Survival Strategies

I’ve been asked by my doctor to get him a film of an imaging study done in the ER. To get it, I have to pick it up in person or wait for it to be mailed. I decide to pick it up.

 

In the bowels of the hospital is the Health Information Management System (HIMS) office. For the hospital, it is the lair of the geeks, relegated to the basement. For the patient, it is the Release of Information office. Here, one lone woman sits at a single terminal in a windowless room answering all requests for hospital records.

 

No matter which hospital in this giant network you visited, this woman can–upon completion of a form–print your records in a matter of minutes, or burn you a CD. You can pick them up, have them emailed, receive a fax.

 

There’s a valet in front of the hospital that only charges $4.00, so you can jump out and run this errand,

 

While many people might argue that a valet charge to pick up one’s own records is outrageous, and that the records should be give to you as you walk out the door, I prefer to take the Louis CK perspective: we’re flying through the sky in metal chairs and everyone is complaining.

 

Do you realize it was not always this way–that records librarians formerly went through rooms of paper files and then charged you for a “Xerox”? That it could take days to get records that might then have to go through the mail?

 

Before going to get these records, I went to get my blood drawn. Each little tube had a bar code, and I had to verify that my correct name and birthday were on the bar coded tubes.

 

Banner Health has taken great pains to reduce medical errors and adopt information technology since I gave birth to my children there 40 years ago. Because I have the long view–yeah, I’m old–and I’m a geek, I notice changes like this.

 

A short seven years ago,when I had my hip replaced, it was not like this. I remember (probably because I was in pain then and walking with a cane) walking through the halls of Scottsdale Healthcare’s Shea facility checking in at one place to get my labs, another to get my registration done, and still another to check in for the surgery. Each time, the same set of forms. Marching, painfully marching, through endless halls to help out systems that didn’t talk to each other and gathered the same information multiple times.

 

Over the past five years, with the ACA and the Recovery Act, the government has spent untold tax dollars to incentivize providers to improve their IT systems in response to customer demands. Now I am beginning to spot the results. Different hospitals have set goals and proceeded at different paces, but I dare to say all of them have done something. And doctors have really rushed to upgrade to electronic health records (many hospitals already had them), and prove “meaningful use,” because they are going to get paid, henceforward, on “outcomes.” Some practices have set themselves up as part of Accountable Care Organizations to be on the forefront of this new risk-sharing business model. And you can’t do that without adequate health IT systems

 

So health care begins to change more quickly than just glacially. As I’ve said so many times before, it’s about time.

Tagged as: ACA, health care reform, health IT, Recovery Act

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