Often, the best illustrations are personal. Here's the stats on my spring break health care administration for my sons:
1 ENT appointment 9 pages of paperwork
1 Occupational Therapy evaluation 4 pages of paperwork
3 dental appointments 6 pages of paperwork
I filled it all out, with compliments from the front desk staff (I am a professional, after all.) But, I don't have great handwriting, and what are they going to do with it after I hand the clipboard back to them? They are going to type it in to their computers. Why can't I just type it into an online form? And, the dentist isn't new, it was just time for an update -- why couldn't they have read it to me and I confirm all the information, which hasn't changed one bit?
I know there's a lot of change in health care right now, but this is one of those process improvement issues that has long been adopted in other fields. In addition, the ENT's fax machine wasn't working so I went the pharmacy 3 times to pick up a medication that should have had a confirmed refill. Why is anyone faxing anything?
I'm sure this has something to do with privacy laws, and security of information, and of course that's important. But I suspect a large part of it is that no one has pressed for this kind of improvement yet, they are too busy with other concerns. While I'm sympathetic to that, I feel it's more evidence for what Walter Cronkite said "It's neither healthy, nor caring, nor a system." A healthy system contains up-to-date health information, a caring system makes it easy for people to share their information and a system means there's an efficient process to do so.
I'm optimistic about the requirement of electronic medical records, even though there's lots of grumbling about them. I think they can and will help patients and their care providers do better. First, let's get off the paper.