Friday, October 3, 2014

EHR software and ebola, what could possibly go wrong?

Forget malware on medical devices. Try ebola. The Atlantic is reporting that software flaws in the exchange of Electronic Health Records (EHRs) is partly to blame for an ebola patient being sent home from Texas Health Dallas.  More information appears on the hospital's website.

According to Bloomberg news, the EHR software at Texas Health Dallas is made by Epic Systems Corp.

1 comment:

  1. One should be careful before assuming what comes from the EHR vendor and what is customized at the hospital level. The hospital website refers to Nurse and Physician workflows. In my interactions with EHRs, these workflows are highly customized by the hospitals and clinics to meet how they want to practice medicine. The comment about the nurse workflow being connected to a standing order for influenza vaccine also speaks to how much these workflows are tied to the billing process. The workflow has all of the steps to ensure that billing documentation is created and the bill is submitted - they want to get paid.

    So, it is unclear at this point whether the lack of visibility of the travel information collected in the nurse workflow to be seen in the physician workflow is an "out of the box" setting in the Epic system, or something customized at the hospital request, and they only now recognized the risks inherent with such a design and are telling other hospitals to not make the same mistake.

    Customizations of EHR workflows are frequently done by hospital IT staff who go through specialized training with their chosen EHR vendor to make such customized options. A "big iron" EHR may require several full-time staff at the hospital to maintain and update.

    All that said, the foolish notion that EHR software is not safety critical, and should not be subject to the basic requirements of software design controls is put in pretty harsh light here.

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