When I showed up at the obstetrical urgent care unit at Brigham and Women’s Hospital, the care I received was swift and appropriate. I saw a nurse quickly and a doctor soon after. They asked relevant questions and immediately put a plan for further evaluation in place. Only then did the nurse turn to the computer to enter everything into the electronic record. As she worked her way through the required documentation, she asked several more questions. Any allergies that weren’t already in the system? Surgeries she should note? And, of course, importantly, had I been to an Ebola-infected country recently?
In September 2014, Texas Health Presbyterian Hospital missed acting upon the fact that a patient had just returned from West Africa, even though it was documented in his record. He came down with Ebola, but wasn’t treated with appropriate precautions, and many patients and staff were put at risk. The hospital was publicly criticized for its behavior. The hospital administration responded by blaming its electronic health records (EHR), since the system didn’t bring the travel history to the forefront as part of the doctor’s workflow. Since then, hospitals have scrambled to systematically screen for the often-fatal virus that took more than 10,000 lives in the past three years. Hospitals have incorporated a relevant screening question into their EHR, like the one I was dutifully asked during my recent urgent care visit. A win for technology and public health?