A week ago, I had to make an emergency room visit late on a Thursday evening followed by an appointment with my primary doctor the following day. Fortunately, my particular issue was not very serious but that Thursday night I certainly was in pain which necessitated the emergency room visit. Now, given my natural inclination towards observation, going to the emergency room turns out to be a great place for people watching and experiencing a system that certainly has its share of commentary, critics, and passionate pleas for change. Here are some of the things I recognized from my visit.
- Medical records at different facilities truly are not connected. That Thursday night at the emergency room, a urine test was given to me. I waited there for 2 hours, but ultimately the doctor on duty came and gave me the results of the test—indicating I didn’t have an infection and that I should go see my primary doctor the following day for an ultrasound and to determine next steps. By the end of the night, I was feeling much better and on Friday I planned to take the day off from work and then go to my doctor.
- When I went to see my doctor the next day, the paperwork I was provided by the hospital didn’t include my urine test results. What I was told at the hospital was that the doctor’s office could process a medical records sharing procedure and then could access my test results through a connected medical record system through a search of my social security number. That turned out to be most definitely not true.
- My doctor’s office said that there isn’t a common system to access records from a hospital outside of their network and the requesting test results process wouldn’t get my results to them until the next week. So, the doctor suggested I get the same urine test, along with a other tests, at the doctor’s office. Thus, within 16 hours, I got the same urine test done twice since the results from the hospital wasn’t easily shareable with my primary doctor. So, the medical system funded the same test twice, one unnecessarily, due to a lack of co-ordination between the different medical bodies.
- Another wrinkle in this process was that I was in my first week at a new job and my health insurance from my previous company was going to be in effect until January 31 while in theory, the insurance from my new company should have been in effect beginning on February 1. I went to the hospital on January 28 and to my doctor’s office on January 29. However, even though I was feeling better and probably could have waited a few days to see how things were progressing before getting an exhaustive ultrasound or catscan, I felt I needed to get any possible tests done by Feb 1 as I wasn’t confident the processing of the new company’s insurance would really be in effect on February 1. I really didn’t want to risk that I did need to go to the doctor say on Monday or Tuesday after the weekend (Feb 1 or Feb 2) and then get an expensive procedure done that I would ultimately have to fight with a bureaucracy to get covered. So, given that I went into my doctor’s office on Jan 31, got the same urine test done again, a new blood test and an ultrasound done, which I have to believe is quite expensive. But I felt good that I got it done by Feb 1.
So, in summary, the key learnings I had from the medical experience was that the system may have certainly created at least two unnecessary tests that the system paid for. The same urine test done at the doctor’s office and the catscan which I may have ultimately not needed if after a few days I was feeling better on my own.
Looking at the health care proposals out there being debated in Congress, I do know the uber-connected medical world is something that Obama administration does champion. I’m not sure of the full economics, but I can envision if the connected health care system prevented a multiple of duplicate tests like mine, that investment would likely pay off—that’s my belief, but I’ve never seen nor tried to look at the overall numbers. Regardless, change will be coming to the health care system—problems like these hopefully start to dissipate.