What We Should Learn from the Ebola Outbreak

Ebola doesn’t spread by mysterious means, we know how it spreads. So we have the means to stop it from spreading, but it requires tremendous attention to every detail.

 Tom Frieden, director, U.S. Centers for Disease Control and Prevention, August 25, 2014

The recent West African Ebola crisis brings into sharp relief the challenges of pre-service and real-time workplace education for health workers in areas of greatest need.  Countries dealing with the Ebola crisis face multiple challenges, chief among them a shortage of trained and adequately equipped health workers.

Anthony Fauci, director, U.S. National Institute of Allergy and Infectious Disease, made this point in an August 13, 2014 article in The New England Journal of Medicine, titled Ebola — Underscoring the Global Disparities in Health Care Resources:

The chance that the virus will establish a foothold in the United States or another high-resource country remains extremely small…[hospitals] generally have excellent capacity to isolate persons with suspected cases and to care for them safely should they become ill. Public health authorities have the resources and training necessary to trace and monitor contacts. Protocols exist for the appropriate handling of corpses and disposal of biohazardous materials. … Isolation procedures have been clearly outlined by the Centers for Disease Control and Prevention (CDC). A high index of suspicion, proper infection-control practices, and epidemiologic investigations should quickly limit the spread of the virus.

While some of the disparity can be alleviated by providing equipment and supplies, the heart of the problem lies in the breadth and depth of education and on-the-job decision support for health care workers.  High-resource countries are distinguished, in Dr. Fauci’s article, by their capacity to respond which is based largely on sound “training,” “protocols,” and “procedures.”

While there is no single remedy for global disparities in health care, the current Ebola outbreak draws our attention to the need for expanded deployment of the new generation of digital educational and decision support technologies, and in building related communities of practice.  These decision support and educational technologies have already revolutionized health care delivery in the United States and other high-resources countries (see July 16 post featuring UpToDate.com).

Finally, the current crisis in West Africa represents an opportunity to identify the most important elements of decision support for policymakers, program leaders, and frontline health workers and, to determine the most context-appropriate delivery systems for advanced preparation and real-time support in future outbreaks of viral hemorrhagic fever.