- Texas Health Presbyterian Hospital has reversed its position that an error in its EHR software caused the Dallas hospital to miss an Ebola diagnosis and subsequently release the patient. According to a "clarification" released by the hospital on Friday night, "the patient's travel history was documented and available to the full care team in the [EHR], including within the physician's workflow." According to the hospital, "there was no flaw in the way the physician and nursing portions interacted related to this event."
- The hospital's initial statement claimed that its physicians never saw the note detailing the patient's relevant travel history. "The documentation of the travel history was located in the nursing workflow portion of the EHR, and was designed to provide a high reliability nursing process to allow for the administration of influenza vaccine under a physician-delegated standing order," the hospital said in a statement. As a result, the hospital said, "the travel history would not automatically appear in the physician's standard workflow."
- According to the hospital, it has now moved travel history to into the workflow of physicians as well as nurses and modified its EHR to reflect the regions of West Africa currently impacted by the epidemic.
There has been some speculation that the hospital's reversal of position is a result of pressure by EHR vendor Epic. Vendor contracts typically involve a gag clause and that the hospital might be ensuring that it wasn't in breach of contract seemed possible. However, an Epic spokesperson denied that this was possible, saying that such allegations "overestimate" the vendor's power. The spokesperson also dismissed claims that an Epic software malfunction was to blame.
What is not yet determined is why the patient was released from the hospital in the first place. While some industry participants blame EHR workflow, others suggest that a hospital culture in which physicians ignore nurse notes is to blame.
Meanwhile, vendors are quickly updating their systems to reflect the Ebola crisis. Athenahealth on Friday announced that it had updated its system to address specific questions related to the virus.