A multimillion-dollar "go-live" implementation of the EpicCare EMR from Epic Systems Corp. came under intense scrutiny Tuesday when two nurses approached the governing body of a California hospital with patient safety concerns. Those concerns stem from an incident at a Contra Costa County hospital clinic at the West County Detention Facility in Richmond, CA, where one nurse says the Epic system's recommended dosage of a heart medication "could have killed the patient." "We're unable to document our medication administration correctly," said an emotional Lee Ann Fagan, speaking to the Contra Costa County Board of Supervisors in Martinez, CA. A nurse familiar with the patient's medical history was able to override the system and adjust the amount of medication. The story immediately spread via local media in the San Francisco Bay area, and highlighted concerns throughout the county hospital system about the Epic implementation.
"The EHR is just a tool," said David Runt, chief information officer for the county health services department and who helped phase the system in over 18 months. "It's just one piece of the health care system. The people are the most important part of this process. We can't rely just on a computerized system."In addition to ongoing training, staff has trained "superusers," safety alerts, diagnostic testing, patient safety daily briefings and other help available. Still, "we are working on resolving many different issues," said Anna Roth, CEO of Contra Costa Regional Medical Center and health centers. "It's the beginning of a long journey that occurs over time," she said. "I think we can do a better job ... at how we communicate everything we're doing to respond to concerns."
David Runt now goes down in my book as the perfect name for a CIO. Also, his understanding that the EMR/EHR is "just a tool" is amazingly perceptive. Ditto the reference by the CEO to a "long journey."