I write about digital health all the time, but my doctor visits have been mostly low-tech – no email, no telemedicine, no online chats. Over the last 18 months, however, I have seen my healthcare providers – eye doctor, pediatrician, family doc – make the transition from paper records to EMRs.
The first change I noticed was a grumpier tone in the office. Everyone hated the new systems. The pediatrician spent most of her time with her back to me typing. The scheduler looked at me like I was crazy when I asked if I could download my records. The optometrist said that she needed a support group to deal with the stress from daily downtime that prevented her from looking up patient info.
Just last month I got my first invite to a real patient portal. The medical assistant at my new OB-GYN told me that all my test records would be in there and I could communicate with the office through email. I was childishly excited. Whoo hoo! The 21st century has arrived!
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A few weeks after my appointment, I had a CT scan. Almost two weeks afterward, I hadn’t heard anything about the results. Feeling very Pollyanna-like, I thought, “Maybe the test results are in the patient portal and the office just hasn’t called me yet.”
I created an account. First, I was surprised to see that connecting with Facebook and Google+ was an option. I certainly do not want to share my reproductive health with my Facebook friends. How many people actually use that option?
I accepted all the terms and checked out my file. Next disappointment: It was all medical jargon. I was hoping for a translation of medical terms, and an information experience designed for lay person me, not healthcare journalist me. Of course I could guess that “gravida,” meant “pregnancies,” but I was really hoping I wouldn’t have to.
Then, I noticed COPD was listed as one of my conditions. I clicked through and found out it was listed as “paternal” but also “active.” My dad died in January and I told the doctor that. What is active about it? OK, a minor thing, I can move on.
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The really disappointing part was that my pap smear results were not in the account either. I got a letter via snail mail – “Everything is good, no worries!” but why isn’t that in my record? How long does it take the information to get there?
And, now, after the CT tech said that I would have results in two days – wildly optimistic, I know – those results aren’t there either.
And the worst part of this user experience? After using the portal to request an update on my test results, I got an email from the practice, that said, “We got your email! We’ll be in touch within 24-48 hours.” A piece of advice for all patient portal designers: Don’t make me log in to a secure messaging system to tell me that. Ugh. Surely the system works well enough that I can assume you got my email.
Even though my electronic experience was lame, I must say the in-person experience was ideal. I had plenty of time to talk to the doctor, we covered a lot of ground and the scheduler was helpful also. I had all the info I needed when I left the office.
But, after leaving the office, my experience reinforced the idea that the most important things happen outside the doctor’s office. If patients are supposed to be engaged and empowered, the digital experience HAS to be better than this. If there were ever a need to use the “under promise and over deliver,” this is it. I was hoping for an efficient, easy-to-understand view into my medical record. Instead, I got the same old crappy experience – formal, unclear language, an unsuccessful search for important information, and an overall feeling of disconnect. And I am a healthy person who is strongly motivated to figure this stuff out! Imagine if I had to make serious treatment decisions and were too sick to even try to wrangle info out of the patient portal?
Oh well, at least I know where to look if I want to know what my blood pressure was in May 2014, and I don’t have to open my file cabinet.