Monday, November 26, 2012

Care coordination dinosaur still lumbering and STILL don't have the info requested

Wow. I knew it could often be a pain to get medical records from another doc, but until recently, I hadn't appreciated just how convoluted the process could be. (That's because until recently, I practice in conventional office settings, where getting records was a task delegated to other staff members. But now I'm trying the micropractice model so doing it all myself, which is instructive.)

For those interested in coordination of care (or wondering why their PCP never seems to know what the other doctors did), let me update you on the latest twist in my quest to get information from the orthopedic surgeon.

A few weeks ago I received the snail mail letter, informing me that I had to submit my request for the surgeon's notes to the hospital with which he is apparently affiliated. So I faxed the request on 11/15/12, including a release of information signed by the patient's DPOA.

Today I finally get a fax back.

No records included.

Instead, I'm informed that the request can't be completed because it's missing DOB. They fax me part of my own fax. It does happen to include the patient's DOB at the top (my EHR automatically inserts along with patient's name), but I guess somehow they missed that part.

They also include their own release of information form, which has to be signed by the patient.

Grrr.

I call the medical records office. I speak to a very nice person who knows nothing about the fax I got earlier, but advises me to fax my request and signed release of information form again. He does promise he'll try to take care of it soon, but warns me that though he'll be able to provide the discharge summary I requested, it will take longer to get the surgeon's initial consultation. That's because he'll have to request those from the surgeon's office (you know, the one I contacted in the first place), and it can take a while to hear back from them.

Oh and, I discover that a second copy of their fax has arrived in my fax inbox. This version includes a page about an entirely different patient. So much for the current system protecting one's confidentiality.

So, more waiting for the information. I haven't felt that it's critical to the work I'm doing right now on the case, but I'd like to see it just because I like to have checked everything.

In a nutshell:

It can be incredibly slow and aggravating to try to get medical records from another doctor. (No wonder support staff in medical offices often look so stressed out.) The current paper-and-fax based system is also fraught with potential for error, such as faxing the wrong patient's information to who-knows-where.

I can't wait for the day when the new dawn of healthcare technology makes these kinds of problems a quaint story from the past.

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