We all know health care delivery is a team sport. Primary care is no exception, and primary care in a pandemic is absolutely a team sport.
Often, when we talk about healthcare transformation we focus on patients or providers. While this may be an important place to spend and focus energy, we often ignore the silent engine that keeps many medical practices humming along so primary care providers can stay on time and patients can receive the services they need.
Medical office assistants, secretaries, registered nurses, registered practical nurses, and physician assistants — these people are the backbone of many medical offices.
A wise friend once told me that health care processes are “kludgey“. Let me save you the Urban Dictionary lookup: “Kludgey — awkwardly or inelegantly made or done“.
Sound like any part of health care you have encountered recently?
Health care is a quilt or a patchwork — an ugly quilt that you don’t take out but leave hidden in the attic. Before the mass adoption of technology, health care worked reasonably well. Everyone used paper, the telephone and had close working relationships.
However, technology and our increasing complexity has made care delivery more challenging. As the system has become increasingly digitized, we have not coordinated our modernization well. Hospitals have hospital information systems, community physicians have electronic medical records, pharmacists have pharmacy management systems.
What do all of these systems have in common? Well, none of them talk to each other! So then, how do we make them talk to each other? We introduce humans into the non-integrated aspects of the pathway to integrate them.
The same friend who taught me about kludgey systems also taught me another phrase: faxes are a “time vampire“. They require a substantial investment of human capital; often bodies need to be thrown at the lack of technical integration to manually integrate information. Practically, this means checking a fax folder, saving faxes in charts, sending messages and notifying providers to send a script.
So why am I talking about all of this?
I’m talking about it to point out the fact that secretaries, MOAs (Medical Office Administrators) and nursing staff, who for decades have provided front line care and built relationships with patients and their families, have increasingly become seconded by a fax machine which needs their time and energy to send single, short, asynchronous communications to a pharmacy on behalf of a provider.
The fax is the single biggest wasted investment in health care today.
We can collect no data, and sharing information is often like playing a game of broken telephone. There are many risks to our current way of working — patients experience delays in care, and care providers and frontline staff waste countless hours communicating in a way that was modern in 1980.
Here is the good news…
e-Prescribing does away with the kludgey fax when it comes to prescribing
e-Prescribing provides the ability for a pharmacist to communicate directly with a physician. No more having to ask staff to act as a messenger; their invaluable time can be reinvested in front line care, preventative care work and so many other things they have not had capacity to do.