"The computer ate my term paper" vs "The computer ate the patient history

[HereSince1628]

How many DU instructors recognize THIS one?

The excuse from the Dallas hospital administration can't even be awarded points for originality.

http://www.democraticunderground.com/10025619483

[hobbit709]

1. the high tech version of "The dog ate my homework"

[HereSince1628]

2. Exactly

HOspital suffering from doggy paper diet syndrome

[Hangingon]

3. Saw my doctor last Thursday.

Using the new required computer program, it took 28 steps to reach my test results. Wonderful new world!

[Mariana]

4. Turns out that isn't what happened.

The hospital has apparently retracted that particular bullshit story.

[HereSince1628]

7. Yes. I know. Exactly the same as most students when you push

them to describe the structure of the paper and the details of their supporting evidence

[alcibiades_mystery]

5. The hospital retracted that version of the story

http://www.nytimes.com/2014/10/04/us/containing-ebola-cdc-troops-west-africa.html?

On Thursday, the hospital, Texas Health Presbyterian Hospital in Dallas, released a statement essentially blaming a flaw in its electronic health records system for its decision to send the patient — Thomas E. Duncan, a Liberian national visiting his girlfriend and relatives in the United States — home the first time he visited its emergency room, Sept. 25. It said there were separate “workflows” for doctors and nurses in the records so the doctors did not receive the information that he had come from Africa.

But on Friday evening, the hospital effectively retracted that portion of its statement, saying that “there was no flaw” in its electronic health records system. The hospital said “the patient’s travel history was documented and available to the full care team in the electronic health record (E.H.R.), including within the physician’s workflow.”

[Johonny]

6. Democrats have tried for a national health care database but it has been blocked for years

Even though many Europeans have one. Republicans hate the idea and even some Democrats afraid of big government "knowing" their medical history block the idea too. Meanwhile anyone in this country who has had a serious medical issue that deals with multiple doctors knows that no one actually knows you medical history. Information typically gets lost, isn't transferred from one doctor's office to another, they have a different system etc... all this would be helped if we moved our medical records into the 20th century. I mean it isn't even 21st century thinking here as other countries have done it for years. It is embarrassing how backwards this country is in medical record keeping. I don't see this as a lame excuse. I see this as typical of the actual system we use in this country, know isn't good enough, and yet refuse to fix because of... IDK freedom or so they claim.

[magical thyme]

8. How about: the patient didn't meet the CDC criteria for suspician?

Because that appears to be the situation.

The criteria needs to be changed to a lower temperature threshold than they currently state in their checklist.

There are 3 criteria in CDC guidelins; Duncan met only 2 of the criteria.

[uppityperson]

9. That may be, but then why did they say the doctor did not know his travel history?

[magical thyme]

10. The hospital spokesperson probably spoke off the cuff and prematurely

They should have simply waited for a full investigation.

[HereSince1628]

12. I think those may be recommendations, not mandates about fever and Ebola

My experience is fever producing illnesses have some variability in terms of the onset and the trajectory of the fever as illness proceeds.

The prepatent period may be said to have 'characteristics' but there is still an expectation that individual presentation can be quite variable.

From what I've read, patent symptoms for ebola emerge anywhere from 2 to 21 days, but the fever typically spikes about 10 days into the infection. Add in over-the-counter meds that fight fever, and a patient a bit over a week into infection and the fever criteria isn't particularly useful.

The patient's history of travel might have been helpful in deciding how much weight that fever should get in decision making.

Insurance companies and malpractice attorneys probably love black and white thresholds. Nice clear edges on liability. I'm not sure experienced MDs and nurses really expect individual occurrences of illness to strictly conform to such arbitrary criteria.

[magical thyme]

13. you are correct; they are "guidelines," there are no requirements

The challenge for US doctors is they've most likely never seen an ebola case in their lifetime so don't have experience to fall back on.

In that situation, I think people will tend to stick pretty closely to guidelines given by those who have seen and experience with the disease.

That's my take anyway.

[daredtowork]

11. In my experiences doctors/nurses are overwhelmed by EHRs/EMRs

These systems do not give clinicians a quick overview of the medical record of the patient. The information the doctor needs is all over the place. Test results are in different categories, scattered over some time period. Everything seems fragmented and in different places. The doctor doesn't have time to deal with it in a 15 minute appoint slot. He or she looks at it for a minute, and then gets frustrated. They then deal with the patient without a clear sense of the medical history, and thus they are unable to diagnose any problem that may have been developing over a long period.

There needs to be a way to summarize all the relevant information into a screen doctors can read at a glance so they don't have to go hunting for all the information.

[HereSince1628]

14. I think they are also much influenced by routine. How big would a record be unless

Duncan had multiple previous visits?

The shifting 'explanations' from the hospital that most fortuitously always move the institution away from culpability challenge credibility.