Doctor's office of the future meets office of the past

Doctor patient tablet

I went to an appointment today with a doctor in a high-paying specialty who presumably has the resources to organize his office the way he wants. I was very satisfied with the doctor’s thoroughness, empathy and communications skills –which for me were the key things I was looking for. But I was also struck by the mix of modern, sleek information technology with some old-fashioned (even retrograde) administrative processes.

The nurses and medical assistants had iPads, which they used to call patients, record information and manage the workflow. The electronic medical record was clearly a bit clunky so the doctor made use of a medical scribe to whom he dictated information as he performed the exam. It’s kind of crazy that he needed to add a person to the process when the EHR was introduced, but I’m glad he did because it meant he could focus completely on the exam and not at all on the computer. That definitely helped the doctor/patient experience. I also noticed that the scribe was trained to turn away when the doctor cued her that private parts were going to be exposed.

Meanwhile, the check-in process reminded me of 1975. I received a clipboard with a set of forms that looked like they had been photocopied a few times. There was a space for my Social Security Number. I left it blank and you should, too, unless you want to open yourself up to identity theft. They asked for my insurance information even though they had photocopied my card, they wanted my pharmacy information in two different places and asked redundant questions about my medical history.

I’ve learned from experience not to bother complaining about the Social Security Number question –better to let them bring it up if they insist- but I did ask if I really had to fill out the pharmacy information multiple times. They said yes: one copy for my medical record and one for some other file they maintain.

These are small annoyances in the scheme of things, but they are noticeable in a customer-service oriented world where websites like Amazon and devices like the iPhone are engineered with the convenience of the consumer in mind.

photo credit: juhansonin via photopin cc

By David E. Williams of the Health Business Group

4 thoughts on “Doctor's office of the future meets office of the past”

  1. Your experience reinforces my feeling that all patients should bring a medical history with them to office visits, especially consultant visits. It saves lots of time — give them the paper document and write on the forms they expect you to fill out “see attached history form”. From a legal standpoint it puts the patient in the information drivers seat and it leaves more time for discussing current problems rather than past history. See the DIY medical history ( Did you ask the specialist for a copy of the visit record? Take a look and see how accurate it is — see if the technology and scribe did a good job.

  2. social security nbers are often needed for laboratories some patients have same names … also date of birth also usefull for bill collectors medicare still uses social security nber

  3. The EHR was clunky because that’s how EHR’s are, clunky. They were not designed for the doctor as the customer but for the government as the customer. Why should the patient even have to bring his own medical hx with him to the office? With a proper EHR, i.e., one designed for the doctor, simply by pulling up some identifiers a subsequent treating practitioner could pull up that medical hx and have it auto-populate his EHR.

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