Nearly every day at MDD we report on the latest advances in health IT, one of the fastest growing sectors in the industry. It seems like new HIT and systems-related companies are cropping up every week, promising to enhance communication between patients and providers, and improve clinical workflow.
But what happens when this technology fails – and trust me, it will – and the people trained to use these fancy pants systems are not taught how to go back to the basics, a.k.a. the pen-and-paper method?
Let me give you an example from my own recent experience with the military’s healthcare system, which I believe is a perfect example of a system that heavily relies on the aforementioned fancy pants communications/workflow systems.
Tuesday I needed to leave a message for my primary care provider. The reason for my message in the first place was frustrating - I needed to tell her that she had either not read or not adequately understood the notes of the hospital's gastroenterologist when he recently declined her referral to send me to him. You see, the GI doctor actually had a good reason for refusing to see me - he took the time to read my history and determined that I would be better off seeing a GI surgeon than himself (I've had a total colectomy and now have what is called a J-pouch where my surgeon fashioned my small intestines into the shape of a J where my colon used to be). But instead of actually reading his notes herself and referring me to a surgeon, the primary doc instead relayed a message to me that my referral had been declined and that if I still felt the need to see a GI I should go to the emergency room.
Knowing that this was an absolutely absurd recommendation as I clearly need to be able to see a specialist regarding my condition, my next step was to contact the referral management office located in the same military hospital as both doctors involved.
The referral management person I spoke with read all of the notes from both doctors and recommended that I leave a message for the first doctor to either speak with the GI directly or at least read his notes completely so that she can see for herself that he was actually suggesting I be referred to a surgeon.
So what happened when I called the clinic to leave a message for the first doctor? I was told by a receptionist that “the system to leave a message is down so you’ll have to keep calling back until it’s back up again.” Hey, here’s an innovative idea: get a piece of paper and a pen and WRITE my message down.
Four calls and 24 hours later the system was finally back up and I was able to leave the message. I'm still waiting for someone to call me back with her response. Why do I get the feeling that I'll be updating this blog next week to say that I'm still waiting for that call? I hope I'm wrong about that though.
I get that technology fails at times. Anyone who has ever used any kind of technology for any length of time knows that it happens. But what about a back-up plan so that patients don’t have to pay the price of a system that fails to teach its staff the basics of taking a phone message? Would it really have been so difficult for the receptionist to take a message the old-school way and deliver it to the doctor who is in the very same office?