Posted on 10/08/2014 4:30:48 AM PDT by Kaslin
A Dallas hospital's bizarre bungle of the first U.S. case of Ebola leaves me wondering: Is someone covering up for a crony billionaire Obama donor and her controversy-plagued, taxpayer-subsidized electronic medical records company?
Last week, Texas Health Presbyterian Hospital revealed in a statement that a procedural flaw in its online health records system led to potentially deadly miscommunication between nurses and doctors. The facility sent Ebola victim Thomas Duncan home despite showing signs of the disease -- only to admit him with worse symptoms three days later.
Hospital officials, who came forward "in the interest of transparency," initially cited workflow and information-sharing problems for the botch. "Protocols were followed by both the physician and the nurses," the statement noted. "However, we have identified a flaw in the way the physician and nursing portions of our electronic health records interacted in this specific case."
Mysteriously, after taking special care to get their facts straight before releasing the statement, the hospital backed off a day later. The very specific communications flaw in the medical records software -- which apparently had prevented some staff from accessing Duncan's travel history from Liberia -- suddenly disappeared.
What really happened?
Here's what I can tell you for sure: Texas Health contracts with Epic Systems for its electronic medical records system -- and the Dallas hospital isn't the only client that has complained about its costly information-sharing flaws and interoperability failures.
Epic was founded by billionaire Judy Faulkner, a top Obama donor whose company is the dominant EMR player in the U.S. health care market. As I reported last year, Epic employees donated nearly $1 million to political parties and candidates between 1995 and 2012 -- 82 percent of it to Democrats. The company's Top 10 PAC recipients are all Democratic or leftwing outfits, from the Democratic Congressional Campaign Committee (nearly $230,000) to the DNC Services Corporation (nearly $175,000) and the America's Families First Action Fund super-PAC ($150,000).
Faulkner, an influential Obama campaign finance bundler, served as an adviser to David Blumenthal. He's the White House health information technology guru in charge of dispensing the federal electronic medical records subsidies that Faulkner pushed President Obama to adopt. Faulkner also served on the same committee Blumenthal chaired.
Cozy arrangement, that.
Epic and other large firms lobbied aggressively for nearly $30 billion in federal subsidies for their companies under the 2009 Obama stimulus package. The law penalizes medical providers who fail to comply with the one-size-fits-all mandate. Obama claimed the new rules would cut costs and reduce errors. But health care analysts at the RAND Corporation admitted last year that their cost-savings predictions of $81 billion a year were vastly inflated.
Epic has been the subject of rising industry and provider complaints about its antiquated closed-end system. So much so that when Texas Health released its first statement about the software glitch in the Ebloa case, Jack Shaffer, a health care IT guru and top official at KRM Associates, immediately snarked on Twitter: "Guess Epic can't share data even with itself!"
Until recently, health care providers say, the company stubbornly refused to share data with doctors and hospitals using alternative platforms. Now, it charges exorbitant fees to enable the very kind of interoperability the Obama EMR mandate was supposed to ensure.
Another reality check reminder: The inspector general of the U.S. Department of Health and Human Services reported last year that no one is actually verifying whether the transition from paper to electronic is improving patient outcomes and health services; no one is checking whether recipients of the EMR incentives are receiving money redundantly (e.g., raking in payments when they've already converted to electronic records); and no one is actually protecting private data from fraud, theft or exploitation.
In July, The Boston Globe reported that there is still "no safety oversight of the vendors who sell" EMR and EHR systems. One malpractice insurance group revealed that it found 147 cases "in which electronic health records contributed to 'adverse events' that affected patients" -- 46 resulted in death.
GOP Rep. Phil Gingrey of Georgia cited criticisms of Epic at a congressional hearing this summer and asked: "Is the government getting its money's worth? It may be time for the committee to take a closer look at the practices of vendor companies in this space, given the possibility that fraud may be perpetrated on the American taxpayer." Not to mention the possibility of an impending Ebola epidemic.
The president-elect of the American Medical Association, Dr. Steven Stack, told Modern Healthcare magazine earlier this month that Epic's software architecture "often leaves out key information and corrupts data in transit."
Yikes. Imagine if some of that key data had to do with an Ebola carrier's travel history. Oh, wait.
Post to me or FReep mail to be on/off the Bring Out Your Dead ping list.
The purpose of the “Bring Out Your Dead” ping list (formerly the “Ebola” ping list) is very early warning of emerging pandemics, as such it has a high false positive rate.
So far the false positive rate is 100%.
At some point we may well have a high mortality pandemic, and likely as not the “Bring Out Your Dead” threads will miss the beginning entirely.
*sigh* Such is life, and death...
She’s a MORON to publish this, flat out! Inventing boogeymen because her political view says their must be one... Anyone claiming conspiracy around EMR systems being inoperable is either woafully ignorant, or a flat out moron. This author didn’t bother to do one miniscule amount of research into EMR systems at all, or she could have never written this... Or she did and wrote it anyway.
