“You have to do it for Meaningful Use…” My office manager stared at me, frustration creeping into her voice.
“But a fifteen page patient visit summary? How is that going to be helpful for patients? What the hell could they possibly say that would require fifteen frickin’ pages after a fifteen minute office visit?!!!?” Rage. White, hot rage. I felt so much rage that I wanted to throw the damn computer against the wall. “And who the hell is going to ever wade through 15 pages of crap to find the important few bits?”
“Look, you have to get 50% of your patients using the online portal and this patient summary has to either be printed out for them or sent to the portal. You can document “declined” but if you do it on everyone, that will get you into trouble, too.” She was pleading.
The problem was that the online portal sucked. It was thrown together at the last minute and the interface on the physician side was awful. It was making my job so much harder and was confusing patients right and left. It was unreliable. Messages often weren’t getting sent.
“Ok. How’s this? I am not going to print it or send it to the portal or even document “declined”. I am going to continue printing out the two page summary that shows patients what I changed with their meds so when they drive over to the pharmacy they can make sure they are given everything that was prescribed. That handout has instructions and their preventive care recommendations and their vital signs. Everyone, but especially my elderly patients, need something concise in hand to take away with them. Since when did the government get to decide how I communicate with patients? This does not improve patient outcomes!”
They had also in one fell swoop taken away my ability to order immunizations in the EHR. My medical assistant had to now do that, so I could not print the superbill until after the immunizations were administered and documented. Completely disrupted work flow. Documentation of certain preventive care measures went from a single screen and two clicks to a multiple screen ten click ordeal. For each point. Worse, I could not document family medical history in my usual concise and organized manner: “Mother died age 45 due to heart disease, also had diabetes and hypertension”. I now had to use push buttons like “mother history of heart disease” and another button “mother history of hypertension” and another button “mother history of diabetes”. It was a difficult to read jumbled mess.
All because the government said so.
“You still have to play the game.” She shifted uncomfortably in her stiletto heels.
“You will get paid less for your Medicare patients.”
“I am not really paid much of anything at all anyway. How can I miss what I do not have?”
“They are following your data…,” she warned. Truthfully the powers that be here were following her data, too. If she couldn’t get her physicians to toe the line, the doctors who hired her to work at this clinic, she would be in trouble, too. I might have felt bad about that, but rage makes you blind to everyone but yourself. “AND, I am supposed to post this how-to instructional page here at your work space to remind you of what to do.”
I rolled my eyes.
“You know what you can do with that.”
“Yes, ma’am, I do.” She grinned at me, and tossed the how-to sheet into the waste bin as she walked away.
End of discussion.
I don’t know who exactly is responsible for this ridiculousness but you should be ashamed. All of you.