Ebola and The Chicken Little Syndrome

Ebola is real. No doubt about it. So was 9-11. And so was the anthrax attack. In each case, a real event set off a national wave of panic.

After 9-11, the U.S. was locked down, citizens worried about another airplane attack on our vital infrastructure. The World Trade Center tragedy begat the anthrax scare. Who can forget that one? A few public officials got some white powder in the mail and all mail was held for anthrax screening after that. I lost a copyright application to the Library of Congress due to the mail being opened and destroyed in Washington D.C. My mother wore latex gloves to get her mail for weeks. No, really.

I’m not suggesting the Ebola threat isn’t real or isn’t serious. I am questioning our reaction to it. Some reactions are valid, helpful and reasonable. Some reactions are political, hysterical and accusatory.

I’m all for the first. I am suggesting the second are counter-productive especially in an emergency.

Dontcha just hate it when I get all analytical and stuff?

Valid, helpful and reasonable

What is a valid, helpful and reasonable response to Ebola?

I’m not an infectious disease specialist. Can’t you tell? But here are some responses that seem pretty reasonable.

HHS held a conference call today to help healthcare facilities craft a response. A one-hour webinar hosted by the HHS Assistant Secretary for Preparedness and Response including people from the CDC, DHS and HHS Intergovernmental and External Affairs are also on the call. You can get an audio and transcript by going to www.phe.gov/Preparedness/responders/ebola.

Also, Modern Healthcare sponsored an Ebola Preparedness Session streamed live and organized by the Greater New York Hospital Association, the Service Employees International Union and the Partnership for Quality Care. It was a three and a half hour telethon. I listened to some of it, and it lays out some very common sense approaches including good gowning procedures.

Also, in the non-hysterical, analytical corner is Ron Shinkman of FierceHealthFinance. His column puts Ebola in the context of other deadly things that are going around, like the flu and other medical errors. Here’s an excerpt:

Were there serious medical errors that occurred at Texas Health Presbyterian involving patients other than Duncan during his treatment? Almost certainly. And if they didn’t occur at Texas Health Presbyterian, they occurred at other U.S. hospitals at exactly the same time the Ebola story has been unfolding. Surgical patients were discharged with a sponge or an instrument in their body that may not be detected for months, if at all. Patients died because they received the wrong dosage of medication, or because they acquired an infection when a staffer forgot to wash their hands.

The difference has been in the response: Little light is shed on these errors, even though they routinely kill 100 patients or more a day nationwide and cost the healthcare system billions of dollars annually. Meanwhile, the two Texas Health Presbyterian nurses are receiving such attentive care that despite Ebola’s high mortality rate they have as good a chance as anyone of making a full recovery.

This would have been an opportune time to focus the spotlight on serious medical errors in U.S. hospitals. The media has blown it.

Thanks, Ron.

Political, Hysterical and Accusatory

As for political reactions, an Ebola czar? Really? An Ebola czar who is a lawyer from Joe Biden’s and Al Gore’s staffs? My first reaction was wondering whether the White House thinks it has a health emergency or a political opportunity to leverage a tragedy. Like I said, just wondering. My second reaction is wondering how many czars we have now. Like I said, again, just wondering.

Hysterical and accusatory reactions are running rampant. Because I am usually focused on electronic patient records, I’ll restrict my comments to that.

We all know that hospitals and doctors are in the middle of trying to implement electronic records systems as a requirement of getting government funding – or losing government funding if they fail to get it right in the next few years. They are already having to cope with the fact that the systems don’t meet interoperability standards and that just about nobody can meet Meaningful Use requirements, and those that meet MU only have to reach something like 5% patient uptake.

Providers already have their hands full trying to meet MU, and now they have to implement some special electronic patient record protocol to make sure they capture Ebola, specifically. This is where we get very myopic at a cost of time and money that will never be recovered.

Dr. David Blumenthal, from the Office of the National Coordinator for Health IT twice removed, wrote an excellent article putting this in perspective in his blog with Commonwealth Fund. You can catch it at http://www.commonwealthfund.org/publications/blog/2014/oct/ehrs-the-new-lightening-rod-in-health-care

Electronic patient records, done well, will have enough specific fields built in to capture travel histories, infectious disease alerts, and other relevant data that Ebola and son-of-Ebola and all other threats will be captured and made available to the providers who need that information.

Until then, the government is just chasing squirrels in a reactive, political, hysterical and accusatory fashion. Which get us…exactly…nowhere. In a very expensive vehicle.