This one article makes anything she has written in the past immediately suspect.
Michelle is way out of her league here. Epic is one of the best EHRs available. I know. I’m stuck with one of the others...
Not even close. I’m stuck on a non epic system and can’t wait to go back. Epic is far and away the best system I’ve used and I’ve been in medicine 30 years.
Talk about somebody who needs to look in the mirror.
You call others a MORON while it is really you acting moronic.
Try reading what I said, I said anyone who is buying into this is either ignorant, or a moron.
Ignorant means you are unaware of the facts.
You are a Moron if you are aware of the facts and still believe this nonsense.
I think that mirror may need some time with you, because your post pretty much proved my point.
Look up EpicCare Everywhere. It interoperates with other Epic and non-Epic EHR systems.
I have it on good authority (the CEO of a hospital that uses Epic) that all versions of EPIC are different and unless you have the same version they don’t talk to each other.
Perhaps EpicCare Everywhere is a workaround solution to that. One would think that a hospital or medical care facility shouldn’t have to operate two different packages for EMR in order to function though.
I wish the title of this column was “Did Obamacare Kill Thomas Eric Duncan?” so people would actually read it.
I don’t think it was being spun as a political act, but rather as a serious flaw in electronic record keeping.
There was an obvious miscommunication at Presbyterian during Duncan’s first visit. The hospital is almost certainly going to get sued over it.
It’s important to highlight a problem that may be widespread so that it can be addressed.
DC does not make software purchasing decisions for private health systems.
bookmarking for later review
I’m sure you are correct. I work in Healthcare IT, and KNOW that a vendor has a basic product and it’s configured for a site. This was a failure on the user level.
Chances are, this was a dumb ass doctor(as most of them are) that dislikes computers, and doesn’t use the systems very well. They hardly ever read anything. I can tell you so many stories from our helpdesk guys and calls generated from stupid doctors. They also tend to be VERY belligerent and hateful. Since they believe they are “smart”, and the ultimate power in the universe, it HAS to be the “computer’s fault”, or “the system”.
Nurses aren’t a lot better, but they tend to be better users.
All I know, is after working in a hospital for about 10 years, I’ve come to the conclusion that I need to keep myself and my loved ones as healthy as possible, because you DO NOT want to put yourself in those people’s hands!(especially with the dark cloud of 0bamacare hanging over it all)
I got VERY sick last year, and I feel like I recovered just in time, for now anyway....
When it comes to systems communicating, that’s known as ‘interfacing’. Most use what’s called a ‘HL7’ protocol or language(I never got into that much). That’s a standard that vendors use to enable their software to communicate with other vendor’s systems/databases. Building and purchasing interfaces can be VERY expensive. Hospitals that have multiple non integrated systems often have an interface person in house to handle it all.
It sounds like from your post that different Epic VERSIONS don’t communicate, and that’s HORRIBLE!!!! They should insure backward compatibility when they make changes. It’s all a money racket really. Pay them to upgrade, or pay MORE to stay with your current version, because you’ll need to buy an interface from us. (they figuratively have a gun to their heads at that point)
Careful! My daughter is a nurse and she just started working in a Pediatric Intensive Care Unit that will be on the front line if Ebola hits our area.
Actually, versions of Epic are backward compatible. You have to go through a testing period, of course, and there will be issues that need to be fixed, but they are backward compatible. We're in the process of upgrading to the latest version now. It's a process, and there's work to do, but that's with any vendor.
I think the problem the other poster was referring to is that if one hospital is on one version of Epic it may have difficulty communicating with another hospital that's on another version of Epic. That's where Care Everywhere comes in.
It’s all a money racket really. Pay them to upgrade, or pay MORE to stay with your current version, because you’ll need to buy an interface from us. (they figuratively have a gun to their heads at that point)
I'm not sure I completely agree with you here, except for the part about the gun pointed at the customers' heads. Physicians and nurses are very demanding, and they always want new features. They drive the upgrade process. They DEMAND the EMR vendor create new capabilities. Well that costs money to do. You can't fault the vendor for meeting their customers' demands and charging them for it. It's incredibly expensive to add new features to a software package like Epic, and they have a right to make a profit from their investment of time and money. It's only good business.
LOL.....
My wife was a RN for years right out of high school, worked her way up to being a nursing unit manager, and is now a Nurse Practitioner at her own office. She's be the first to tell you that MANY nurses have no business doing what they are doing. After all of the textile jobs left our area, women that SHOULD have been sewing shirts and socks went into healthcare, and you can tell.... Most of those types don't last long though, because they either burn out, get fired for insubordination, drugs, or straight up incompetence. I'm amazed that so many of them get through the math portion of the RN program in school(LOTS of them wash out right there).
Working in IT at a hospital, I've seen it first hand myself. I'm NOT speaking from a position of ignorance here! lol
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