Ebola 2014 – Dallas, Texas
On September 30, 2014, the first travel-associated case of Ebola occurred at a hospital in Dallas, TX. Thomas Eric Duncan traveled from Liberia /West Africa to Dallas. Although the Centers for Disease Control and Prevention (CDC) and the WHO were aware that probable and suspected cases of Ebola and Ebola deaths in 2014 occurred in Liberia, Sierra Leone, and Guinea, doctors at a local hospital in Dallas, TX, were unaware. Dallas is a large city with hundreds of flights to and from West Africa. However, physicians did not consider the patient's travel history. American EHR systems are not interoperable with international disease surveilling systems and do not receive updates on disease outbreaks. The patient arrived at the ED of Presbyterian Hospital with a high fever, dizziness, nausea, abdominal pain, headaches, and decreased urination, complaining of pain, travelling from an area known to have outbreaks of Ebola. Still, the symptoms were misdiagnosed as a sinus infection. The patient died on October 8, 2024, eight days later.
Novel Coronavirus 2020 – Seattle, Washington
On December 31, 2019, the People's Republic of China voluntarily, in compliance with IHR 2005 requirements, reported cases of what was thought to be pneumonia associated with a wholesale seafood market in Wuhan, Hubie Province. On January 7, 2020, Chinese health officials amended the report and confirmed that the cases of pneumonia were associated with Coronavirus, 2019, nCoV2. Wuhan is a large international city of thirteen million people with daily flights to and from the United States. The Chinese government reported the infections on January 7, 2020, and by January 30, 2020, within 23 days, over 9,976 cases were reported across 21 nations, including the United States.
On January 19, 2020, a 35-year-old man checked into a Snohomish County, Washington hospital, just north of Seattle, after returning from Wuhan, China. The patient disclosed that he had just returned to Washington from visiting family. The patient's travel history inspired local and state health officials to notify the Centers for Disease Control and Prevention (CDC) Emergency Operations Center. The Chinese government voluntarily reported the infections; however, the virus spread rapidly because local public health systems and hospitals do not receive the WHO's weekly epidemiological Record (WER) in EHR systems.
Traditional EHR Systems
Traditional EHR systems allow real-time patient data-sharing across a closed network or system. However, EHR systems are not interoperable and do not share information across non-local regions or international borders, which are the traditional migration patterns of infectious diseases. Global trade, international travel, logistics, and interoperability shortfalls have been the source of zoonotic infestations. Zoonotic diseases traverse the globe quickly, and current EHR systems are not interoperable with non-regional or foreign EHR systems or foreign industries and technologies through which diseases travel, impeding effective disease surveillance, which, when coupled with changes in International Health Regulations in 1969 and 2005, makes the global disease burden a national public health problem.
Transitioning to a Global Approach
Globally, the disease has taken more lives than all the world's wars combined. Preventing multinational disease migration requires transitioning from current processes, the traditional EHR systems, to multinational systems that benefit large cities on both a national and global scale, leveraging the power of multiple governments, technologies, and subject matter experts. However, such a change requires careful and thoughtful collaboration among nations, learning from previous mistakes, and ensuring that any multinational solution to disease migration benefits all countries, not just the wealthy nations but the low-to-middle-income nations.
About the Author
Dr. Sterling K. Carter is an academic researcher, writer, and the Chief Executive Officer of SBC Global Consulting in Vancouver, WA, USA. SBC Global Consulting is a global research and consulting firm devoted to helping organisations improve productivity, efficiency, and reduce waste. Sterling holds a Doctorate in Management with a concentration in Global Leadership, a Master of Business Administration with a concentration in Logistics and Supply Chain Management, and a Bachelor of Science in Information Technology from Colorado Technical University. Sterling is also a Lean Six Sigma Master Black Belt, a Certified Agile Leader, a Certified Scrum Master, and is certified in Data Analytics. He has over a decade of experience consulting in multiple verticals, including healthcare. After completing his doctorate and publishing his dissertation, The Strategies Global Leaders Need to Improve Interoperability of an EHR System, he has devoted his life to global health and health systems integration and interoperability.
Disclaimer: The opinions expressed in this article are the author’s own and do not reflect the views of IGI Global Scientific Publishing.