Wow, what a life awakening experience!
This past year after falling from a ladder I had the experience of being taken to an ER at a large local hospital, admitted and then being transferred to another larger hospital’s neurological ICU section. Being involved on HIT (my company assists small practices with implementing minimally invasive IT, EMRs and business related products / process solutions) it turned out to be quite an education but because of the “health circumstances” I had it is a lesson I would never want to learn / experience again.
So in a nutshell what happened is I was on a ladder about 7’ up, apparently fell (I actually to this day do not remember anything beyond being up on the ladder) and my wife, out of the corner of her eye, saw me fall. She dragged me into the house, onto the couch where I remained out for about 5 minutes and then we proceeded to our local large hospital ER where I walked in to get checked out. A CT scan showed I had a small bleed on the brain and a decision was made to transfer me to an even larger hospital that has a dedicated neurological ICU floor. The HIT person inside me asked if they were electronically transferring my EMR records / scan to the other hospital’s EMR system and they then stated they would fax the report there because their EMRs were incompatible. Figures!!! I later found out the first hospital was using C*****, the other one was using E*** and that also turned out to be a reason for a whole lot of duplicate questions being asked of me by countless numbers of healthcare pros- uggh, my head hurts!
Ambulance arrived to take me to the next hospital and during the directions that my wife was writing down on how best to get to there a question arose of how I got to this first hospital, to which she informed them “I drove him here”. I/she was surprised to hear a “non- appreciated” response of “you shouldn’t do that, that’s our job” – hmmm – somehow we missed reading that “rule”! Then the rest of the transport was uneventful.
Arriving at the next hospital was met with scores of healthcare pros asking tons of questions, many repetitive from the other hospital, then scheduled for another CT scan before being taken to a room on their ICU floor. Finally a chance to get some sleep, my sweet wife slept in the chair next to me all night while a caring neighbor watched our children, but bright and early the morning were more health care pros, doctors, med students, new nurses coming on shift, blood drawers, deliverer of meds. . . asking more information or providing information of which I believe I remember hardly a 1/5th. I do know there was a fair amount of questions asked concerning pre-existing conditions I had, meds / supplements I was taking and any / all drug allergies. When I finally did “wake up” (sorry, no coffee or food yet till they determined I didn’t need surgery – that came 2 days later) I asked my very kind ICU nurse: “Just what information would you say is critical for doctors to have when a person is admitted to ER, especially if unresponsive?”. She kindly gave me a short list which I committed to memory and promised myself to make it the “initial” part of my ICE (In Case of Emergency) PHR (Personal Health Record) wallet card / I-Phone too in case this ever happened again. Then my only concern will be is the health care facility going to be able to review it first and save me a ton of repetitive ER/ICU questions.
After 2 full days in ICUs, another (3rd) CT scan the second day that shown no further bleeding, I was released to a room in the general section, my first hospital breakfast and COFFEE. I again was visited from early morning on by more doctors, med students, nurses of various types, blood drawers (which none could tell me any test results of previous draws – hmmm?) and nutrition support (brought the food trays).
I guess I realize that all these health professionals have vital parts to play in patient care and I am truthfully not knocking them for that but as finally (hopefully not again) being a patient I really don’t know who I can call as my primary care doctor for this condition/stay that I can call or e-mail to answer any follow-up questions I may have. The head RNs were great and could check into the hospitals EMR information and print out some reports / answer basic questions (God love them – they were His / my angels) but they couldn’t answer “reason for certain medication” questions or “discuss CT scan results written in DReze”. . . I did have the name of a doctor written on my board in my room but honestly I don’t remember actually meeting / talking with her – there were just so many professionals coming all times of day and night. I did have a Dr that I needed to follow-up with the following week (different than the name on the “board”) that I can’t remember meeting in the hospital. I had a neuro-medication prescribed by yet another person, not the filling pharmacist either, that was meant to prevent seizures that states under “Uses: . . . It is not known how it works to prevent seizures.” and I wanted to ask the doctor about that and why it is prescribed to me. This med also caused me drowsiness, dizziness and weakness (known / documented side effects) but my discharge instructions state to contact my personal primary care physician with questions if these side effects occur. My personal primary care physician (PCP) typically doesn’t specialize in this area, is not really familiar with this med and why it was prescribed so who do I call, the pharmacist, the person that prescribed it, the person who’s name was on the board or the doctor who discharged me (yes, this was yet another doctor) or my RN or ????
I know it is probably hoping for too much but wouldn’t it be nice (accountable) if when you were admitted to the hospital you were assign one (“1”) primary care doctor with maybe a resident / intern collaborator / back-up that would co-sign-off reviewing your scans, labs. . . and then during pseudo-regular daily scheduled rounds (so “the family” can be present if it warrants) these scans, labs. . . can be reviewed, with you, family and this 2 person doctor / team, on the computers that already are present in the rooms or maybe even projected on the patient’s room TV? Additionally wouldn’t it be nice (efficient) if this primary doc/ intern / resident team be the ones that ingest your ICE PHR information into their EMR, explain the meds, review diet recommendations (and why do you always seem to get overcooked veggies with hospital meals? – but maybe that’s just another future blog topic!), review with you / sign-off your discharge instructions, be the one/s you have follow-up appointments with, help coordinate the paperwork necessary to insure you have all the EMR e-records that are essential for you to have included in your Personal Health Record (PHR) as you leave the hospital, make sure you have their business cards, with contact info, to be able to e-mail them with follow-up questions and be the primary contact/s for your personal primary care physician to me able to collaborate with for your on-going care / treatment plan? Hmmm, must have been hit on the head to think that might someday come true. BTW, come to think of it, why doesn’t your personal PCP make hospital visits any longer? Hmmm, that must have gone the way of “house calls” too!
As it stands today, is it truly possible too many docs. . . will spoil the patient care broth?