Regarding the convenience, the system cuts both ways. “As a rheumatologist, I need to be focused on the complex problems, defining a treatment plan, and dealing with complex complications,” says Dr. McClatchey. “If I’m in the room telling somebody that their blood count is normal, that’s a waste of everyone’s time.”
Patient Kiosk
Dr. McClatchey’s next push is the organization-wide installation of patient kiosks—again, as a facet of customer service. “Think about it,” he says, “one of the things that just grates on every patient’s nerves—me included—is the clipboards. How stupid is it that we have to do this every time we go to a new doctor? The kiosk can bypass that.” Ideally, the patient will arrive in the office, sign in on the electronic clipboard, enter the pertinent information, and then save that entry, never to be typed again in any of the offices of Dr. McClatchey’s organization. Though systems integration remains a challenge to realizing this goal, the solutions are in sight, and Dr. McClatchey is highly motivated through frustration. “It’s just nuts that we have all these isolated islands of medical information,” he says. The customer should be better served.
The VA Way
Customer service is also on the mind of Salahuddin Kazi, MD, associate professor of internal medicine and chief of rheumatology, and chief health informatics officer for the VA North TX healthcare system in Dallas. In August 2010, the VA rolled out the Blue Button initiative, allowing veterans to access their “MyHealtheVet” web-based electronic medical records off site. “With just a computer and an Internet connection, this allows you to remotely download important data about the care you are receiving at the VA,” says Dr. Kazi, “so if you need to go to a private [non-VA] physician, or go to an outside emergency room, you have the information you need to ensure that you get safe and effective care.” The available information is all text as yet (no radiographs, for example) but the results of all testing and imaging are available at a mouse click. The records also combine data from active duty care with current VA histories.
Since the rollout, adoption has been swift. “We have about 5 million vets and at least a third of that number is now registered users of the MyHealtheVet e-portal. We’ve already processed over 20 prescriptions this way,” Dr. Kazi says. His involvement entails designing the architecture of the interface. “Much of my work is human ware—how do humans interact with information,” he notes. Or, simply put, making sure the user (customer) can find the right button, and have the button connected to the correct data.
