Why No Electronic Medical Records in the U.S.?
April 13th, 2010First, I have an admission that I really shouldn’t feel that ashamed about. In addition to a seizure disorder, I’ve had clinical depression and anxiety for years. It’s weird that there’s still a stigma associated with mental health disorders in 2010, but there it is. I’ve tried various combinations of medications and therapy, and I’ve finally found a medication that has worked for me for the past few years.
My Former Primary Care Physician
My old doc was a pretty good guy. Dr. C’s practice is with Mercy Primary Care in Westbrook, ME. I chose him because it was close to where I worked at the time, and he is a D.O., which I prefer. I never had any problems with Dr. C. The practice, however, was another story.
Getting prescription refilled at the office was an absolute nightmare. First, you need to wade through a maze of menus on their phone system. Admittedly, this is part of modern life that one just has to learn to live with wherever you get services. Until recently, the menu system eventually directed you to leave a message for the nurse with all of the requisite info on your refill. The last time I called, they did away with this formality – now the message tells you to call your pharmacy and have them fax the request over.
I probably got my script refilled four or five times over the past few years, and was never able to get this “system” to work the first time. That’s not hyperbole or exaggeration – I literally was never able to get a prescription called into my local pharmacy by calling once. I’d get about a week left on my medication, and call it in. After that I’d go back and forth between my pharmacy and doctor’s office, each side blaming the other. On more than one occasion, the doctor’s office would tell me to just come in and they’d give me their free sample kits while they sorted this out. One time, I even ran out of the samples while they “sorted things out.”
Time to Change Practices
The time was approaching when my prescription was going to run out again. I had enough of the medication runaround. I decided to get a doctor that was closer to where I lived, and I chose one within the Mercy system because, despite my bad experience with prescriptions, they’ve always been great in the past. So I chose a new doctor at the Auburn St. office.
I filled out the paperwork to have my medical records transferred to my soon-to-be new doctor, and waited to hear back.
Another Runaround (And, yes, I Share Some of the Blame)
I admit, I cut it pretty close when I sent in the paperwork to have my records transferred. I had almost two weeks left of medication. I got low enough that I knew I was going to have to call it into my old doc again, before I got a chance to see my new doctor. On Friday April 2, I called Dr. C, and got the voicemail directing me to call my pharmacy, and I did. I went to my pharmacy the following day, and unsurprisingly, they had not heard from my doctor. They assured me they would fax the request a second time.
The next Monday morning, I left a message for the nurse at Dr. C’s. I didn’t hear back from them, so I went to the pharmacy at noon. They still hadn’t heard from my doctor, so I had them fax a third request. My wife stopped by the pharmacy that evening, and they still had not heard from my doctor.
Having seen this pattern before, I got pretty upset. Tuesday morning, I called the office and informed them that I’d be coming by, and I intended to leave with a prescription in hand. I had less than a week of meds left and wasn’t going to keep doing this. When I got to the office, the receptionist had me sit in the waiting area while they got a hold of someone.
Medical Records in Limbo
While I was waiting in their waiting room, I got a phone call. It was the nurse from doctor’s office! Perhaps they thought I was upset enough that they didn’t want to deal with me in person. She informed me that their system showed that I had transferred to a new doctor. My medical records were no longer at the Westbrook office – they had been shipped out the day before on Monday, April 5th (note that this was after I had called for a refill). They were unable to fill my prescription, she said, and I would have to do it through my new doctor.
I drove over to my new doctor’s office that morning. They had not received my records from the Westbrook office yet. In fact, they didn’t receive them until Thursday. It took Mercy’s inter-office mail four days to send my records across town. Once the new doctor had my records, she would still be unable to fill my prescription until after my first office visit. It’d be another week (April 20th) before she’d be available to see me.
So nobody can fill my script right now.
Meanwhile…
I’ve run out of meds. A few days ago, I started splitting them in half, and now I’m taking them every other day. Right now I’m lightheaded as hell – my brain keeps getting these little “zaps” of dizziness, and I seem to be trembling a bit more than usual. It’s probably not safe for me to drive. I don’t mean to sound melodramatic – there are millions of people who are suffering from horrible, real problems that dwarf mine right now. There are far worse things than feeling lethargic, mopey, and half-drunk all the time.
I feel pretty let down by this whole process, though. I was changing doctors within the same medical system. Why does Westbrook not have a copy of my old records? Why, in this day and age, are they not transmitted electronically? Why is it still so hard to have a doctor’s office approve a refill at a pharmacy? How much time, effort, and money is wasted on a process that results in such sub-par care? Why am I going through drug withdrawals because of an administrative failure?
I’m sure there are lots of people who fear a massive, centralized database of our most personal medical information. But does storing and transmitting them electronically really reduce our privacy? My records or refill could’ve been transmitted electronically using the same SSL encryption that we entrust with our financial transactions every day; instead, they were handled by a courier and a staff in a mailroom somewhere. I’m sure the manila envelope with my medical history (which, at this point, probably indicates that I’m “difficult“) was handled by scores of admins, nurses, couriers, etc., on their way to their intended destination. Those bits could just have well been sitting in an encrypted in a database somewhere.
I’m sure it’s all part of bigger question about costs and where best to invest in patient care. The software developer in me thinks we could’ve solved all of this with some relatively inexpensive IT infrastructure and open standards for medical records processing. Maybe that’s on its way. Meanwhile I’ll keep trying to type – I wonder if this is what my cat feels like after a catnip binge?




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