made this change to increase the visibility and documentation of the travel question in order to alert all providers. We feel that this change will improve the early identification of patients who may be at risk for communicable diseases, including Ebola."

You see, the software didn't fail. It just needed to be configured differently.

I'm sure the software did its best.
Calling it "bad" just makes it feel stressed.

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