Tuesday, November 08, 2016

It Rather Looks Like Staff Security Training At SA Health Needs A Thorough Review.

This appeared a few days ago.

Steve Herczeg’s inquest hears nurse allowed student to record details on electronic system using her password

Andrew Hough, The Advertiser
November 1, 2016 6:57pm
A STUDENT nurse was wrongly allowed to record critical medical observations on a former Socceroo, under a supervising colleague’s name, in an Adelaide hospital’s controversial electronic system, an inquest has heard.
South Australia’s first World Cup qualifying player, Stephen Herczeg, 72, of North Haven, died in agony last month in the Queen Elizabeth Hospital from respiratory failure caused by a ruptured bladder and collapsed lungs.
State Coroner Mark Johns is conducting an urgent inquest into the “catastrophic”, but mysterious circumstances, surrounding the September 19 death.
Mr Johns has heard how Mr Herczeg, a Hungarian-born grandfather known as “Steve”, died when his catheter bag was mistakenly connected to “high-flowing” oxygen tubes pumping 15l of air a minute.
The inquest has heard this was caused by a series of hospital mistakes, although police have speculated he may have caused his own death through “delirium”, based on a senior’s doctors comments.
On Tuesday in the Coroners Court, registered nurse Waitmatai Fiorentino admitted to a series of care errors as she oversaw his “handover” from the emergency department to a general ward.
Ms Fiorentino, a former administration officer who had been in her role since April, admitted she had wrongly allowed a student nurse to record key details in the hospital’s electronic system, EPAS, using her password.
More here:
What this bit of the awful saga makes clear is that the Allscripts implementation of ePAS is flawed. Adding information to an electronic health record should be protected by user log-ons being covered by at least two security factors and sensible time-outs of a few minutes so there can be some confidence as to who exactly it is who is recording information.
As the push to electronic records accelerates, and courts have to rely more and more on these records, the consequences of not having staff properly trained as to their responsibilities (and decent security)  will have both clinical and medico-legal consequences.
After this evidence it seems clear some serious policy and technical change seems to be required in S.A. with the ePAS.
I note in passing Allscripts does not seem to be going all that well although it is still a pretty big compny:

Allscripts Q3 Results

Allscripts posts Q3 results: revenue up 11 percent, adjusted EPS $0.14 vs. $0.13, missing analyst expectations for both. The company also issued disappointing earnings guidance.
Allscripts shares are down 17 percent in the past year and have dropped 44 percent in the past five years. The company’s market value is $2.16 billion.
Netsmart contributed $38 million in revenue for the quarter. Allscripts and a private equity firm acquired the behavioral EHR vendor in April 2016 for $950 million and merged it with the homecare software business of Allscripts with the expectation of generating $250 million in annual revenue and $60 million in annual profit, although the Allscripts ownership stake was not specified. Netsmart acquired LTPAC EHR vendor HealthMEDX on October 27, 2016 for $36.3 million in cash.
 Here is the link:
It will be interesting to hear what the Coroner recommends.
David.

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