Information exchange
I sometimes struggle for ideas for my blogs and often find that reading the blogs of others sparks an idea in my head. This blog is based on comments I made to Anne Cooper (@anniecoops) about her recent musings on Information Governance and her assertion that the processes involved in capturing personal data aren’t always carried out with the sensitivity required. Here’s a link to Anne’s blog.
Thank goodness it was an ophthalmology clinic and not sexual health
I agree with Anne that having sensitive conversations in the waiting rooms of GP surgeries and hospital out-patient clinics is often difficult and frequently impossible. My GP’s surgery has a radio station piped out of speakers across the waiting room in an attempt make it difficult for other patients to overhear conversations at the reception desk but in my experience this only forces people to talk even louder in an attempt to be heard over the ramblings of the manic DJ. Perhaps patients should have the option of going into a separate room to book in or talk about a personal matter.
In my reply to Anne I gave two examples where this ‘front-line’ gathering of information had gone wrong for me.
1. In the summer of 2012 one of the renal consultants expressed concern at the elevated levels of calcium found in my blood results (they had been high for a number of years) and sent me for a series of scans and tests to try to establish the cause. At my next appointment in the October we discussed the results of the scans and the tests but he could offer me no explanation as to what was causing the elevated calcium levels and referred me for a bone density scan. Imagine my surprise when a week or so later I received my copy of the consultant’s letter to my GP in which he suggested that the underlying cause might be Sarcoidosis! There was no mention of Sarcoidosis being a potential diagnosis at my meeting so I contacted the renal unit and asked to speak to the consultant. He wasn’t available but would ring me back. A week later I again contacted the unit and was unable to speak to the consultant but was reassured he had received the original message and would call me back. By the Thursday of that week, having still not heard from them, I again rang the unit to be told that the consultant had tried to call me several times and had been unable to contact me. The nurse I spoke to asked me to confirm my telephone number; the number the consultant was using was to a house I moved out of 5 years earlier.
Now I visit several departments in this hospital on many occasions every year and at each and every appointment I’m asked to confirm my contact details so how could the consultant have been using a telephone number 5 years out of date?
2. A year later I was on the general surgery ward of the same hospital having undergone an operation which arose from the investigations into my elevated calcium levels and was visited by the pharmacist to organise my drugs for use during my hospital stay. The pharmacist began by reciting a list of my medication to confirm that everything was correct. There were two errors, one of the drugs on her list I hadn’t taken in two years the other error related to the wrong dosage of one of my immuno-suppression drugs. The dosage had been amended over a year earlier.
Again, whenever I attend any hospital appointment I’m asked to confirm which drugs I take, indeed at the tortuously long pre-op assessment I handed over a printed list of my current medication. So why was the pharmacist using out of date information?
To answer my own questions I can only assume that in the case of the consultant they were using old paper records which hadn’t been updated to discover my telephone number and in the case of the pharmacist there may have been a transcription error or indeed they too were using old paper records.
It is pointless having sophisticated technology in hospitals if the hospital staff don’t use it, preferring to use potentially out of date paper records. It is equally pointless if updates to patient’s records aren’t immediately reflected in that patient’s records in other departments. None of these problems were caused by the information technology. The gaps in these systems and processes are where disasters lurk.