Ebola, the fear surrounding the disease, and criticism of how officials have responded to cases appearing in the U.S., has taken up considerable media attention. There’s already a wealth of second-guessing about the response of Texas Health Presbyterian Hospital, which had admitted a patient, Thomas Eric Duncan, treated and discharged him, and then readmitted the man when he lapsed into what was a case of the deadly virus.
Critics say that hospital management did not properly respond to the problem. Some people blamed the nurses, who defended themselves as following what the Centers for Disease Control and Prevention had instructed. The CDC is also taking its share of lumps.
But what few have discussed is the role the hospital’s information systems played. When Duncan first entered the hospital, he told a nurse he had just come in from Africa, but the information was not passed along. Had it been, doctors might have kept Duncan under observation and reduced the number of people he could have been in contact with.
A traditional weak point in medical systems has been the transmission of information. Routinely one care provider orders a test, another specialist or facility never receives the results and has to order another. One person writes something in a chart, someone else misreads the handwriting and takes action based on incorrect information.
Then there are hospitals that have software for various departments but no overarching integration to be sure all the information is available everywhere it is needed. A pharmacy might not have the drug history of a patient and so not be alert to the potential of a dangerous interaction between two medicines.
Information and communication are at the heart of the practice of medicine. And yet, with the industry having developed as a set of many separate care providers and practitioners, those two fundamental skills and activities are often poorly executed.
Integrated systems can improve efficiency and care while ultimately lowering cost. An adequate information system at Texas Presbyterian might have had an automatic alert for information that could indicate a number of potentially dangerous conditions, whether Ebola, bacterial meningitis, or measles. The easiest way to stop an outbreak of any communicable disease is to isolate cases and keep others from becoming infected.
Although the knowledge and input of healthcare professionals are critical, such information systems are ultimately the responsibility and purview of computer scientists and IT experts who understand the importance of electronic communication and automated responses to trigger conditions. Professionals should take the opportunity to remind executives in healthcare how what may seem low-level issues that can always be worked around can ultimately trigger a series of events that cause heartache, open a facility to legal liability, waste resources, and publicly sully an institution’s name.
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