The Missing Sync
There’s a shortage of primary care physicians – everyone knows that. Now that healthcare reform will induct many more individuals into the ranks of the insured, they all need primary care doctors.
The problem is that today it is difficult to get an appointment with the doctor on short notice. For example, if you need to have a child’s sore throat checked for strep, you probably can’t get an appointment the same day. Your doctor might actually tell you to go to a convenience care clinic at the pharmacy to get the strep culture done.
Guess what? Going to the convenience clinic is less expensive than seeing your doctor for the test. It is also faster, and yes, more convenient. Will these clinics replace your family doctor when you need her the most? We expect that our family doctor knows our history, treats us the way we want, and if we’re lucky he understands us as people over time and not just as charts. But when something unexpected happens that’s not quite an emergency and we go to a convenience clinic, our doctor isn’t there – and neither is our medical record.
Convenience care clinics are on the rise. They are located within drug stores, and in some supermarkets and Walmarts. You can see a doctor and get a test done and receive results from the test more quickly than your doctor’s office.
Clinics vary in their offering, but most are essential preventative and routine health services for a standard set of common health aliments. Some examples are: Acne, bladder infections, strep throat, pink eye, blood sugar testing, camp and school physicals, cholesterol screening, common vaccinations, ear aches, flu, minor wounds, sinus infections, upper respiratory infections, wart removal.
The question is “How important is the medical record at time of care?- One could argue that having information on the patient’s history and drug allergies improves the patient’s quality of care. However, someone who goes to this type of clinic is not in an emergency situation. They will likely be able to answer the questions on medical history and allergies.
Being able to send a record of the visit and test result from the clinic back to the primary care doctor is definitely important. The clinics become one more place that bits and pieces of a patient’s encounters with the health care system don’t make it to their medical record home.
Ideally, data on the visit is electronically sent to the patient’s medical record home, wherever that is. If that is not available, the patient has the ability to enter data into their personal health record (PHR), and their visit can be recorded. But how does that visit make it back to their medical home? Unless the data can be securely transferred from the PHR to the medical home using the likes of a health information exchange (HIE), that visit will float around in the health care world’s cyberspace forever.
The different ways that individuals encounter the health care system are on the rise with convenience care or retail clinics, urgent care clinics, and house call physician visits. As the number of these types of visits increase, the more fractured the individual’s health record becomes when these visits are not recorded. Chronic disease patients already experience the hair pulling aggravation of keeping paper records and physically bringing them to all their doctors. The more an individual uses the health care system, the number of providers increases and the effort to synchronize separate medical records goes up exponentially.
With the “electronification” of health records – specifically in physician offices, and the effort to launch HIEs nationwide, there may be hope that those bits of our health data floating around in the health-sphere can find a way down to earth.