E-Patient Update: Don’t Give Patients Needless Paperwork

Recently, I had an initial appointment with a primary care practice. As I expected, I had a lot of paperwork to fill out, including not only routine administrative items like consent to bill my insurer and HIPAA policies, but also several pages of medical history.

While nobody likes filling out forms, I have no problem with doing so, as I realize that these documents are very important to building a relationship with a medical practice. However, I was very annoyed by what happened later, when I was ushered back into the clinical suite.

Despite my having filled out the extensive checklist of medical history items, I was asked every single one of the questions featured on the form verbally by a med tech who saw me ahead of my clinical appointment. And I mean Every. Single. One. I was polite and patient as I could be, particularly given that it wasn’t the poor tech’s fault, but I was simmering nonetheless, for a couple of reasons.

First, on a practical level, it was infuriating to have filled out a long clinical interview form for what seemed to be absolutely no reason. This is in part because, as some readers may remember, I have Parkinson’s disease, and filling out forms can be difficult and even painful. But even if my writing hand was unimpaired I would’ve been rather irked by what seemed to be pointless duplication.

Not only that, as it turns out the practice seems to have had access to my medication list — perhaps from claims data? — and could have spared me the particularly grueling job of writing out all the medications I currently take. Given my background in HIT, I was forced to wonder whether even the checkbox lists of past illnesses, surgeries and the like were even necessary.

After all, if the group is sophisticated enough to access my medications list, perhaps it could have accessed my other medical records as well. In fact, as it turned out, the primary care group is owned by the dominant local health system which has been providing most of my care for 20 years. So the clinicians almost certainly had a shot at downloading my current medical data in some form.

Even if the medical group had no access to any historical data on my care, I can’t imagine why administrators would require me to fill out a medical history form if the tech was going to ask me every question on the form. My hunch is that it may be some wrongheaded attempt at liability management, providing the practice with some form of cover if somebody failed to collect an accurate history during the interview. But other than that I can’t imagine what was going on there.

The reality is, physician practices that are transitioning into EMR use, or adopting a new EMR, may end up requiring their staff to do double data entry to one extent or another as practice leaders figure things out. But asking patients to do so shows an alarming lack of consideration for my time and effort. Perhaps the practice has forgotten that I’m not on the payroll?

About the author

Anne Zieger

Anne Zieger

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.

9 Comments

  • Been there, filled it out again and again, too. The problem is that when installing a system, there is often a failure to look at all data sources. Instead, an EHR get put up without doing a decent analysis of the current system, so that what should be brought in automatically isn’t and what is written down on paper is asked again and again because elements of the old system weren’t dealt with. Thanks, Anne.

  • It is not a problem of technology, it is a human problem. The problem of transitioning to the new way, the problem of over protectionism, problem of being paranoid. Anne absolutely hit it on the head by saying, ‘…wrongheaded attempt at liability management’

  • Thanks for your responses, Chandresh and Carl. For what it’s worth, I am fairly forgiving of medical practice IT issues, particularly given that independent practices may not even have an IT expert on staff.

    But this particular practice is large, seems well established, and is part of a larger group with significant resources. So I saw the documentation issue as a major fail, and also a sign of inappropriate arrogance!

  • Well said. I’d add that it’s one thing on a first visit to a doctor in the practice you are already in to review some specifics, but first you do paper, then the aide asks, then the nurse asks, then the doctor asks yet again. And to make it worse, the templates many EHRs use even when customized include many items that don’t pertain to a given specialty, leading either to more questions or the doctor having to click through while you set and wait.

  • There’s a simpler solution to the problem of assembling a patient’s information. It’s just what you and everyone else needs, Anne.

    Let the patient carry all their records and information on a device in their pocket. And when they see a provider anytime, anywhere, they merely give their device to the provider! No clipboards. No forms. No questions. No mistakes. How simple is that?

    Best of all, this very system is available today. It’s called MedKaz (see MedKaz.com).

  • I’m not familiar with it, but consider that every single portal is at least a bit different in how it is accessed, how it displays data, and how, if at all, it downloads data. Oops – no standards. I have one portal for a hospital that I use for ortho, another for hospital in patient once in a great while, most of my doctors, and more. Lots of portals, lots of overlapping info.

  • Are we coming a full circle? Ages ago, patients kept and carried their own records in a hefty folder. They still do in some countries. Patients had ‘control’ of their records. Then it went away, now we want it back!

  • Portals aren’t a useful solution as you point out. Most contain only summarized notes and if you see multiple providers you or your providers must visit multiple portals to understand your issues and care—but providers don’t have the time to do so.

    In contrast, MedKaz assembles all your records from all your providers (plus the application to manage them) in one place—on the MedKaz mini drive you carry on your keychain, in your wallet, or wear as a pendant. Your records are instantly searchable and displayed as pdf documents in a browser. It is the safest and most secure system available, HIPAA compliant and enables any provider you see to coordinate your care and avoid medical errors and unnecessary tests, visits, studies and procedures.

    And yes, Chandresh, this is returning to patients carrying their records—but with three modern twists. First, MedKaz does not do away with provider records, it complements them. Second, they are electronically searchable with only two or three clicks. Third, providers who support MedKaz enjoy a material new revenue source, eg. a PCP can increase his/her income as much as $50K per year, hospitals depending on their size, many $millions.

    (Full disclosure: our company, Health Record Corporation, created MedKaz.)

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