October 8, 2014

Ebola, Electronic Medical Records and Epic Systems

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.

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.

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