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.
Reading, Writing, and Reflecting 
I had a similar experience with poor record keeping and poor communication a couple of weeks ago. My mother (an Alzheimer’s patient) broke her leg and needed surgery to repair the break. They had her scheduled for emergency surgery before I reminded the anesthesiologist that she was taking a blood thinning drug (Coumadin) that could have caused her to bleed to death in surgery. They had absolutely no idea she was on the drug – even though it was prescribed by a physician in the same HMO as the hospital.
It was a good thing I was there, and it was a good thing I knew enough about Coumadin to bring this to their attention.
— hippieprof
Look up HIPPA. It explains a lot. Every visit you should be offered a copy. It is a law. A government idea.
Look up HIPPA. It explains a lot. Every visit you should be offered a copy. It is a law. A government idea.
I am well aware of HIPAA (not HIPPA).
HIPAA is designed to insure that private information is not spread to those who might use it against the patient.
HIPAA explicitly allows the sharing of information to facilitate treatment of the individual. It has absolutely nothing to do with the case I cite.
— hp
Thanks Hippieprof and fletcm for your comments and visiting my blog. I believe the comment about HIPAA was addressed to me… I admittedly did not research much before posting this experience. I’m familiar with HIPAA but not with all of the details.
Hippieprof– nice to read your last blog post and see that you are blogging again. I’ll be visiting your blog frequently.
this can happen with any body,
nut i think that, there may be their fault, but it also happens in one’s day to day life ( in other instances of life)
at that particular moment, one ma be angry to those people, bu then giving some though to it, there might be something at theor end, which they can not control, and so this happened…
I don’t know i am talking sensibly, but that’s what i feel
still there is medical system in place,
in India even if you will get the test reports from the other doctor by going to his office and bringing the reports to the new hospital , the new doctor and new hospital will not trust that test results and patient has to undergo all the tests again.
Thank you for sharing .
chetan– agree this happens but my point is more about the data systems not being connected…it will get there I’m sure. Sm– yes, while there may be flaws in the US system, it does work in many ways and is better than many other places in the world