September 25, 2012

When Patient Experience Meets Meaningful Use

With cold and flu season in full swing, it stands to reason that I would be taking a much needed trip to the doctor’s office. Luckily, it has been some time since I had to see my family physician. In visits past, I would be handed a clipboard to fill out my insurance and patient information as well as a plethora of release and HIPAA forms. This information would later appear in the universal manila folder hanging on the door of the designated exam room to be reviewed and completed by nurses, technicians, residents, and finally, my physician/friend, Dr. Mike. Dr. Mike and I go way back. He has been our family physician for many years and I look to him for frank and honest discussions about my family’s health. He is an old-school physician that has been thrust into the digital age due to Meaningful Use initiatives and he is not sure what to make of it.

Upon my recent visit to Dr. Mike, you can imagine my surprise when I arrived at reception to check in and was handed a thin, black touchscreen tablet as opposed to the normal clipboard with devoted pen. As I woke the device, I discovered all of my current billing records, insurance scans, and the HIPAA forms that I would need to sign. I confirmed that this data was still up-to-date by simply checking a box. All of my information was confirmed and through the use of the office Wi-Fi network, wirelessly updated the reception desk.

Now comfortably seated in the exam room, the nurse arrives to gather pertinent data. Blood pressure and temperature are taken and this data is updated on my electronic health record (EHR) that has cued up on her iPad without her intervention; these devices Wi-Fi enabled. She proceeds to ask for the list of symptoms and any other data that is required for Dr. Mike to treat me. Amazingly, she enters this information directly into the iPad using a series of menus in the EHR application. Within just minutes she says I will be seen shortly and leaves the room. Where is the folder on my door? Where are the multicolored sheets that describe each of my visits to the good doctor? Clearly, Meaningful Use has challenged my family physician to bring his office to the 21st century and he has embraced the technology. But how is he handling the transition from color coded and tabbed manila folders to EHR and Wi-Fi networking?

“So, you’ve converted to electronic health records?” I asked Dr. Mike upon his entrance to exam room #2. “It has been an expensive process but after a bit of time, it is getting easier on all of us” he replies while opening his laptop. Is he utilizing the financial incentives for implementing Meaningful Use in his office?  He said that he has, but isn’t quite sure the process is worth it for him. “Are you looking into connecting to the health information exchange?” I asked, “There is a four year plan in place with the State of New Hampshire to connect all hospitals and physicians to the Health Information Exchange. You could practice telemedicine and get reimbursed for that down the road. They are looking for pilot physicians I believe.” Knowing me as he does, he looks over his glasses and asks if he looks like the type to visit his patients over a webcam? Touché, Dr. Mike, but he does admit that he will look into it to see if it makes sense for his practice.

We are finished our exam and he breaks out his notepad to write me a prescription. Looking at all he has done to support wireless connectivity in his doctor’s office, implementing technology to support Meaningful Use and EHR, I look at him incredulously. “Dr. Mike, don’t you use e-prescriptions?” His response stuns me. “Yes, I do. But sometimes it doesn’t go through. If you go to the pharmacy and expect to pick up the medicine right now, it may work better to have that piece of paper in hand.” Even with the investment that he has made to support HIPAA, HITECH, and New Hampshire’s implementation of the Health Information Exchange (HIE), he still doesn’t trust the system. As a technology advocate myself, I believe and trust the system. I ask for Dr. Mike to please use the e-prescription system for me. After a few clicks on the laptop he says that I am all set.

My pharmacy is on the other side of town so as I am driving there, I have a slight twinge at the thought of my dear friend Dr. Mike being right. What if my prescription isn’t there? What if the system failed or if the pharmacist on the other end has the same feelings for technology and decided to not check the system? No, I am going to trust that networking technology in medicine is the key to efficiency and power on to pick up my prescription.

I walked up to the counter and mention that my doctor has sent in an e-prescription for me. The pharmacist asked for my birthday and then my name. I volunteered my prescription card. “Did my prescription come in?” I ask, hoping that Dr. Mike isn’t right. He nods and tells me that he does not need to see my card; the information came over with my data from the doctor’s office. I sign the kiosk that clears my information and he hands me my much needed prescription. I walk away triumphant because I know that technology like Wi-Fi networking, EHR, and Meaningful Use can really enable a better patient experience and ultimately bring the medical community a much needed bridge for information and improved patient care; even when physicians like Dr. Mike are not sure what to make of it all.

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