SOLTuesday: Poor Hospital IT Communication

Today, I went to a nearby hospital for an x-ray of my hip. The x-rays are done on a walk-in basis, so I did not need to make an appointment. I arrived and was, I guess, logged into the computerized system at 12:20 p.m.

 

Here’s the e-mail I sent to the hospital about what happened next. “Almost AN HOUR LATER, I received three e-mails, one telling me to check my Mt.SinaiAccount because I had a new message, the second telling me to Prepare for my visit by completing forms online, and the third had the subject line ‘Have you arrived?’ and the following text: ‘Hello Sonia, It's almost time for your 12:20 PM appointment. Once you arrive, let the clinic know by logging in.’ The three texts said exactly the same thing.

 

“THIS IS RIDICULOUS. I was already there, the x-ray was done. Why is the system sending me e-mails and text AFTER the fact? Obviously, the system has to be told to NOT send these e-mails and texts for walk-in appointments. It's extremely annoying.”

 

I wanted to inform the hospital that something was wrong with their default e-mail and text communications. First, I went to the the hospital’s website and found a phone number for Patient Relations. A recording reported that because of “higher than usual call volume,” I should leave my name and phone number. About 15 minutes I got a call from a difference phone number.The caller was clearly in a call center, as I could hear sounds in the background. I told him what I later described in an e-mail to the Patient Relations e-mail address. The caller then started asking questions. He knew my zip code. He then asked whether I had diabetes — and his accent was so thick I did not understand him for several tries. He asked if I had pain and if I had arthritis. Then he wanted to know my Medicare number. I do not know why he needed to know that, I said several times I didn't have it with me, and he kept asking if I could get it. I began to wonder if he really was calling from the hospital and hung up the phone. I've never been asked for my Medicare number when speaking to anyone else at this hospital.

 

After this abortive phone call, I sent the e-mail above to the hospital’s Patient Relations office. And then I sent another e-mail to them: “If the number I called above, 212-659-8990, is not your number, your webpage needs fixing. If the number that called me, 212-601-9340, is not from your call center, then perhaps your webpage and phone number have been hacked.”

 

At least I didn’t give out my Medicare ID. But how did this happen?

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SOLSC March 23: U.S. Medical System Sucks, part 1,234,567

            I had a colonoscopy and endoscopy done on February 14, by a doctor in a different hospital system than my primary doctor. (I’m fine.) I asked the center where the test was done to fax the reports to my primary doctor. 

            A few days ago, my doctor e-mailed me that she had not yet gotten the reports. I just spent almost 20 minutes on the phone with the hospital system trying to speak to someone who could fax the reports to my doctor. Here’s how it went.

            1. I call the center where the procedures were done. A recording offers me several options, one of which is “prescription refills and test results.” I’m not sure that’s who I should talk to, perhaps I should have pressed “all other requests.” This offers me one of the two options, so here I press “test results.” The human who answers the phone asks who the doctor was who did the procedure and directs me to call that doctor’s office and ask for Veronica. However, the phone number she gives me answers with a recording saying it is the Men’s Health Clinic — clearly not for me.

            2. I get the phone number for the doctor who did my procedure from my phone contacts. The human who answers says this is not the right office and transfers me to...

            3. Some other office, where the human who answers says she is not the right person and transfers me to...

            4. Some other office, where the human who answers says she is not the right person and transfers me to...

            5. What I think may be the hospital’s main switchboard because it rings for a whole minute until a very harried voice answers with the name of the hospital and “please hold,” where I hold for three minutes, then hang up in disgust.

            6. I go back to Step 1, calling the center where the procedures were done. This time, a human answers immediately. After I explain my request she starts to speak and I assume she is about to transfer me, so I interrupt, perhaps rudely, to say, “Before you transfer me, I’ve already been transferred five times...” and she says, “I’m not about to transfer you.” She then asks my name and birthdate (the phone ID for all medical calls) and says she will send my request to Medical Records, but “he”doesn’t have a direct line. “He”? Medical Records is one person?

            She then asks if I have MyChart, which of course I do. What person seeing a doctor connected to a hospital system these days doesn’t have MyChart? If I have MyChart, I can go in, print the report, and fax it myself.

            Of course I can do that. And remove one more task from the provider and give one more task to the patient/client. I suppose some people might find this more convenient, but I find it more burdonsome.

            That’s it for the day.

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I’m participating in the 16th annual Slice of Life Challenge over at Two Writing Teachers. This is day 23 of the 31-day challenge.  It’s not too late to make space for daily writing in a community that is encouraging, enthusiastic, and eager to read what you have to slice about.  Join in!

SOL Tuesday: In a medical quagmire

            In mid-January, I took a Cologuard test. That’s the at-home screening test for the eminently treatable colon cancer that you can take if previous colonoscopies have been uneventful and you have no risk factors.

