Saturday, February 25, 2012

Exciting news! Nope. I feel like a hamster.

A true story, starting with this message from a patient's multi-specialty practice:

Look at these features!

Our retired friend explains:

Some time later, I received this message:  "Please login (sic) to ABC Medical Group patient portal to view your lab results."  So I try to log in to get my lab results but cannot retrieve them. I ask for a password reminder.

The amusing (but more than a little frustrating) part of it was that they had sent me a new password, but both my husband and I could not enter the password because there were a bunch of capital Os and the letter 0, along with lowercase os. We both tried a number of times and combinations and none worked.  

I figured, though, that I would try again.  To get my password, there was a security question I had to answer: "What is my profession?" 

I replied "gardener" as I had answered when my doctor asked me the other day.  The transaction failed -- "improper response."   It is not my fault that he did not transmit the correct answer after he filled out the questionnaire the other day.

I feel like a hamster running on a wheel.


Anonymous said...

This is 'meaningful use' from the end-user's standpoint. Not meaningful at all, and not much use.


Paul Levy said...

From Facebook:

Mary: Kaiser has the same problems Paul.

Amy: I can't make that patient site work to save my life, but I did get someone else's lab results. I'll never use that system, never.

Cathleen: Well the paper system had the same sort of problems as online systems. One time I was mailed someone else's medication prescription from a medical practice within the health system my physician was in, but it was not for me and I had not even requested any prescription. So that was quite a breach of confidentiality with the paper based system.

Amy: I expect and except human error. I have significantly less acceptance and tolerance for technical ones

Paul Levy said...

My friends adds this supplement to her story:

"I marched into the doctor's office yesterday and showed the woman at the desk the gobbledygook with all the os and Os and 0s. She couldn't decipher them either. I asked for my lab results to be mailed. They arrived today. Forget the password mess. I will plead an aging brain."

Anonymous said...

This is the kind of multiplicative cost that 'technological innovation' adds to our lives. 'Nickel and dimed' can now be called 'seconds to minutes.'

At least the hamster has time for exercise. She doesn't have email.

Anonymous said...

I have had similar troubles with logging in to online patient communication and records systems for the large practice that I go to and it has been very frustrating.

That being said, I have also had an excellent experience getting very quick communication with our doctor and her NPs via the website. For instance, my daughter had pain with urination, we left a urine sample at the lab on a Tuesday night at 7pm, logged in and found the abnormal results early Wed. morning, called the office and got a prescription for antibiotics by 10 AM. We didn't have to make an appointment, miss work/school. It completely streamlined the process.

We also use the email feature to update our doctor on minor changes in symptoms to to make minor adjustments to medications as needed for chronic problems. It's great! Of course there are times we need to go in or have a phone conversation, but this really helps.

Anonymous said...

While we are talking about big multi-specialty practices, can I ask a question about how they work?

My PCP is in a large multi-specialty practice in MA. The practice absolutely insists that all referrals for sub-specialty care go to providers in their practice.

For the most part I have complied, sometimes reluctantly. I've seen ortho, derm, podiatry, gyn etc etc. I've given them plenty of business.

But now I want to go to a sub-specialty provider outside of their practice and definitely don't want to see their doctors for this particular part of my care. They have told me they will give me a referral for one visit for a "second opinion", but otherwise if I want to see that specialist outside their practice for ongoing care, I will need to get a new PCP outside of their practice who can refer me.

I told them I understand their business model is to encourage patients to stay in the group, but that I have a right to go whatever practice I want to and that my insurance will pay for. They responded that this is "managed care" and that if I want to stay with their group I need to use their providers only.

I have a lot of reactions to this. I'm angry I'm being made to jump through hoops with a resulting delay in my care. I feel my rights as a patient are being infringed upon for their business interest. AND, I'm offended that they are willing to lose me as a long-term patient for this short excursion to the outside world.

But besides that, here are my questions:

1) Is this really "managed care?" I thought that had to do with my insurance limiting where I can go and how many visits will be covered, not the policy of the medical practice.

2) Can they really do this? Do I have any legal rights that, if my doctor deems that sub-specialty care is medically necessary, that they need to give me a referral to the practice of my choice? I heard of pediatricians "firing" patients who don't vaccinate their kids, so is this in the same vein... if you don't play by our rules go play somewhere else?

Thank you for your time and consideration.

Paul Levy said...

You raise good questions. I don't have the answers. Perhaps others will comment.

Lauren said...

I take issue with this post because I had a provider in the last city that I lived in that had a functioning patient portal and I LOVED it! Now that I have moved to a new city and have a new provider without the patient portal I am frustrated because I feel like I have gone back in time to the stone age.

It used to be I could log in and search for available appointments by provider and schedule online, during non-business hours, rather than calling and being put on-hold (without fail) by the front desk staff. I received a notification via email that my lab results were ready for my review in the portal along with my provider's comments just days after my appointment. Now I call into the doctor's office 2 months after my appointment when I finally remember and have a free, private moment, during my crazy, overloaded work day. I sometimes wonder - what if I had never called in? Would they eventually call me? When my new provider handed me a paper prescription, I was floored. "What do I do with this?", was my initial thought. I had forgotten, having spent several happy years having my prescriptions electronically forwarded to the pharmacy.

If you can imagine for a moment all of the time savings, communication streamlining that the portal can offer... there are many wonderful things about it. I am saddened that your post puts a bad taste in many people's mouths for a functionality that does work in some instances and is a far improvement over the old school way many physician's offices operate.

Anonymous said...

Lauren, I don't think Paul's post is directed against patient portals, since BIDMC had one of the best. I think the post is a kick in the pants to practices and hospitals which claim to have patient portals but they are so in name only, useless and frustrating as they were to this patient. Pretending is worse than just using paper.