When a Clinician Becomes a Patient
As a Health Informatics Specialist and an RN (registered nurse) I took particular interest in my surroundings recently when I had the pleasure of becoming an inpatient myself at a local Greater Toronto Area (GTA) hospital. Within a span of 5 days, I experienced an emergency surgery, recovery, adaptation to new diagnoses, patient education, and lastly, a plethora of medications!
There were many positive facets to my care, but also a few that got me thinking that we have not progressed technology-wise in the basic clinical world as much as we had deluded ourselves to believing. The following story of my stay will point of some of the things I noticed and ways I am confident we can improve our healthcare system.
Technologically Advanced (or so we thought)
Firstly, as a Health Informatics Specialist, I took great interest in the fact that the majority of clinicians documented their notes in one of the following ways:
- Scrap of paper from somewhere in their lab coat,
- 3×5 notebook they would carry around,
- Or wrote on their palm (the original palm pilot)
It was only later in the day that they would have to sit down and transcribe their notes to the paper-based chart. When I asked why they didn’t document at “point of care” with the computer that was in the room, I was told they didn’t have a program for this purpose and that the computers had not been used (or even turned on) in four years!
Over the next few days, I spent quite a bit of time observing my room’s state-of-the-art monitoring equipment. Although it was an amusing way to spend the time, it got me thinking once again about improvements that could be made. This ‘state-of-the-art’ monitoring equipment had no real system behind it for added functionality. Wouldn’t it be a clever addition to accept notes, show more than a 24 hour history, and print out its findings?
Sleepless in the CCU
Sleepless with a lot of time to spend waiting in my room provided a great opportunity for me to surf the web for information about the diagnoses and prognosis I was given. First, I went to the hospital’s website and immediately noticed that there was no patient portal to be found. Second, one has to be an employee to find any useful information and/or links to medical or surgical information. I then later checked the rehabilitation site and was again faced with nothing for patients to access. It would be a great improvement to the patient experience if there was a way for patients to have an area where they could get information from the hospital online. Perhaps a lot of a clinician’s time could potentially be saved with answers being readily available on the web from the hospital’s website.
The Case of the Plastic Wrap
Throughout my stay I had many test procedures performed in various parts of the hospital, which resulted in being wheeled around and often asked to hold my own chart (which was in a binder). As I took a peek inside to curiously see the details of my condition and any assessments, the binder was promptly taken away from me by a nearby nurse, then plastic-wrapped, and handed back to me to hold for the remainder of my journey to the lab. From this, I concluded that what happened must be a relatively common occurrence, otherwise plastic wrap would not have been so readily available. Have we forgotten that the chart is information that really does belong to the patient? Most importantly, had the information been entered into a technology driven Information System, this situation could have been entirely avoided. With a system, it would have forced me to go through an organized process to see a copy of my chart after being discharged through the Privacy Office.
Better Technology Means Better Care
A few days into my stay I became a little more relaxed as it was the weekend and fewer physicians and other staff were present. I was a little surprised that an institution that operates “24/7” had staffed so few patient educators, nutritionists, and other specialists. In fact, none were assigned to this ICU. I was told that some of the clinical staff work 8 hour days Monday to Friday, and would not accept emails from patients on the weekend. This forced me to leave many voice messages to which I could expect a call back within 48 hours. I did ask how to have receive a copy of my chart and was given the process to follow post discharge. However, on discharge, the Attending physician, handed me a plain brown envelope, winked and said I would enjoy the contents. He could not say out loud in the room that it was my chart!
I have always assumed that the care at this hospital would be superb given the research focus, credentials, and standards of the facility. However, had I not been a clinician myself, I am confident that I would never have been given any medical staff’s contact information. In fact, while the very busy nurses sat with me relieving my anxieties, they started to share their angst about the disparate technology in patient care. Later, two physicians also shared with me the impact of inadequate clinical technology on their practices and the lack of integration with the community.
Overall, it was a very interesting journey that I have gone through and I am very grateful for all of the incredible clinicians that have been part a part of it with me. This has increased my passion for technology beyond what I thought was possible, even in an industry where I have 2 decades of experience. My eyes really opened up to the fact that we have come so far in the past 15 years, but even more so, that we have so much further to go. With the right set of tools and technology across the healthcare domain, we will be able to drive better outcomes, better report cards and better patient care from both a patient and clinician perspective.
Disclaimer: Any views or opinions presented in this blog post are solely those of the author and do not necessarily represent those of Aversan Inc.
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