Texas Hospital Updated EHR Protocols in Wake of Ebola Misdiagnosis, Death

The Texas hospital that treated the first patient in the US to die from Ebola announced changes in its electronic health record (EHR) workflow intended to flag patients at risk for transmitting the disease.

Following the admission of Thomas Eric Duncan to inpatient care at Texas Health Presbyterian Hospital, hospital officials admitted that Duncan had been misdiagnosed in the facility’s emergency department (ED), which caused his condition to deteriorate rapidly.

In a statement released on October 2, Texas Health officials said that the attending physician treating Duncan was not aware that he had recently been to Liberia. The hospital blamed the misdiagnosis on workflow problems in the EHR—specifically, they said an individual’s travel history is tracked in the nursing workflow but not the physician workflow.

However, the following day, Texas Health backtracked and said that travel history information is accessible by all members of the care team, Health Data Management reported.

In his testimony to Congress, Daniel Varga, MD, chief clinical officer and senior executive vice president at Texas Health detailed its ongoing efforts to improve the way its EHR screens for Ebola symptoms as well as other infectious diseases.

These measures include a better placement and title of the screening tool, and expanded screening questions that cover areas such as:

  • Exposure to persons known or suspected to have EVD (Ebola virus disease)
  • High-risk activities for persons who have traveled to Ebola endemic areas (i.e., “Have you touched a dead animal or helped carry someone sick?”)
  • A pop-up identifying the patient as high-risk for Ebola with explicit instructions for next steps if the answer to any of the screening questions is positive


Click here to read Varga’s written testimony in full.


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