A patient came to see me recently for a second opinion on an abnormal blood test result. He was accompanied by his parents. They had driven a considerable distance for this visit.
The patient’s mother announced at the outset of the visit
that she had been assured that all of the relevant records had been transferred.
My forthcoming comment will shock
neither patients nor medical professionals.
Nary a single page of records was anywhere in sight.
This vignette illustrates two incredibly frustrating and
recurrent realities.
Medical records that referring offices promise they have sent
me often never arrive. They are dangling somewhere within a extraterrestrial black hole. On a regular basis, conscientious
patients see me in the office assuring me that they were told that their
records have been forwarded. They may
have been forwarded somewhere, but all I know is I don’t have them. This drives patients to a state of apoplexy,
and I don’t blame them. There are variations
on this madness. For example, I may have requested a colonoscopy report but receive a mammogram report instead, which is somewhat less useful to me. I can’t pinpoint where the breaks in the
chain of custody are. There are
occasions when I must dispatch a patient directly to the referring physician’s
office to assume possession of the medical papers and to deliver them into my
hands only. Only the strongest among us
could take on a challenge of this magnitude.
The second inexplicable frustration is why I cannot (with a
patient’s permission) access other electronic medical record systems from my office computer. I regularly see patients referred
to me from an area emergency room (ER).
If that facility is not in my system, then I can’t access the
records. Conversely, if one of my patients
is seen in that ER, they can’t see my records.
Does this sound like best practice in 2022? It’s downright ridiculous.
But this particular case had a fortuitous twist. The patient’s mother, using her sixth sense,
brought a complete copy of the patient’s records with her. She passed the dossier to me which allowed me
to perform the task at hand.
She was the hero of the day, if not the week or maybe even
the month. But should patients and their
families have to work this hard? Shouldn’t
the system be designed to facilitate and not hinder their care? When will this perennial conundrum be resolved? Why does the medical establishment tolerate
this? If medical billing were similarly
flawed, and payments arrived late or not at all, do you think that the medical
establishment would remain indifferent?
It’s the free market capitalist system, VHS and Betamax hundreds of times over. We don’t need that many EMR choices. In Maine we have a statewide data repository where most EMRs upload at least labs, imaging and procedures…
ReplyDeleteHans, good hearing from you. I understand your point regarding competition among EMR vendors, but as an end user, I would enthusiastically support something closer to universal access. It's insane that we are blocked out of so many systems which adversely affects patient care. MK
DeleteRecently I had to visit an Urgent Care location in Southern California that had no connection to my health care providers in the CLE and was stunned that they were able to access all of my current medications and allergies. It felt a little Big Brotherish, but it did make it easier for the Doc who saw me.
ReplyDeleteJonathan, the blog is honored by your comment. There are times that I am able to access outside records, as you experienced on the west coast, but even when this occur, the transfer is incomplete and difficult to access. My point at the close of my post regarding medical billing is that if there were similar glitches regarding reimbursement, that these wrinkles would have been smoothed out as soon as they appeared. Apparently, physicians facing medical record access challenges rank low on the priority scale. MK
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