Skip to comments.Ebola, Electronic Medical Records and Epic Systems
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.
By the end of the week I think we will be plagued with tv ads from the Rose Law Firm......” Did one of your loved ones die from a medical miscommunication resulting from the use of the electronic records system called Epic? If so you might be entitled to monetary compensation”
If you live long enough to get a trial date.....
I am sure we will, but not quite yet
I thought that Care Everywhere was Epic’s interoperability solution. As I understand, it displays encounter information from non-Epic systems as well as the native data, if the patient opts in or doesn’t opt out.
I am a Michelle M. fan, but this article reveals that she is talking outside of her knowledge base.
Massively complex medical records systems are imperfect, as are those who configure and use them. It is the human condition in complex systems. Those systems add certain types of risk, but at the same time they reduce many more risks inherent in the old paper records systems. New systems greatly improve many types of communications and prevent many errors and omissions.
In terms of Epic vs other vendor products, Epic has domfinated the free market in sales for one reason: it is by far the best system overall. It is massively expensive, but it is so much better that other products are not selling in the world of health system software solutions. Judy’s company simply built the best mousetrap, and she is pulling far ahead of everyone else. Too bad she is a big liberal, but the software is non-partisan...
Not so, EPIC is a giant leap backwards in medical records keeping technology. So backwards that even “obesity” is no longer an acceptable clinical diagnosis.
EPIC is not the product of competitive bidding, but of beltway cronyism.
EHRs put the entire patient history at my fingertips. Paper gets lost, fades with age, etc.
The problem here is a breakdown in verbal communication. Ask anyone, the patient will tell the nurse one thing, the doctor something else. I have been asking all of my febrile sick patients about travel history, regardless if the nurse has asked or not.
Which, in turn, begets mediocrity at best, and gross incompetence in general.
I’ve seen and used many medical health records. They are all highly flawed systems with huge security gaps, bugs, and horribly maintained and structured databases. EHR’s are a scam. Once it’s online, whoever has access can pull up medical records. They are easier to steal, trade and sell then paper records. They are a massive disaster that will eventually cause millions of private records to be viewed online. It is a joke.
The reason sensitive information should be stored offline is because it is HARDER to steal. Obamacare basically ensures that soon American health records will all be on a database with low end security protocols and connected to private networks which have connections to the internet. All just waiting to be hacked, and misused. The records will be carelessly shared by people with no knowledge of how computer networks work under the guise of “public health” and “better [government run] healthcare”.
Here’s a contract to the lowest bidder with IT staff dumber then a monkey with a rock. That’s exactly what is happening right now. All the IT staff I know just cannot keep up with the emergence of new protocols, security flaws, and tech. There is too much out there. The IT staff at most of my jobs have been incompetent, lazy and arrogant.
Obesity is coded as 278.00 in ICD-9 and E66.2 in ICD-10. I am not sure why you say it is not a valid diagnosis.
What is unmentioned is that developing a health record protocol and system was not the object. The object of the exercise is to get paid for the work.
Just as Soylandra was designed to appear to be developing a renewable energy system EHr is doing the same with records
The real goal and purpose is to steal from the US Treasury.
The Democrat Party is a Criminal enterprise
Just point me to their GitHub page so I can verify that.
A link to this thread has been posted on the Ebola Surveillance Thread
While I do not have direct knowledge of what happened at Texas Health Presbyterian, I do have direct knowledge of the Epic EMR software. I am not an Epic employee, but I do use Epic and configure it on a daily basis. It is my day job. I have it running right now on the same computer I'm writing this post on. My son (also not an Epic employee) has implemented their ASAP Emergency Department application in both adult and pediatric emergency departments in three hospitals. What I can say is this:
Epic is an extremely complicated, comprehensive, highly configurable, integrated system of computer applications. NO hospital installs Epic without doing massive configuration to customize it to run the way they want. Many of those customizations have to do with who sees what data entered by whom. It is far more likely that the problem at Texas Health Presbyterian Hospital was due to the way they configured the system than to any inherent bug in Epic.
The fact that this has disappeared from the news is probably because Judy Faulkner, the owner/CEO/founder of Epic, probably called Texas Health Presbyterian and threatened to sue them for blaming their software. As soon as I saw that news article blaming Epic, I thought to myself "I'll bet Judy's gonna jump on that and squash it fast." And if it was due to Texas Health Presbyterian's configuration of Epic, and not to Epic itself, I don't blame her at all.
It will take them six weeks to find the right ICD 10 code for ebola...
Putting software in charge may be the problem. /s
IIRC, EPIC versions from one to the other don’t communicate with each other. I could be confusing that with another EMR system brand.
What a bunch of BS.. anyone who has worked in Health Care IT can tell you first hand, pretty much ALL EMR systems stink... none are interoperable.. EPIC, CERNER... et al.. .they are all proprietary systems designed to keep you locked in, its the business model of every one of them, there is no business incentive to release the data.
Problems with the VISTA scheduling component were at the heart of the VA problems with patients not being seen.
Etc etc etc...
To try to spin this as a POLITICAL act is NONSENSE... Anyone buying into some political conspiracy around EPIC being what it is because it gives to democrats is an abject ignoramous or a flat out moron.