Ebola — Better to keep your mouth shut and be thought a fool …

In case you missed it, there’s been a disturbing development in the ongoing U.S. Ebola saga. This time, it’s not the spread of the disease, it’s the spread of misinformation.

Tara Courtland

Communications Director Tara Courtland

Ebola patient Thomas Eric Duncan was initially evaluated, misdiagnosed and released by Dallas Presbyterian Hospital and after the story hit, the National Institute of Allergy and Infectious Diseases blamed the nursing staff. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said publicly that the nursing staff “dropped the ball,” having known about Duncan’s travel from Ebola-stricken Africa, but not putting it into his chart.

Now it turns out, it was in his chart — his Electronic Health Record included all of that information, but the doctor didn’t see it.

That was the first mistake that the feds made, but it wasn’t the last. No sooner had Fauci corrected that mistatement, then another official, Tom Frieden of the Centers for Disease Control and Prevention, said it was nurses’ own fault they contracted the disease while caring for Duncan.

“There was a breach in protocol and that breach in protocol resulted in this infection,” Frieden said. “When you have potentially soiled or contaminated gloves or masks or other things, to remove those without any risk of any contaminated material touching you is critically important and not easy to do right.”

The next day, of course, Frieden took it back after reports began surfacing that the nursing staff was ordered to treat Duncan for two days without hazmat suits and that’s more likely how the disease was transmitted.

Then there was the travel. Nurse Amber Vinson, who’d cared for Duncan, was diagnosed with Ebola just after returning from Ohio on a passenger plan.

Frieden called her out again, saying “She was in a group of individuals known to have exposure to Ebola. She should not have traveled on a commercial airline.”

That’s strike three for the feds after it turns out that Vinson had been in regular contact with the CDC, which Frieden runs, and had been given permission to take the plane.

In times of crisis, we need to be able to count on our leaders to provide accurate information to keep us safe — and calm. Three major mistakes in a row not only erodes our confidence, it also slanders the front-line responders who are now literally risking their lives to care for the sick.

Our national healthcare agencies may do well to remember the old adage: “Better to keep your mouth shut and be thought a fool than to open it and remove all doubt.”

NPR first reported this story at http://www.npr.org/2014/10/24/358574357/was-cdc-too-quick-to-blame-dallas-nurses-in-care-of-ebola-patient.

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Getting connected — by federal mandate?

Will it take yet another government mandate for connectivity between hospitals to occur?

An interesting article in the “New York Times” entitled “Doctors find barriers to sharing digital medical records” succinctly describes the problem that still persists in the evolution of patient documentation

NEMT CEO Linda Sullivan

Going back to 2008 when the HITECH Act was passed, one of the primary goals was easy yet secure accessibility of our medical records regardless of where we were geographically.

According to the article, only 14% of physicians are able to exchange patient data outside of their own systems. While this lack of connectivity is common between nearly all systems, Epic was sighted as a prime culprit, no doubt because of the huge number of installations they have implemented.

Epic’s business model is sustainable long-term because not only are they paid handsomely for implementing their systems, they charge ongoing fees for many things, including transmittal of patient documentation to another system. That’s a great profit center, which costs them nothing once the software is in place.

I am certain connectivity between systems will occur. The question is: What will it take to make it happen, and when?

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Posted in Meaningful Use, News and stories, Uncategorized | Tagged , | Leave a comment

What about when they leave?

There is a lot of focus when we bring an employee on board. We make sure we have all the HR done correctly and we follow our HIPAA guidelines. New team members are set up in all the systems and then we start training.

NEMT President Linda Allard

But what about when an employee leaves? Do you have policies and procedures in place to make sure that all their access to PHI is removed? How quickly will it happen? Are there checks in place to make sure that it does happen?

It is easy to focus on employees and on-boarding them correctly with HIPAA and the other paperwork required. We all know our policy and that they need to sign their documents and do their training.

Are your policies and procedures for when an employee leaves equally known by everyone? Do you have a checklist that will be signed off to ensure that you have taken care of removing the employee from all the systems they need to be removed from? What about all their passwords? Who is responsible for disabling them?

