Repetition is not progress.

If you’ve been following updates from me on Facebook recently, you may know that I’m due for arthroscopic surgery on my left knee in about a week. I haven’t talked about it here because, really, who wants to read about me while I whine about how I’ve been in pain for six weeks?

But I do have a point in talking about it now, so please bear with me.

I had to visit an orthopedic surgeon for the first time once I realized the pain wasn’t going away. This orthopedist, the one who repaired The Great Spousal Unit’s ACL 18 years ago, and fixed her broken ankle five years ago, is also performing my surgery. Seeing him means filling out the requisite paperwork, and at their insistence, registering for their patient portal (it’s a fairly large practice). Aside from the paperwork, and creating a new user name and password that I’ll never remember, I lost about 15 minutes that I’ll never get back. But that’s not all.

After my first visit, I was sent to get an MRI on my swollen, painful knee. I haven’t had an MRI in decades, so this meant going to a new place, filling out more paperwork, and losing another 15 minutes. The radiology practice also insisted that I registered for their patient portal, which I declined this time (“Don’t you want your MRI images mailed to you?” / “No, I’m happy with the CD you gave me, thank you”). Two sets of medical history, drugs that I’m taking, and pump settings. But that’s not all.

My surgery will be performed at a surgical center near my orthopedist’s office. The orthopedic surgeon is part owner in the surgery center. Guess what? The surgery center needed me to submit medical history, a list of medications I’m taking, and my pump settings. And the only way to submit all this is through their patient portal. This fifteen minutes stuff is getting repetitive. Fifteen minutes is time to wait for your BG to come up when you’re low, not to document the same information for the third time in a week and a half.

When People With Diabetes think about interoperability, we often think about getting our CGM readings to display on our insulin pumps, or sharing our CGM data with our spouses while we’re at work. And that’s true… all of that, in my opinion, qualifies as important steps in interoperability.

But I also think of interoperability as having one source of data, in one place, for all to access. For instance: I have my medical information, my device data, my list of medications in one secure place, and I get to decide when I want to share it with a medical team. I give them access to it at my discretion, for the amount of time I decide.

So if I need to see an orthopedic surgeon, and they want to see all of this, I can choose to allow them access to my information, and they can get it with a simple click from their desktops. In an emergency, we’ll have to work out a way so someone can access my information instantly from the hospital.

Certainly, my orthopedist can say to me, “If you don’t allow us access to your medical data, we won’t treat you”. But I’ll know that 1) My medical information is in one place, always; 2) Access to my information could be gained by others at my discretion; 3) My information could be kept up to date and accurate by me, on an ongoing basis (who knows if I made a mistake on that first set of information I submitted, or the second, or the third?); 4) I could revoke access to the data when it’s no longer needed; and 5) The data is available, staff isn’t necessary to hand it out, file it, or access it when my appointment comes up.

I could add to the list all day.

Nearly everyone is on board these days with the idea of less burden on the patient, and what I’m talking about here, in theory, solves some of that. What I think healthcare professionals and insurance companies have forgotten about is the importance of less burden on healthcare professionals themselves, and how less burden on collecting the same data over and over (and not making them read handwritten forms) will gain them extra time to care for patients.

I’m going to keep talking about it, because it needs to be talked about. A central place for someone’s medical information may be just as impactful as interoperability between diabetes devices. I mean, seriously, after my knee gets worked on, they might have to work on my hands because they’re tired from writing and typing. This can and should happen. I hope someone is working on it.

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  • Caroline  On June 5, 2015 at 4:29 pm

    Great point about the hassles and inconvenience of medical records and patient portals. To play devil’s advocate…how would you address the issue of monopoly, or lack of innovation, in a single unified EMR/portal system?

    Liked by 1 person

    • StephenS  On June 5, 2015 at 5:13 pm

      Good question Caroline… I would vote for a patient-controlled single unified EMR/portal system. With funding based on need, not on percieved need (or percieved not need). Not that that would ever be allowed to happen. But I can dream. Thanks!


  • Scott E  On June 7, 2015 at 9:47 pm

    There’s a part of me that agrees with you — that it would be nice to have to complete the same pages upon pages of medical history for each doctor I see (a former endo of mine had me fill it out AT EACH VISIT…and he never looked at it!). It’s a futile and pointless exercise; there’s more to the reason for the visit than a checkbox. And some of the forms are so generic that they are laughable. (My son saw a podiatrist last week, and the forms asked about allergies, cholesterol, vision…stuff that really doesn’t pertain to the feet).

    But on the other hand, I agree with Caroline, that a centralized information-clearinghouse would become so burdensome and bureaucratic that it would become useless. Also, I – personally – want my doctor to be as comfortable has he possibly can while under his care. In the overall scheme of things, I have more at stake than he does, and I don’t want some silly procedural change to throw him off his game.

    Liked by 1 person

  • Michelle  On July 6, 2015 at 11:04 am

    Amen! Could easily be solved by some enhancements to the insurance providers portal – they already have the data that every doctor/ hospital already ask for – why not let us add what is needed or expire any data that no longer relevant and the give access (the same way we give our spouse access) to the records?

    Liked by 1 person

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