WHY DO WE DO THIS?

Multiracial patients waiting for vaccination against coronavirus at clinic

Every Doctor Visit ALWAYS Starts the Same (Inefficient) Way

By Kenneth L. Hill, Jr., MD, FAANS

As a physician with nearly 20 years of experience in neurosurgery, I know there is extreme frustration in dealing with the bureaucracy of healthcare, among other issues. This bureaucracy is extremely broad and open-ended; however, I am currently speaking specifically to the administrative process and the paperwork associated with the check-in process and obtaining health history information from the patient. Personally, I believe that this even starts prior to the patient exam, and I could argue before the visit altogether. As with most cases of discord, it often starts with communication, or rather poor communication. Likewise, in the case of healthcare, this key communication is often inadequate from the moment that a patient enters a provider’s office. This problem is shared by both the patient and the provider; nevertheless, it is accepted as the standard and remains unresolved. The end result is frustration shared by the patients, providers and staff. It is understood and accepted that a doctor will “input a lot of patient data from a form the patient completes on paper”1 that is excessive, subjectively abstract, often redundant and routinely incomplete or inaccurate. All these failures are system failures that need to be resolved and can be resolved by taking appropriate and innovative measures.

The personal health record (PHR) is a chronicle of the health of an individual over time that is collected and maintained by that individual. In every situation, this information is obtained from the patient. Even in the current era of electronic health records, this information is still required from the patient to guide safe and appropriate treatment. The patient’s input to this process is critical. It is critical because life happens and the details of the changes in a patient’s health are not always captured through one’s electronic health record. Additionally, these records do not always get communicated, nor do all providers have the access to the same record if not part of a particular healthcare system, nor is there always seamless technical processes, etc.2

Universally, the PHR is collected in the manner of the forms provided to update one’s information, either electronically or via paper. This is the monotonous process at every visit where patients often say “That information is in your system” or “Didn’t I complete that last time? Nothing changed.” Even in a situation when one’s healthcare is provided by a single institution or healthcare system, this process continues. We understand the most accurate and complete record comes from patients as the individual. 3,4,5 This information is different than the information and data stored in the Electronic Health Record (EHR), which is maintained by providers. The PHR is a snapshot of the patient history at that time as provided by the patient. The PHR is an add-on service that is performed at every encounter, at every healthcare provider, in every provider setting around the world, every single day.

The basic information collected in a PHR is standard. However, there are numerous variations of this information as every healthcare provider from western to eastern medicine, from holistic to traditional allopathic medicine, will often have a unique way of collecting specific information that they value for their practice. Similarly, there appears to be many variations on the method of collecting this information and the content of the information collected; however, this is not true. The information is simply a variation of the past medical history (PMH), past surgical history (PSH), allergies, medications, etc. The process of obtaining this information is taught very early in one’s medical career. I remember learning and practicing this during the first semester of my first year of medical school, before I even understood the reasoning behind it. Despite being drilled into the fabric of all healthcare encounters, we treat this as a new process each and every time.

Due to my frustration of repeating a dated process in a dated fashion, I generated a neurosurgeon specific data pool. As a practicing neurosurgeon out of Jacksonville, FL, I created a survey because I am interested in creating a solution to this longstanding issue. With the implementation of the HITECH act, there was optimism that information and information technology would communicate seamlessly and help to remove this redundant process. Unfortunately, that did not happen. In 2021, a small sample survey of neurosurgeons was surveyed (unpublished data). The top 3 most painful issues associated with the intake process was indicated as (in no specific order of significance) 1) getting the information, 2) redundant paperwork, and 3) collection of medical records.

These results are not surprising. Surprising would be that all neurosurgeons queried would agree that the communication of the PHR is seamless. It would be unexpected to discover that acquiring this information is effective and efficient. Unpredicted would be a collective agreement that the excessive waste in time and energy in collecting this standard information has been resolved with the advent of current technology. Astounding would be that the development of greater capabilities with technology have resulted in improvement at the bedside for the patient and the provider. However, this is not the sentiment conceived or shared by neurosurgeons, as represented by this survey. I would predict that other physicians and healthcare providers would provide similar results if questioned.

The solution is not difficult to conceive nor implement. The difficulty lies in how to articulate the solution and obtain buy-in.

The problem: collecting the health history of all patients without repeating the same labor intensive process every time and communicating that information to providers efficiently. The solution: develop a consumer friendly and focused universal method to collect standard health information and then develop a common and established way to communicate that information accurately and efficiently, without requiring redundant processes by the patient and the provider.

The development of a systems solution in this manner would be the “Holy Grail.” To do this would require broad vision with dedication to the solution.

MĪNA Health

The great thing is, this is the mission of MINA Health and the solution is available now. MINA is a free smartphone based PHR that uses secure and patented technology to convert the PHR into a QR code for scanning by your provider. The solution is MINA Health.

Find out more at: MINAapp.com

Every Doctor Visit ALWAYS Starts the Same (Inefficient) Way

By Kenneth L. Hill, Jr., MD, FAANS

MĪNA Health

References: