Did an EHR miss Ebola in the case of Thomas Eric Duncan being released from a Texas hospital with Ebola-like symptoms after telling an ER nurse he had recently been in Africa? Beth Walsh, writing in CMIO, discusses a report of a panel of experts put together by Texas Health Resources, which ran a hospital that released Duncan without initially diagnosing or treating Ebola, which he later died from.

According to the report, the admitting nurse made a note of Duncan’s visit to Africa in the EHR, but her notes were not immediately visible to a physician who later examined Duncan. The report noted that processes in the emergency department “did not optimally address the early identification of Ebola or other emerging diseases during the first ED visit, nor did [the hospital] optimally utilize the full capability of the electronic health record.” Turns out that while travel history is accessible to everyone in the emergency department, to view the information, a clinician would have to look beyond the initial patient assessment screen.

Kudos to Texas Health Resources for organizing a credible panel of outside experts from prestigious academic centers and the Joint Commission to get to the bottom of what happened. From a healthcare PR perspective, Texas Health Resources has taken constructive, transparent steps to learn from the incident and help others understand how to avoid this kind of tragedy in the future.

So, did the EHR miss Ebola? The answer is both yes and no. A nurse entered a critical piece of patient history in the electronic record, but not where the physician could readily see it. Early on in the Ebola outbreak, the disease was not sufficiently on the radar screen of clinicians. In the end, an EHR cannot substitute for human wisdom.