Dr. Wes, a blogging cardiologist, posted a follow-up to his recent post on e-mail correspondence between physicians and patients.
The majority of emails he receives tend to be for very simple things like checking a lab result.
Current EMRs don’t make reviewing and sharing lab values efficient. Dr. Wes writes:
[O]ur current model of the electronic medical record sending every single result to our inbasket, even though it contains previously read or acted-upon results is creating a “Boy-Who-Cried-Wolf” scenario for doctors suffering from information overload. The electronic medical record must to a better job of filtering the myriad of tests that end up in our inbasket each day (I’m thinking of EKG final results that I have already read or recurrent INR test results within a therapeutic range, for instance).
And once those results have been read (or reread), patients still have to call or send an email to receive the result.
A secure web-client that allows patients to access their records on their own could handle this more easily— assuming that Grandma is savvy enough to look up her “Coumadin level” online.
But, playing Devil’s advocate, do we really want patients to be combing through their records without guidance? Imagine if every 134 serum sodium level spurred middle-of-the-night emails from frightened patients who are gonna swallow a tablespoon of salt if they don’t get an email back from their physician right now.
During nursing school, I had a full-time day job repairing Macs for a local Mac store. We had an open phone policy which allowed anyone to call in with technical questions. It became a huge drain on productivity and job satisfaction as we had to field calls from hopeless users who said things like, “When you say click, do you mean, like, with the mouse?”
Technical calls took a long time to answer. Each case was unique: the computer, OS, peripherals, software, etc. As the number of these calls increased, management eventually decided to have us charge for calls longer than five minutes. This upset the callers who believed that there was some magic button they could press that would make their problems go away, if only the greedy technicians would stop asking so many questions.
Customers— or insurers— should pay for expertise, and not just for physical presence. Physicians deserve to be compensated for time spent on email correspondence at rates comparable to office visits. The mental tasks are the same, regardless of the medium.
Jared Sinclair is an ICU nurse who blogs at jaredsinclair + com.
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