My husband and I returned from vacation in June to discover that my dad had had multiple strokes, which led to hospitalization. I won't expound on the details as I plan to focus on HIT, not on electronic health records (EHRs) or electronic data exchange. Rather, my focus is on hospital-patient and hospital-family communication—or lack thereof—and how technology could fix this abysmal component of the system.
When he had the stroke, my Dad was admitted to a small community medical center in southern New Jersey. He remained there for 12 days and then was transferred to an acute rehabilitation center in northern New Jersey, close to where I live. After an unforeseen problem arose, he was transferred to a major university hospital, where my tale of communication woe begins.
The caliber of the hospital staff at the community hospital did not compare to that of the university hospital in which the tenure and professionalism as well as patient care were excellent. However regarding hospital-patient and hospital-family communications, the community medical center trumped the university hospital. The patient information capabilities at the university medical center were simply Byzantine. One might think that a largely endowed teaching hospital would have better, more streamlined communication, which could be state-of-the-art technology enabled—not medieval.
Take for example the phone call I made to obtain my dad's room extension. I literally waited in limbo on hold for an operator for over 20 minutes (of course, I was multi-tasking while waiting), listening to all the state-of-the-art medical services the hospital had to offer. Service this! One would think that there would be either a human instantly on the line or—and here's the trick—a voice response unit that would allow you to enter the patient's last name and/or other identifier so as to quickly and efficiently obtain the room extension number.
Provider organizations are so entangled in the muck and mire of implementing EHRs that no thought has been given to the efficient and effective communication of patient information (albeit, an oxymoron) or the quality of the delivery of such. By the way, I did check the Web site of said university hospital before beginning this tirade to see what Web services might be offered—such as patient room or extension number look up—and there was nada. However, you could schedule an appointment online. After my experience with the phone system, I would not be inclined use the online appointment feature.
Now many of you may be thinking that what I am proposing would not be HIPAA-compliant. First of all, HIPAA has been mostly misunderstood and moronically implemented, and the fact is that it sabotages patients and their families more often than it protects patient information. A voice-response system or a Web-based patient lookup service is the same as phoning the hospital and asking for the patient's room number or extension.
Having cleared that up, let's turn to quality delivery of updated patient information to family members. Email, people! With all the money being spent on medical technology and HIT, implementing an email account for patients' families (obviously for those families who use email and have Internet access) could provide a daily update on the patient's condition (in layman's English), notification if the patient has been moved to another room, etc. (At the university hospital, they moved my dad three times, forcing us to play the juvenile game of "where did they hide the patient today?" This is both demeaning and demoralizing to patients' families, who are already stressed out beyond comprehension.) The email account would be password-protected and would exist only for the duration of the patient's incarceration...oops, I mean stay.
When they transferred my dad to a sub-acute (more nursing than rehab), the university hospital forgot to ship him with his dentures and glasses—and those were the only two personal articles he had with him. One would think that a simple computer entry of the patients' personal effects could be generated so that, when they are released or transferred, all their belongings go with them.
While I am not an advocate of technology for technology's sake, it seems to me that medical providers should focus the lens outward to look at the bigger picture and consider how proven technology could be used to improve the quality of the patient's family's experience as well as that of the patient.
Maria A. DeGiglio is President of, and Principal Analyst for, Maria A. DeGiglio & Associates, an advisory firm that provides clients with accurate and actionable information on business and technology initiatives. You can reach Ms. DeGiglio at firstname.lastname@example.org.