E-Patient Update: Sometimes Tech Gets In The Way

Posted on September 22, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Being such an enthusiastic tech user, I tend to assume that adding technology to the healthcare equation is a plus in almost any situation. Why not automate scheduling?  Data gathering? Pharmacy?

To me, it’s always seemed like a no-brainer that tech adoption works to my advantage as a patient. The more I can avoid going through basic motions manually, the better processes work, giving me more time to spend with my clinicians. Right?

Apparently, not so right. When you take patients into account, sometimes doing transactions the old-fashioned way may actually be more efficient – or at least more flexible – than running things through an automated process. If nothing else, it may be easier to accommodate patients if you don’t have to run them through your workflow.

That, at least, is the lesson I’ve gleaned from studying the day-to-day flow at Kaiser Permanente, where I get all of my healthcare. After watching Kaiser employees work, and asking a few unobtrusive questions, I’ve come to believe that going offline may actually be better in some situations.

Tech-friendly, but not tech-dependent

Now, make no mistake: Kaiser isn’t in the stone age technically. For example, it seems to build most of its clinical operations around what is reputed to be the mother of all Epic installations. (Back in the day, it was rumored that Kaiser spent roughly $4 billion to roll out Epic, a massive sum even by national organization standards.)

Throughout my care process, the fact that clinicians and support staffers are all on Epic has played to my advantage, particularly given that I have a few chronic illnesses and see several specialists. I’ve also benefited from other Kaiser technology, such as kiosks which automate my check-in process for medical visits.

In addition, I’ve gotten a lot of benefits from using Kaiser’s robust web portal, which offers the capability to exchange email messages with clinicians, set appointments, pay premiums and co-pays, order and track prescriptions and check test results.

All that being said, I’ve encountered manual processes at many steps in my journey through the Kaiser system. While some of these processes seem wasteful – such as filling out a standard pre-visit form on paper – others turn out to be more useful than I had expected.

‘People forget their card’

One situation where technology might not be needed is taking people into the doctors’ suite for consults. In theory, Kaiser could set up an airport- or DMV-style ticker letting people know when their doctor was ready to see them, but having nurses yell last names seems to work fine. I’d file this under “if it ain’t broke don’t fix it.”

The pharmacy is another area relying on a mix of low- and high-tech approaches. Interestingly, the pharmacy offers an airport-like board displaying the names of patients whose meds are ready. But when it comes to retrieving patient info and dispensing drugs, the front-line staffers enter the patient numbers by hand. I would have expected there to be a barcode on the membership card, but no dice.

According to one pharmacy tech, it has to be this way. “People forget their [Kaiser member] card all of the time,” she said. “We can’t assume members have It with them.”

These are just a couple of examples, but to me they’re telling. I may be missing something here, but it seems to me that Kaiser’s approach is practical. I’d still like to automate everything in my healthcare world, but obviously, that doesn’t work for everyone. Clearly, offline patient management models still matter.