Electronic-Record Gap Let Dallas Ebola Victim First Leave ER

A flaw in an electronic health records system is being blamed for the release of a man with Ebola into the Dallas area, because notes from nurses weren’t automatically sent on to doctors.

While the patient, Thomas Eric Duncan, told a nurse that he had been in Africa, that information wasn’t automatically included in electronic records seen by the doctor, according to a statement by Texas Health Presbyterian Hospital, where Duncan is being treated. The software is made by Epic Systems Corp., according to news releases and the hospital website.

“As designed, the travel history would not automatically appear in the physician’s standard work flow” within the electronic records system, the hospital said.

The documentation of the travel history was located in the nursing work flow portion of hospital notes, “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.

There are now 50 people in Dallas being monitored daily for Ebola symptoms, down from 100, said health officials. Ten are considered high risk and will be physically checked by health workers twice a day. The rest are lower risk and will be examined once daily and check in by phone, said Texas health commissioner David Lakey. So far none has developed symptoms.