Today was (almost) the last straw.

If you’ve read this column before, you’ve listened to my diatribes about the insanity of the forms we are required to fill out, the wasted efforts, the missed opportunities, the duplicative care.

This one today takes the cake.

Going through my mail this morning, trying to clean up the work on my desk before I head off for a (hopefully) few days of jury duty, I opened a letter from a home health agency.

The form needed to be signed by the doctor, critical information necessary for the ongoing care of a patient.

“Bathroom aids.”

That’s all it says.

Bathroom aids.

Now, I could have easily just signed it and stuffed it in the self-addressed, stamped envelope (bringing the total postage spent on this action up to nearly a dollar), but if you’ve read this column before you probably know that’s not my way. Nosy, devil’s advocate, and a know-it-all. I decided to look into the patient’s chart and find out who he was, since his was not a name I recognized, and I wanted to find out why he needed whatever this was.

Turns out he is a 78-year-old man who had been seen a few months ago by one of our internal medicine residents for a hospital discharge visit, but after that had ceased getting care in our practice. There were multiple telephone calls for refills of medicines, referrals to specialists, and forms that needed to be filled in and mailed back.

But not a lot of actual medical care.

So what were these bathroom aids that needed signing for?

The paperwork said that this was a “verbal order” received from the ordering physician (meaning me) on such-and-such a date several weeks earlier, which is not true. I’ve never spoken to the nurses or anyone else at this agency about this patient; I think they just make this stuff up.

But he did have a history of a stroke, and falls with subsequent fractures, so he probably deserved to have some durable medical equipment to improve the safety of his home environment.

This kind of equipment has been shown to prevent falls in the bathroom, to keep people safe at home and therefore out of the hospital, and to help caregivers deal with the basic activities of daily living for patients with neurologic deficits.

I’m not interested in denying this man a grab-bar or a shower chair — it’s just that this paperwork, the work that was required to generate this order, to print it, to fold it, to put it in an envelope, to deliver it to me, and then to have me bellyache about it, does not seem like the best way to coordinate and improve his care. And don’t even start thinking about the cost of the paper, envelope, postage, salaries …

Clearly this form is just a form for a form’s sake, something to stick in a file somewhere so that if an auditor comes after them one day and says, “Wait a minute; you gave this patient an elevated toilet seat in 2014 without an order from a physician providing care for him,” they can plunge their hand down into a file in a back room somewhere, pull it out, hold it over their heads, and proclaim themselves safe and legal.

And yes, fraud and waste happen, we know they are an enormous part our bloated healthcare system, and not getting a handle on that has led to massive increases in costs across the board.

But I figure it’s about time that we harness all of the energy of the patient-centered medical home (PCMH), and the massive care coordination infrastructure that we will be building, to provide a system that really allows us to have a safe and highly functioning network of home care for our patients, so they don’t fall in the bathroom or any other room.

As we build PCMHs, accountable care organizations, and other models of care, and as Medicaid, Medicare, and the commercial insurers in this country demand that we provide cost-efficient care, we need to scrap the systems we have that generate mindless tasks that serve nobody, that do nothing real to advance anyone’s health.

Forms like these should be auto-populated, automatic, and visible across all of our electronic systems, so the team is able to see what a patient has, what someone caring for them thinks they need, what is covered by their insurance, and even how they are using it and whether they are using it to its best effect.

If the system is paying for walker, and it’s lying unused in a nursing home closet or in the patient’s closet at home, then isn’t that an opportunity for someone to reach out to the patient and get them to dig it out of the closet?

Perhaps we can embed sensors in walkers to show that they’re being used, home physical therapy equipment to show that patients are doing their exercises as directed, and other types of personal and environmental monitoring to collect really useful data on the health of our patients outside of our offices.

The recent NPR piece about the incredible number of wheelchairs scattered all over Rochester, Minn., around the Mayo Clinic seems like an opportunity rather than a problem. Perhaps we can figure out an electronic tracking tool to help these wheelchairs scurry back home, where they can be available for someone who actually needs them today.

And we need to ensure that our care coordinators, and whatever system we build moving forward, are able to really coordinate the care of all of our patients, in whatever health settings they exist, and from all the directions in which the health care system is touching them. We need to make sure that no one is falling in their bathroom for lack of a form, signed by me, today.

By the way, this guy has had his “bathroom aids” in the house since the day he went home from the hospital several months ago.

And has not fallen.

Fred N. Pelzman is an associate professor of medicine, New York Presbyterian Hospital and associate director, Weill Cornell Internal Medicine Associates, New York City, NY. He blogs at Building the Patient-Centered Medical Home.