Hospital EMR helps curb hep C outbreak, but privacy concerns linger

Exeter Hospital is not the only group embroiled in legal disputes, however
By Erin McCann
10:55 AM

Exeter Hospital officials say the organization’s electronic medical record (EMR) system helped identify patients infected with the hepatitis C virus and ultimately prompted the hospital’s notification to the New Hampshire Division of Public Health Services.

In the case of David Kwiatkowski, the radiology technician hired by Exeter Hospital who exposed thousands of patients to the hepatitis C virus, officials say the hospital’s EMR allowed physicians to access integrated patient data and ultimately discover the connection to Kwiatkowski.

“Core [the hospital’s affiliated multi-specialty physician group] gastroenterologists were able to identify similarities in three individual hepatitis C cases that ultimately triggered our notification to the New Hampshire Division of Public Health Services and helped lead to the discovery of there possibly being a connection of hepatitis C cases related to Exeter Hospital,” Ryan Lawrence, an Exeter Hospital spokesperson, tells Healthcare IT News.

“This ultimately allowed us to end Mr. Kwiatkowski’s alleged criminal activity, which appears to have occurred at multiple institutions in multiple states across the country affecting a still unknown number of patients,” adds Lawrence.

Officials have confirmed that Kwiatkowski has infected at least 32 Exeter Hospital patients with the hepatitis C virus.

Paper records, officials say, could potentially mean a higher number of patients infected.

“Our long-term significant investment in information technology was driven because of our belief that it will help increase the quality of our care and the safety of our patients,” says Lawrence.

The same EMR system that helped identify the connection between Kwiatkowski and infected patients, however, may also present serious patient privacy issues after New Hampshire state officials recently requested “unlimited access” to the hospital’s medical record system. The state has already tested more than 4,700 patients.

Despite facing pressure from both the state and general public, Exeter officials have resisted granting the request, stating in an Oct. 3 press release, “Exeter Hospital is required by state and federal law to protect our patients’ confidential medical records from inappropriate access, even by state officials.” The hospital has already given the state medical records of patients thought to be involved.

Assistant Attorney General Jeanne Herrick indicated, however, that other patients could be affected. "We're concerned those records wouldn't appear in the same way they otherwise would've appeared," she says, as reported by Seacoast Online.

Exeter Hospital is not the only group embroiled in legal disputes, however. Just this Wednesday, a class action lawsuit was filed against UPMC Presbyterian and Maxim Healthcare Services for negligence in the case of Kwiatkowski.

Specifically, the lawsuit alleges that UPMC and Maxim were negligent in the hiring, retention and supervision of Kwiatkowski. In addition, it alleges UPMC allowed Kwiatkowski to gain access to a controlled substance, Fentanyl, and failed to protect the safety and well being of their patients. The class action alleges that UPMC and Maxim knew or should have known of the risks of employees pilfering or diverting narcotics. It is believed that UPMC had a similar problem with narcotics being diverted and an "action plan" was created to detect, monitor, and report employee drug pilfering and diversion.

In spite of their own protocol, when Kwiatkowski was found with drugs in his system and empty syringes on his person, no action was taken by UPMC to complete a DEA Form 106, as required by law to document a theft of a controlled substance.

Kwiatkowski was working at UPMC in 2008 when a co-worker accused him of lifting a syringe of Fentanyl from an operating room table and replacing it with another syringe filled with another substance. Reports indicate empty syringes were found on his person and in his locker. He was fired after a drug screening showed Fentanyl and other opiates in his system. The syringe left on the table was found to have been used by Kwiatkowski and refilled with another substance. UPMC did not report his behavior to law enforcement or any government agency.