A View from the Other Side
My doctor, who I’ve been going to for the last 20 years and who I love is kind, patient, knows me and my family, a real advocate for my health and a man I trust. Recently, his office got bought and his office changed to a new EMR.
Now, me being who I am, a computer nerd who supports EMRs for a living, I was real interested in this transition and, if you follow my posts, you know that I think switching EMRs is a proposition fraught with risk: you’re in for trouble with a capital T when switching EMRs. If you aren’t forced to make such a change there’s no way you ever should – it just ain’t worth it. But hey, in this case the practice got bought (good thing – their survival was in doubt) and my doctor pal made a nice chunk of change: good for him! I hope it happens to me someday! I tell you what, I’ve already got the boat picked out that I’m going to sail around the Caribbean and over to Europe, raising a glass to each golden sunset with a grin as I go.
But the golden payday hasn’t happened to me, and there he was, going thru the dreaded EMR transition but for all the right reasons: we have a great relationship so I called periodically to ask “how’s it going?”
“Bad”, he replied, “nasty and hard. But it’s what I expected and on the plus side, the new EMR is better than I thought it’d be.” We talked a bit more about family and the US political circus and hung up. “Well”, I thought to myself, “maybe I’m a little too dramatic, too much the Cassandra, singing songs of EMR doom that don’t apply when it comes to EMR switches.”
But then, my friend, I tried to get my prescription, the one I’ve had for 15 years, renewed. How it started: I noticed my prescriptions that I take for high blood pressure and gout hadn’t been mailed to me. “Hm”, I thought, “that’s unusual.” My medications usually arrive in cute little plastic pouches ready for easy daily consumption a month ahead of time. That way I get to tear open a single pouch and pop the pills down the hatch as opposed to opening 4 different bottles, trying not to drop pills, making sure I don’t have duplicates, etc.
“I show that our requests to fill meds haven’t been responded to for over 6 weeks now” said a harassed clerk at my pharmacy of choice when I finally got thru. “I tell you what”, she said to me with kind contempt, “you call your doctor and I’ll fax them and maybe they’ll respond.”
I called the clinic, where I had to deal with a new phone tree and new front desk personnel. They didn’t know me, and I was amazed at the dramatically negative change of atmosphere the new changes made: instead of joking with people I knew while they scheduled me, it took 15 minutes to talk to somebody who couldn’t find my name in the new software, and they transferred me back to a nurse who didn’t pick up so I left a message. She called back 2 days later.
“What’s your pharmacy?” she asked.
“Carezone”, I replied. “You don’t have that in my record?” I asked in surprise.
“No”, she said testily. “We’re on a new system.”
“Oh” I said. “Can’t you look at the old system?”
“No – I don’t know how to work the old system, and anyway I can’t get to it.”
“Oh” I said, wondering how they were supposed to fill in the inevitable medical record gaps they would encounter from old system to new: “Well, I’m running out of medications for high blood pressure and gout and I need to get them refilled. You’ve had my prescription at the clinic for 10 years or more so it really shouldn’t be a problem.”
“I can’t find that pharmacy – it’s not listed in the database” she replied. “I’ll call you back” and she hung up. Click.
The next day, I got a call from a King Soopers pharmacy located in a town I no longer live in, notifying me my prescription was ready for pickup. ‘Well ok’, I thought, ‘at least I can go drive for 30 minutes and get my meds, but I sure prefer my regular pharmacy that delivers, to my door, my meds organized in cute little tear-open packets so I can swallow what I need to in one swell daily foop.’
So I called the clinic back to report that the wrong pharmacy had my prescription, and… the long and short of it is, folks:
- I spent a couple of hours getting and receiving calls to establish a prescription I already had.
- The nurse I didn’t know had to hand write and then manually fax my prescription to the right pharmacy.
- King Soopers filled a prescription they will have to cancel and recycle those meds.
- Between my time, the clinic’s time, and the time spent at 2 pharmacies we have maybe 5, 6 hours spread over 3 days down the drain.
- And the real killer: I find to my surprise that my loyalty to my doctor and his clinic has almost completely evaporated. He’s sold out to the man and I’m here to tell you that’s exactly how it feels. I figure ‘why drive 45 minutes to his clinic when I could go to somebody 5 minutes down the road? Maybe the next doc will own his clinic and care what kind of impression his staff makes!’ Which is wild because my doc is a damn good doc: he’s proven that he knows his stuff many many times.
There you have it: this business of seeing patients is an intensely personal business from Front Desk to Nurse/MA to Software to Doctor… thinking of switching EMRs? I can’t recommend it. Thinking of selling out to the man? Careful! It ain’t everything it’s cracked up to be…