Todd Biske: Outside the Box

I had a doctor’s appointment today, and in the office, they had a poster asking their patients for patience as they work to implement electronic records. The signs have been up for the last few visits, so I think the bulk of the efforts are complete. From an experience standpoint, I’m very satisfied.

When the effort first started, one of the first things they did was take a digital photo of me at my next visit. In addition to the office staff now recognizing me when I come in the office, I personally feel that this has greater potential for reducing errors. Why? Every staff worker that’s not permanently seated at a desk is carrying around a laptop (Fujitsu Lifebook, I believe). When they are dealing with patients, they should be seeing my smiling face as they enter in various information. That provides a constant reminder of who they’re working with. When dealing with paper files, there’s a risk that someone gets them mixed up, and the people using them don’t realize it. While I’m sure this is a very infrequent occurrence, it’s still possible, and having the person’s photo there the whole time should reduce those occurrences even more.

With today’s visit, the cool thing that happened is that my doctor needed to issue a new prescription, and she simply typed into her laptop and told me it would be at the front desk. When I went to the front desk, they handed me a printout, but also indicated that the printout had already been faxed to my preferred pharmacy. Cool.

Overall, I like what it has enabled. The thing that stood out like a sore thumb, however, was the dependency on the FAX machine. They communicated with my pharmacy via FAX. They issue requests to the lab downstairs via FAX. It would be great if some standards could exist so that the doctor’s systems are directly communicated with the pharmacy network or the laboratory. While the electronic prescription FAX has the medication printed in a nice 14 point serif font, it still gets turned into a bitmap, spat out on a sheet of paper, and interpret by some pharmacy technician. From my standpoint, I’d prefer that the doctor’s office talk directly to the pharmacy’s information systems to make this happen and take as much human element out of it as possible. I’d rather have the pharmacist talking to people about their medications than having to interpret doctor’s handwriting or some poor resolution fax.

The other piece of this that could be improved is to provide a secure way for me to get at the information. Suppose you get a cholesterol test. Often times, the doctor may just tell you, “you’re normal.” Typically, however, it’s important to look at trends. (Aside: Yes, just as you should be looking at the metrics of your IT systems and associated trends when things are working fine, you should be looking at your own metrics and trends for your own physical health!) To look at trends, you need the actual test results. Today, I have to call up and have someone read them to me. It would be far more convenient to have some secure electronic way of accessing it. It’s especially true when you’re dealing with multiple doctors. They have a major data synchronization problem, where the patient is viewed as the authoritative source, but often times, we don’t have all the information because our doctor’s haven’t given it to us, or if they did, it was 6 months ago. How many of us have our own medical record keeping system?

Anyway, kudos to my doctor for trying to push the envelope a bit and leverage technology. Here’s to hoping the trend continues.

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