Our colleague Gary who often shares links with PSA, recently was required to arrange a Covid19 test for himself and his wife, after exposure to a house painter who tested positive. Here’s his report, with an addendum covering the actual test done from his car.

Our consult with our primary care physician worked out ok although there is definitely room for improvement.

 

Getting on to Blue Jeans was pretty straight forward – it is set up as a meeting room rather than as a video call.

 

In the meeting room one can elect to use your computer/tablet/phone video and audio (separately) and elect to use a regular phone call audio if preferred. This is consistent with Blue Jeans’ genesis in the Enterprise space where participants might have a wide variety of devices and connections available. The only issue in set up is that the “support” person from the physician’s office needed my help to turn her video on.

 

The next issue was that the actual physician’s consult was like an office visit, meaning that we had to wait 45 minutes for the physician to enter the room. After years of use, I expect a teleconference to take place on schedule. A pet peeve of mine is that the healthcare system ignores the cost of the patients’ time.

 

Once the consult began, it was apparent that the “tele-health” part was just being appended to an existing manual system. Both the intake person and the physician asked a lot of (repetitive) questions which could have been input by us (preferably via voice) while we were sitting twiddling our thumbs in the on-line waiting room. Reminds me of Drucker’s comment about the negatives of automating an existing manual system; the process needs to be re-envisioned for the technology.

 

The final issue was the audio/video quality from the physician to us. It was obvious that the local connection LAN/WAN at the doctor’s office was not designed to support the requirement. When Karen or I had the floor, the quality was quite good, with the doctor, not so much.

 

The bottom line, however, was decidedly positive. We did not have to drive to the doctor’s office, sit among likely sick people and then drive home. We got the referral for CV-19 testing we were seeking and are scheduled for a drive-by spit test late this morning.

and Gary’s testing anecdote:

We had our drive-thru test and the process worked better than expected. They had enough help and facilities that the entire process took less than 15 minutes to complete both Karen and me, even though they had a continuing flow of incoming vehicles. The use of a saliva test instead of a nasal invasion was a decided plus as well. Now the painfully long wait for the results.

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We’ll see how quickly telemedicine gets “UpToDate”, to note an online service described in another post. Way back when there was a stimulus program after the US Investment Banks induced crash of 2008, there was a directive from the administration to establish electronic medical records, perhaps as it was such an obvious thing to do, and would presumably cut costs as part of overall healthcare reform.

My personal anecdote on my own electronic medical records is that they may exist  within one medical practice to some extent, but then again, one can’t be sure, as it appears that blood test results from past years may not be readily available. That has clear impact on the quality of my care, as changes in blood test numbers are very indicative of underlying conditions.

So I’ve taken to brining my own paper printouts of same, which obtaining of same can be a rigamarole of notable absurdity. Then there’s the amount of paperwork I STILL fill out when visiting various doctors and dentists, or just arrive to get a blood test at a facility where I’ve had blood taken many many times before. Clearly the “electronic medical records/ keeping track of patients information and insurance details, doesn’t exist, at least where I am in Las Cruces NM. This extends to medical care “portals” where one is supposed to be able to find various medical records online. Spotty and frustrating at best.

One example of trouble with electronic medical records is what’s happened with my Dermatologist. He resisted doing anything for a decade, and finally gave up/gave in and hired a third party firm to sort of “envelop” his practice and provide himself with electronic records and patient interactions online. It’s unclear if this is an advantageous arrangement for his practice, and the patient interactions provided are extremely buggy. At best.

So…seeing as how the above is dysfunctional, one looks to the current healthcare emergency for impetus for change, and getting “up to date” for telemedicine, or HFH.