Where do you start to update a system so deeply mired in antiquated technology and a culture so resistant to change?
Health records requests. Why should I have to request my own medical records? When I do make a request, why does it take days to get them? Why do I have to physically pick them up? Why do I get a stack of papers, or, if I’m lucky, a CD? Can’t my records just be sent to me electronically when I’m done with any medical encounter?
All fair questions. Patient-controlled and patient-shared medical records are paramount to health care’s transformation. For one thing, when providers have complete and accurate records sooner, better care outcomes will follow. For another, when patients feel included, have a say, and are given more control over their health care experience, higher engagement follows, and stronger patient/provider relationships happen. There’s no downside here. Transparency breeds trust and confidence. Successful service brands know this; it’s about time health care figured that out, too.
Incorrect or outdated medical information. I can’t remember all the medical details of my life. For example, I had a procedure for my back, but don’t ask me what it was called. And I don’t know whether my mother had cervical cancer or ovarian cancer. But I know that information exists. Somewhere.
Even without proper access to their medical records, let alone family history, patients are often asked for information beyond their memories when they fill out visit forms. Patients can’t be expected to know all the complex medical terms about their health care. The reality is some of the intake information is going to be wrong or omitted altogether. Until patients can leverage more control over their health care records and provide accurate information, we need to reset our expectations for what they can provide upfront.
The need to update the simplest of patient details. Why do I need to verify things like my address, phone number, and insurance every time I visit a provider? You can’t automate that most simple of tasks? Furthermore, why can’t I just update things myself, the same way I do on so many other online accounts?
No reason, except for health care’s resistance to change. We should be collecting patient information once and then ping the patient if an update or other information is needed. When the simplest of tasks can’t be accomplished without verification, a patient might start to wonder about their provider’s ability to handle complex tasks. And that threatens trust.
The lack of pricing information. I got a lot of medical bills and I have no idea why. I pay for insurance, but the doctor’s office still sends me a bill. Why is it so hard to provide invoices and bill details I can understand?
The lack of transparency and understanding around pricing and costs in health care is a major reason why people hate it and, unfortunately, avoid it.
Organization-based EHR systems. I’ve moved around a lot in my lifetime. But in this day and age, I wonder why my records have to be so scattered. None of my providers ever have my current information and I’m required to update my records everywhere I go. And that slows down my care.
This is the dumbest approach to technology implementation since AOL. Who thought that centralizing patient information around health care organizations was going to facilitate care for people who use multiple organizations, move, get tested at different places, get medications from pharmacies outside the organization, have surgery done in other places, or use urgent care? When providers treat people by using inaccurate or incomplete medication history, care suffers, and a lot of money is wasted. Organizational-based EHR systems have been a complete disaster that has set health care back decades.
Confusing test results. When my doctor gives me test results, it’s like listening to a foreign language. So frustrating.
This is so typical: In health care, we love making it easy to get tests done because it is billable. Once it’s done, though, no one gives a hoot about helping patients understand the results, unless there’s an issue of liability. Patients should not have to resort to internet research for understanding test results or a condition. We need to get serious about empowering patients with knowledge and understanding, their way.
No coordination between medical providers. Plumbers and electricians collaborate when working on the same house. Is it too much to ask that my two doctors connect during my visit with one so that treatment can be coordinated effectively?
It’s not uncommon for a patient to receive care simultaneously from two doctors in separate locations or organizations. But connecting them is a tripping point for health care. Ancient thinking.
Referrals that don’t connect the dots. When my primary care doctor refers me to a cardiologist and I go to see that cardiologist, why does that cardiologist ask me why I am there?
Another common complaint about a system that doesn’t put patients first. Lack of communication between providers is not a good way to instill confidence in care.
Appealing an insurance denial. The process of appealing an insurance denial for coverage is a paperwork nightmare for me and for my providers. It’s disheartening and I’m worried about future coverage.
It doesn’t have to be that way. The whole medical visit, including the doctor’s notes with the diagnosis and plan, should all be sent proactively to the insurance company. We can and should use technology to automate the process of supplying documents that payors need to minimize denials and appeals. With that, doctors and patients can spend more time focused on care.
Fax machines. In the doctor’s office I worked in, we had a staff member whose duties included the delivery of incoming faxes to people three times a day. So 1995.
Yup, fax machines are still around in many providers’ offices and serve as “Exhibit A” to the antiquated technology slowing down health care in America today.
Where to start?
Quite simply, with a new mindset about health care. And we can all play a part. Here are a few starter thoughts about how you can apply a new mindset to the ills of health care technology.
Raise your voice. Be more critical of antiquated practice technology that doesn’t support staff and patients or elevate the health care experience.
Stretch your mind. Imagine the ideal care scenario for patients and providers, one with no compromises. Then dedicate yourself to finding and using innovative solutions that support your thinking—not to mention your staff and patients.
Remember the big picture. New features are important. But also consider a higher-level cause within the health care ecosystem. Is it ground-breaking? Is it fixing health care’s dysfunction? Is it making life easier?
Let the purging–and a new mindset–begin.
Samant Virk is a neurologist and health care executive.