MARTINEZ -- Contra Costa's new correctional medical computer system recommended what could have been a fatal dose of a West County jail inmate's heart medication last week, a detention nurse said Tuesday, calling it one of many recent close calls with the month-old program.
Fortunately, the inmate's nurse was familiar with his medical history, recognized the discrepancy and administered the correct amount of Digoxin.
It's just one of a number of computer errors that medical staffers say are endangering inmates, medical staff and sheriff's deputies at the county's five jail facilities since Contra Costa switched on July 1 to EPIC, a computer system that links the correctional facilities to the Contra Costa Regional Medical Center and other county health care operations, two nurses and their union representative told the Contra Costa County board of supervisors on Tuesday.
"It's dangerous. It's very dangerous," said an emotional Lee Ann Fagan in a phone interview. The registered nurse works at West County Detention Facility in Richmond. "It's hard to work in an environment that's so frustrating.
"What nurses want is for the EPIC program to go away until it's fixed," she said.
EPIC is the county's new $45 million computer system software integrating detention medical records with the other arms of the county health system. The system has led to 142 nursing complaints in July, said CNA labor representative Jerry Fillingim, who told supervisors the system does not mesh well with detention health care.
"I have never in all the time working with the California Nursing Association seen that many (complaints) be filled out," he said. "Each day these nurses are fearful that they will kill somebody ... I think the county tried to rush it, making it comprehensive for everything."
EPIC has never included corrections in its software, and is treating Contra Costa as a "guinea pig," Fillingim said.
The county wanted to create a uniform electronic health record (EHR) and executives said the tool is important, but not the be-all, end-all.
"The EHR is just a tool," said David Runt, chief information officer for the county health services department who helped phase the system in over 18 months. "It's just one piece of the health care system. The people are the most important part of this process. We can't rely just on a computerized system."
In addition to ongoing training, staff has trained "superusers," safety alerts, diagnostic testing, patient safety daily briefings and other help available. Still, "we are working on resolving many different issues," said Anna Roth, CEO of Contra Costa Regional Medical Center and health centers.
"It's the beginning of a long journey that occurs over time," she said. "I think we can do a better job ... at how we communicate everything we're doing to respond to concerns."
Staff superusers have warned management of EPIC issues, and two hour-hour training sessions in May and June were inadequate, Fagan said.
"They were next to useless because the program wasn't in place well enough to practice," she said. "Everyone in the classes could see the gross loopholes in information."
Although nurses across the county's health care system have complained, the problems have been acute in detention, Fagan and Fillingim said.
On Monday, one inmate told a nurse she was supposed to be seen by mental health specialists because she was hearing voices, but the follow-up appointment was not registered in the system. The same patient had a Pap smear scheduled for two weeks ago to test her for sexually transmitted diseases, but the appointment disappeared from the system, Fagan said.
Nurses cannot access tuberculosis history for inmates, so when some are transferred to Immigration and Customs Enforcement (ICE), staff cannot provide a full medical summary.
"We don't exactly know how that happened, we can't tell," she said.
The kinks will be worked out and patient safety issues fall to the top of the list, Runt said.
"When we go live is just a point in time and now it becomes a period of stabilization and optimization," he said.
Contact Matthias Gafni at 925-952-5026. Follow him at Twitter.com/mgafni.