My client was inpatient for an infection. The service that was following her decided to get a consult from Infectious Disease to assess what may be causing the infection. A biopsy was taken and we waited for results. For one of the potential microbe, penicillin was the drug of choice and it had to be taken for 6-12 months. There was a question of whether my client was allergic to penicillin because of a recent ER trip. The ER doctors thought maybe, the recently started Penicillin had caused the symptoms because nothing else presented as a possibility. Into the chart the allergy went and traveled with my client.
She was discharged before the final results and sent home on a two antibiotics that seemed to keep the infection at bay. The next day the infectious disease doctor called me. As it turned out, my client had that particular microbe. The alternative drug choice from penicillin was known for causing nausea. We also discussed whether she was really allergic to penicillin. He suggested she get tested for sensitivity at the allergy clinic. I thought what a great idea!
Allergy sensitivity testing requires the placing of a small amount of the medication the skin transdermally and observing whether there is reaction. Simple.
The following Monday, I called the allergy clinic. I explained the need for allergy testing as suggested by the infectious disease doctor. And here is where the insanity of the system stepped in. I was told she would need to enter the clinic, which was part of the hospital system, as a new patient. Silly me, said, but she isn’t new to the system and has a clinic and hospital number. Didn’t matter because that was how it was done. I tried to tell them that they could speak with the ID doctor as it was important to get this information. No impact what so ever.
I had to make an appointment to meet with the allergist. What this means is filling out once again the new patient forms, which will have the exact same information as their computer currently has from the inpatient stay and multiple clinic visits to other specialties. It will be time wasted by sitting in the waiting room, telling the same story to a doctor ,who will ask the same questions and get the same answers. The testing cannot be done the same day because testing is done only on Wednesdays. No new patient visits on Wednesdays. For some patients it means amother copay and more coinsurance.
How absurd is this? Why bother to have electronic records if they don’t get read or believed? Why can’t doctor A talk to doctor B and not reinvent the wheel? The purpose of EMRs was to avoid this nonsense and yet, I don’t believe it has improved the quality of patient healthcare. I understand that doctors want to gather their own information but this seems like overkill. My client would benefit greatly to be able to switch to penicillin. I wondered who thought this system was a good idea.