A Case of Murder and EHRs -- Chapter Seven
A Case of Murder and EHRs
Copyright 2007 by Peter J. Groen and Jaime Nasuti.
Published with permission of the co-authors.
CHAPTER SEVEN
The warning message began flashing on Dirk's computer screen, a somewhat rare occurrence. Not too many high-profile public officials tend to be admitted to the VA Medical Center in Martinsburg, West Virginia, for treatment. Especially not a presidential candidate.
"I better check this out right now," he thought.
As the VA's information security officer (ISO) for the Martinsburg VA Medical Center, it was one of Dirk's jobs to keep an eye on suspicious activity within the VA health IT systems. Dirk opened up the warning message from the computer and quickly scanned and evaluated the information the computer had automatically gathered and forwarded to him. He saw that Dr. Douglas had ordered a series of tests for Congressman Martin. He called the chief of staff to confirm that Dr. Douglas was the physician officially assigned to care for the congressman. This was confirmed and Dirk hung up the phone relieved.
Politicians never sat well with Dirk. With the upcoming election looming, Dirk made it a point to watch the numerous debates just so he could speak intelligently about why he hated all the candidates. However, a recent interview had caught his attention when a candidate began talking about the VA's electronic medical record. No one ever seemed to give the VA any recognition for its technological advances in the field of medicine or the high quality of care it provided, as confirmed by the Joint Commission on Hospital Accreditation. But it still didn't matter to Dirk. He still wasn't going to take the time to go down to his local precinct to cast a vote on Election Day.
Just as he hung up, another security alert appeared on his computer screen. Dirk opened the computer-generated warning and noted that another physician, Dr. Rose, had apparently logged on to the hospital's computer system, accessed Congressman Martin's chart, and had placed an inpatient pharmacy order. This was odd, especially since the chief of staff had just told him Dr. Douglas had been assigned as the Congressman's primary treating physician. It was not an unusual occurrence for doctors to open the chart of a patient being treated by someone else, since they often worked in teams or were asked to consult on a case.
However, it was unusual for a doctor to order a prescription for another doctor's patient. The computer was also indicating that the prescription could result in a deadly drug-to-drug interaction. Something definitely seemed out of place.
Dirk immediately called the chief of staff's office again. He gave the secretary a rather curt response as to why he was calling to speak to the chief of staff. She could tell this was an urgent matter and quickly connected him. Once the chief of staff got on the phone Dirk quickly explained what he had discovered. The chief of staff was silent for a moment and then said he needed to get the hospital director involved.
He then said, "Make sure! Double-check the computer's audit trail and let me know everyone who accessed the congressman's record and what they did. I will personally put a hold on anything in Martin's record and verify nothing adverse has been given to him. I hope this turns out to be a non-issue, but you never know."
After he hung up, the chief of staff called his secretary into his office. "Get the director on the phone," he said. "Also, find Dr. Douglas now! Get him in here and be quiet about it."