Better Healthcare Communication Heals All Wounds
A number of our clients are providing technologies and methodologies to help improve healthcare, and the industry is buzzing around CMS’ proposed regulations on accountable care organizations (ACOs), the financial and legal framework for keeping costs down and making healthcare more sustainable. With government/Meaningful Use incentives around implementing technologies like electronic health records (EHRs) and health information exchanges (HIEs), we’ve seen significant steps toward improving physician/patient communication – but as a consumer of medical care, I will say the improvements cannot possibly come fast enough.
I have primary responsibility for my elderly mother, who lives as independently as she is able to in a wonderful assisted living facility near my home, but who needs support around choosing and dealing with any medical providers or issues. Since I don't have any medical background, I've engaged excellent geriatric care managers to help my mother and I navigate the particular medical needs of the elderly. Even with that great support network I've established, I must say it is not easy to get Mom the care she needs, largely because most physicians are very disconnected from one another. As an example, my normally very healthy mother was ill a few months ago with what could have been pneumonia. When I called the gerontologist who has been caring for her, with visits to her home, for five years, I was told I could take her to the hospital where he has privileges, which was a distance, or take her locally, but he could not see her there. I chose the latter, as it was less taxing for the patient.
At the local hospital, which is affiliated with a much larger Boston hospital and provides excellent care, Mom was introduced to specialists as well as a "hospitalist" who provided the primary care role while she was in the hospital. They treated her well, but the discharge report was a series of separate sections by the specialists and the hospitalist. We had this sent to her gerontologist, but it isn’t at all clear whether any real communication happened between those hospital physicians and Mom’s primary care at the time.
For a variety of reasons, my mother and I decided to stay with one of the specialists she met in the hospital and to find another local primary care physician, rather than her current gerontologist. We thought there would be benefit in having all of her doctors able to talk with each other and see her in the event she had to be hospitalized again. We located a very good primary care physician and have been taking her back and forth to the initial, and then follow-up, appointments with her heart specialist and her new primary care over the past weeks.
Despite the fact that we have had all records sent to each physician and that the two doctors practice in the same hospital and know one another, however, the primary communication channel for each physician still seems to be my mother, the patient, and myself and the geriatric care manager who often accompanies us to visits. Since I live and breathe communication technologies -- work laptop and Blackberry and home MacBook -- to stay in touch with everyone in business and my personal life -- it's very jarring for me to watch a physician flipping through paper files and asking questions of someone who often can't remember what day it is, let alone what tests they had done in 2006.
We are working hard to fill in the pieces of the jigsaw puzzle of my mother's medical history to answer her new doctor’s questions. This included contacting a hospital, which has since closed, where she was admitted almost six years ago. A very nice man and his part-time medical records person located the records from that hospitalization and they are having them scanned and printed for me so I can bring them to her new doctor. I fully expect to get an additional question or two after he reviews this paper, however, and I will be without an answer once again, feeling like I forgot to study for a quiz. I can’t help but think that all of this care would be greatly improved – and much more efficiently provided – if physicians could network and communicate with each other more easily. Even the use of email alone would help everyone in this medical equation. [Note: my own personal physician uses a laptop and email and it makes an amazing difference.]
I know I'm actually fortunate that the communication dilemma I am wrestling with only involves a primary care physician and one specialist. I have friends who are juggling numerous specialists on behalf of a parent. If each of them requires the health proxy to be a fountain of information and dates and inter-communication, these poor souls are doomed to spending hours documenting meetings and keeping all of the data up to date and distributed to all interested parties.
Heading into Memorial Day, the first long weekend of a Spring/Summer that is still being shy about coming out in full force, I can only express my gratitude to the technology and health care industry players who are trying to effect changes. May those changes come quickly.