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EHR No Substitute for Nurse-Physician Communication

 |  By Alexandra Wilson Pecci  
   October 07, 2014

How nurses and doctors communicate—or don't communicate—using health information technology is the focus of a multi-year study funded by the federal Agency for Healthcare Research and Quality.

The life-and-death importance of nurse-physician communication and the use of electronic health records came to a frightening, critical head last week when a nurse noted in a sick patient's EHR that the patient had recently traveled to the United States from Africa.


Milisa Manojlovich, PhD, RN, CCRN

Despite the note, the patient was sent home. He later returned to the hospital and was eventually diagnosed with the Ebola virus.

Revising an earlier statement that blamed the bungled incident on a "flaw" in its (Epic) EHR system, Texas Health Resources backtracked last Friday saying, "As a standard part of the nursing process, the patient's travel history was documented and available to the full care team in the electronic health record (EHR), including within the physician's workflow. There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event."

In either event if the nurse used the EHR alone to communicate that critical piece of patient information, it obviously didn't work. According to Milisa Manojlovich, PhD, RN, CCRN, associate professor at the University of Michigan School of Nursing, it's a case of the medium not matching the message.

Leaving too Much to Chance
"The Ebola example is a great example of communication technology not being used appropriately," she says. "There needed to be a sense that the medium of the electronic health record is not the best for this."

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Alexandra Wilson Pecci is an editor for HealthLeaders.

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