This case study illustrates the need and importance of interoperability with respect to transferring healthcare data for treatment. Specifically, documentation of an allergy was not transferred between systems before surgery and reconciliation of information was not performed in time to prevent a serious event.
A 50-year-old man with a history of substance abuse suffered a gunshot wound resulting in paraplegia. He presented in the emergency department at Hospital B in the evening with pain and fever after having been previously seen at four hospitals, including Hospital A where he left against medical advice. Medical records obtained from Hospital A by the emergency department staff at Hospital B where he had gone for treatment indicated that he previously had antibiotic treatment for sepsis.
Subsequently, the ED staff diagnosed the patient with sepsis resulting from decubitus ulcers, he was started on an IV, given vancomycin and piperacillin and admitted to Hospital B.The next day he became unresponsive, underwent a code blue, and was transferred to ICU in a coma. The diagnosis was massive rupture of red blood cells due to a reaction to the antibiotics vancomycin and piperacillin. The result was brain injury and an unresponsive state necessitating discharge to a long-term care facility. The ICU eventually received records from the other hospitals that documented a previous cardiac arrest cause by an allergic reaction to the same antibiotics. Unfortunately, when the ED staff asked the patient about allergic reactions, he reported that he had a blood transfusion reaction and this was transcribed as a statement indicating the patient had no aLlergies.
With better systems interoperability between Hospitals A and B, data recorded at the first hospital would be available within minutes at the other hospital. Lacking built-in systems interoperability, the ED staff could have called the other hospitals to get a verbal report of allergies and treatments. The allergy could then have been entered into Hospital B's systems (adapted from Reider 2015).
Review the case study on page 318 of your book. It discusses the need and importance of interoperability with respect to transferring healthcare data for treatment.
- Name and discuss two interoperability issues present in the case study.
- What could the facility have done to prevent his occurrence (related to question 1)?
- Do you think the interoperability issues are common at actual hospitals (explain your answer)?
- What do you feel the consumer (patient) perception of interoperability is (i.e, do they think that their data is easily shared between hospitals)?
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