Wednesday, June 24, 2009

Online medical records...NOT

I wanted to get my prescriptions refilled before my benefits run out on Thursday. Last week I dropped in at my doctor's office, filled a few vials from a very belated blood requisition with the phlebotomist, and talked to my GP for a few minutes. She opened my secure personal file on her computer, and noted that last time we'd talked she still wanted me on a statin (but I had wanted to try to get my LDL cholesterol down by lifestyle changes, which she had also noted). She took my blood pressure (120/80) and added it to my records. She renewed all my prescriptions online by direct link with my drugstore, and by the time I got there an hour later my oral meds, insulin, test strips, and Novofine needle caps were waiting for me, along with my bill for the co-payment. Earlier this week I received an e-mail requesting my presence ("please call for an appointment") and a copy of my blood test results for me to review before I went to the medical office.

Then I woke up.

Between 2002 and 2005, I knew or heard of a dozen people (literally) from my then-workplace who left to pursue careers at the then-new-ish Smart Systems for Health Agency (SSHA, now eHealth, which has been in the news a lot recently). I even applied for a job there... These were all business analysts, project managers, database administrators, programmers, and so on. It was a pretty exciting idea---develop software and processes to create secure online medical records for most Ontario residents. (I think they all left SSHA to take productive jobs.)

And after years of hot air and multimillions of tax-payer-funded dollars spent, most Ontario residents still don't have online medical records. From the link above: "2007 statistics show that 25 per cent of family physicians in Ontario have electronic records, compared to 50 per cent in Albert, 89 per cent in the United Kingdom and 98 per cent in the Netherlands." Probably a few remaining rural Dutch residents who still live in windmills (kidding).

In fact all that happened last week at the doctor's office was true, except for the online medical records part, which I made up (and I did thank everyone for letting me in without an appointment). It was when I got to the pharmacy that I found that the doctor had neglected to write my name at the top of the prescription form. This was on Sunday, and of course I had put off getting the thing filled until I ran out of something, so of course the pharmacist couldn't fill the prescriptions. They've known me for years, but rules are rules, though I did get a few pills to tide me over.
I went back Monday and asked about my prescriptions. The druggist on duty said there had been nothing faxed from the doctor's office though the office manager had called me that morning, asked me to come in to review the blood test results, and assured me they had indeed faxed the correct information. So the druggist went to the fax machine and there was the corrected form under a bunch of others. It was a busy early Monday afternoon (and very hot outside), and the 15 minutes I was told I had to wait turned into well over an hour.

I was finally transferring my goodies to my bag when I noted to the pharmacist that the NPH insulin I use was in a new package. He said, no, it's the same package, and opened one to show me a large vial that you fill disposable needles from. He then realized that the "pen caps" on my prescription were for a different injection system, and I had to wait another 15 minutes while they corrected the prescription and adjusted the bill upward somewhat. (They still owe me two months' worth of one of the orals, for which they didn't have enough in stock. If there had been an online order they could have had it restocked before I got there.)

While I waited---again---I used the in-store blood pressure monitor: 118/75, though my pulse was over 120. I'm sure that by the time I retire at age 75 the province will be able to read the RFID chip in my arm and tell me I'm not eligible to be diabetic anymore. But it was a lovely dream while it lasted.

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