Your Sunday Long Read

The White House and CDC have been telling hospitals to prepare for possible Ebola patients for a while now.  It would have been nice if the hospital where one of them showed up last week actually listened, because the entire process was a carnival of errors that came close to a medical disaster in Texas.

Health officials’ handling of the first Ebola patient diagnosed in the United States continued to raise questions Friday, after the hospital that is treating the patient and that mistakenly sent him home when he first came to its emergency room acknowledged that both the nurses and the doctors in that initial visit had access to the fact that he had arrived from Liberia.

For reasons that remain unclear, nurses and doctors failed to act on that information, and released the patient under the erroneous belief that he had a low-grade fever from a viral infection, allowing him to put others at risk of contracting Ebola. Those exposed included several schoolchildren, and the exposure has the potential to spread a disease in Dallas that has already killed more than 3,000 people in Africa.

On Thursday, the hospital, Texas Health Presbyterian Hospital in Dallas, released a statement essentially blaming a flaw in its electronic health records system for its decision to send the patient — Thomas E. Duncan, a Liberian national visiting his girlfriend and relatives in the United States — home the first time he visited its emergency room, Sept. 25. It said there were separate “workflows” for doctors and nurses in the records so the doctors did not receive the information that he had come from Africa.

But on Friday evening, the hospital effectively retracted that portion of its statement, saying that “there was no flaw” in its electronic health records system. The hospital said “the patient’s travel history was documented and available to the full care team in the electronic health record (E.H.R.), including within the physician’s workflow.”

The hospital had said previously that the patient’s condition during his first visit did not warrant admission and that he was not exhibiting symptoms specific to Ebola.

The admission came on a day when health officials narrowed down to 10 the number of people considered most at risk of contracting Ebola after coming into contact with Mr. Duncan. They also moved the four people who had shared an apartment with him from their potentially contaminated quarters, as local and federal officials tried to assure the public that the disease was contained despite initial missteps here.

Now, this could be the hospital administration throwing the ER staff into the grinder, and it certainly wouldn't be the first time that ever happened in the annals of hospital administration politics (yes, my mother was indeed a hospital nurse for 25 years) but it seems to me that somebody dropped the ball here and sent the guy home.

The larger issue is that Texas's healthcare system is overloaded and that of course Gov. Rick Perry and the state's GOP controlled legislature turned down billions in Medicare expansion money to help fix that, so the real responsibility lies in the hands of the Republicans running the show.

As you read the article, keep in mind that Republicans are demanding a better healthcare system, but refuse to do anything to actually pay for it, administer it, or take federal dollars for it, some of which have already been paid for by Texas taxpayers.  Hey, if Texas wants to pay for Medicare expansion for California and New York and get nothing in return, well, that's your call, guys.