I focus on HIPAA, but there are also many other HR and hospital controls that need to be taken care of. Who checks to make sure these things are done? Do you have a person assigned the responsibility of checking behind all employees who have left?

Having policies in place is great and knowing exactly what you need to do when a team member leaves is wonderful. However, oversights can happen, and having a procedure where checks are made to make sure everything was done correctly is really important. Having a member of your team responsible for all employees and team members who have left is critical. Having this taken care of will ensure that you are protecting PHI, your facility and the team member who left.

 

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It said what????

Most of us work with our computer every day. As a result, we start doing things on autopilot. While this ability is helpful in getting work done quickly and efficiently, it can work against us if we stop paying attention. Here are some suggestions to help maintain your sanity as well as keep sensitive data safe.

Andrew Clarke

 

1. Read the error message.

If you are logging in, and you get an error message, make sure you entered the correct username and password for the program in question. That might sound simple, but I have had many users ask for a password reset only to find that they were entering the username and password for program A in program B.

 

2. Don’t end up with unwanted programs.

When installing programs, sometimes you are prompted to install other software at the same time. Uncheck any boxes that don’t apply to what you want and / or click “cancel” for items you don’t want to avoid unwanted tool bars, search programs, etc. The bottom line is to only get what you want and not fall for slick installation marketing. They know most people just click yes and OK during installation without paying attention to what’s on the screen.

 

3. Pay attention when something happens unexpectedly.

If you work with a program every day, pay attention to screens that show up unexpectedly. These screens could be an indication of a problem that needs to be reported. Not paying attention at this point can lead to bad results such as loss of data. Weird messages could also be an indication of viral activity, so report any such occurrences immediately.

 

4. When in doubt, stop!

If you’re not sure if something that comes up is a problem, stop and ask. Never assume. You don’t want to be the one who accidentally sent PHI to the local news channel.

Pay attention. Take your time. Read the screen. Stop when in doubt, and ask for help.

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Posted in IT, News and stories | Tagged , | 1 Comment

The Tough Mudder aftermath and other first world health problems

I’m sick and I hurt. This is really a classic example of a first world healthcare problem. Yesterday, I woke up with a very bad cold and I ran a Tough Mudder anyway. If you’re not familiar with the Tough Mudder, it’s a 10+ mile obstacle course of mud, barbed wire, fire and electric shocks. There’s a lot of crawling over gravel and pulling yourself up and over walls.

Tara Courtland

Communications Director Tara Courtland

You pay a lot of money for the adventure — between $75 and $250, plus travel, hotel, gear, etc. And then you hope that you don’t require a trip to the hospital (plenty of people do) during the run. Best case scenario, you spend the next 48 hours mostly unable to move, covered in bruises and scrapes and muscle soreness that make even climbing the stairs difficult.

Spending the day running through mud and extreme heat and cold didn’t do anything to help my sinuses, my cough or my throat either.

So today I can’t move, except to cough and whine for someone to bring me more tissues.

I mention this to illustrate the incredible disparity in medical problems in our society. On one end of the spectrum are people without access to healthcare, people with chronic health conditions who can’t afford medicine, people who don’t go to the doctor when they’re sick or who use emergency rooms for minor ailments because it’s the only option they have. Thousands or millions of people in this country live in fear of an injury that will leave them unable to work, even for a few days.

On the other end are people like me who pay good money and travel long distances for dangerous recreational activities figuring “there’s a fairly good chance I’ll break an arm but it probably won’t be any worse than that. And I’ll get sicker because I’m not taking care of myself, but I can just take the day off tomorrow to recover.”

And I’ll buy stuff for the symptoms: ice packs, some Arnica, an extra bottle of Advil, a heating pad, a box of Benadryl, a bottle of Sudafed, some nose drops, a couple boxes of tissues, several flavors of herbal tea and a jar of honey.

No big deal, it’s just money. In fact, more than a full day’s worth of money for people making minimum wage in my state.

It doesn’t make me hurt any less and it doesn’t make my sinuses feel any better, but it’s somewhat comforting (and guilt-inducing) to know I’m here cause I chose this. I get to pick my health problems. Plenty don’t.

TM wall

Tara Courttland (in black) spent 5 minutes climbing this wall and five hours complaining about how much her arms hurt afterwards.

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