            I did not expect the e-mail that I received a week ago that reported the test was positive. Helpfully, the e-mail shows my test result (Positive) and the normal test result (Negative). That was a shock. I immediately e-mailed my doctor, let’s call her Dr. J., who replied that I should see a gastroenterologist and asked if I had one. No, I did not. So she responded, not with the name of anyone, but with a phone number, and the note that she didn’t know who was available.

            Without having the name of a doctor, I decided to resort to my friends, first e-mailing a friend who I knew had a GI doctor she liked. When I called his office the next day, one of the first questions I was asked was about insurance. When I said Medicare and a supplemental, I was told this doctor did not take new patients on Medicare. (This is a recurrent problem. When my longtime doctor retired six years ago, the doctor she recommended also did not take new patients on Medicare. Many doctors will grandfather in their current patients once they go onto Medicare, but won’t take new patients. Why? They don’t get reimbursed enough?)

            Daunted by the thought of calling the four or five other doctors recommended by friends and being told they didn’t want new patients on Medicare, two days later I called the number Dr. J. had given me. After I explained my situation — I’d gotten a positive result on a Cologuard test and Dr. J. had recommended I see a gastroenterologist — the person I was speaking to said the earliest appointment they could give me was: mid-July.

            I was aghast. “This isn’t a routine situation,” I said. “That’s six months from now.” The person was apologetic, but firm. There was nothing earlier. After I ranted a little bit, she asked if I was willing to go to another location. That’s when I learned I was speaking to the GI division at the Mt. Sinai location where Dr. J.’s office is; she’s in the geriatric practice at Union Square. Of course, I could go to another location; in fact, if she could find someone at Mt. Sinai Morningside, that would be even better, as it’s only a few blocks from my home.

            I was transferred to Mt. Sinai Morningside, and eventually to the office of Dr. M., where I was told I could have an appointment at the end of April. Well, three months is better than six months, but it still felt like a long time for me to wonder whether I had colon cancer (a 4% chance) or only precancerous polyps (51% chance) that might turn into cancer in the next three months. I ranted a little bit here as well, and the scheduler suggested that I could see whether my doctor could speak to Dr. M about seeing me sooner.

            So I e-mailed my doctor the same day to report the situation. She said she would reach out to a colleague for suggestions.

            There was no news on the weekend, of course, only increasing anxiety over now thinking I knew the name of my death and wondering whether I’d have enough time to finish all the writing I want to get done.

            Monday I received notice of a new message on my Mt. Sinai MyChart page, a badly designed website. It read: “Earlier appointment offers are no longer available for NEW PATIENT on Thursday April 27, 2023 at 10:00 AM EDT.” Who sent this to me? What did it mean? Was there some time recently when I might have gotten an earlier appointment, but that time had passed? Maybe this was only a form letter, but couldn’t they have at least inserted my actual name instead of the bland “NEW PATIENT”? It felt so disrespectful.

            In addition to fear of what further tests might reveal, I was now beginning to feel helpless, as well as angry. I called Dr. J.’s office and spoke with one of her staff. What is going on, I wanted to know. My message would be passed on to the doctor, I was told. Half an hour later I got a call from the office manager. She was very apologetic, said she was doing everything she could to see about getting an earlier appointment. She was in touch with the office manager for the GI division. Again I ranted about how outrageous this felt, how helpless I felt — surely this wasn’t standard operating procedure for someone who’s gotten a positive Cologuard test.

            The office manager then gave me the phone number for something called “physician access,” schedulers who could make appointments for any doctor in the Mt. Sinai system. Was I willing to go anywhere in Manhattan? Of course, I practically shouted. She also gave me the number for “patient relations” should I want to make a complaint.

            I immediately called physician access and got an appointment in three days(!) at an easy to reach location. There was a brief glitch when I googled the doctor’s name and did not find him listed at the Mt. Sinai location where I’d been told his office was. I quickly called back physician access and was assured that he did indeed exist, and at the location; he was new, so no doubt the website had not been updated.

            I called  the office manager back to thank her for her help. But I also wondered, why couldn’t I have been given this number to begin with? How exactly did the bureaucracy of this immense hospital system operate? Surely the stress and anxiety of the past week could not be good for my health — don’t all the wellness articles say “AVOID STRESS”?

            What could Mt. Sinai do better? I think it’s far too easy for people who work in an institution to forget that others, patients in this case, do not know how the institution works or, when it’s as big as a large urban hospital system, how all of its parts fit together. Perhaps a little booklet that explains clearly, even with graphics, where your doctor works, how that center or division or clinic fits into the overall system. And especially, where and to whom to go for help for the variety of issues patients might have. 

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It’s Slice of Life Tuesday over at Two Writing Teachers. Check out this encouraging and enthusiastic writing community and their slices of life every Tuesday. And add one of your own.