Systems That Talk to Each Other—Except When You Need Them To (TLWH 9.4.26)

Have you ever wondered why customer service is so rotten these days? I’ve been thinking about that since having my “annual” visit with a new doctor at a new clinic in my new city yesterday. Actually, only the doctor was new, as the clinic is part of the conglomerate that owns St. Luke’s Hospital, where I was a patient eight years ago, and my doctors were part of St. Luke’s Urology. 

I’ve concluded that being a patient in the consolidating corporate world of medicine today does not make me a customer. They like to make it sound that way in the unending stream of commercials and other propaganda, but I end up feeling like a bolt in a bin in an autofactory, not the guy driving the new car.

First, I need to write about the problem with medical records. Now that records can be sent electronically, not as a pile of paper or a fax, transferring records to a new doc should be a seamless customer (patient) service delight. Not so for me.

The morning after my “annual” with a new doctor, I asked one of my AI partners if I was the only one seeing an overall decline in customer service. It (how’s that for sensitive pronoun use?) wrote back, “The decline in customer service quality over recent years isn't just a perception—it is the result of systematic changes in corporate strategy, technology adoption, and labor dynamics.”

This is not a complaint about the people delivering health care. From nurses and front desk personnel to lab technicians and doctors, they are all top-notch people struggling in a messed-up system. Technology advances have accomplished much, but leave much more to be done to maximize the patient experience.

In July, I wrote that a year had passed since a doctor wrote a 90-day prescription, with three allowed refills, for drugs that for more than 25 years have kept my blood pressure and cholesterol low enough to prevent my death. The corporate insurance-dominated health care system requires that the prescriptions for these drugs be renewed by a doctor each year, even though we pay cash for the drugs.

When the bohunk and I returned to the woods of Cook County in 2016, we renewed our patronage of the Sawtooth Mountain Clinic (SMC), a longstanding non-profit enterprise that provides medical care in our remote corner of the world. It is attached, physically at least, to North Shore Health (NSH), the hospital and care center in Grand Marais. Both facilities are closely affiliated with what was known as St. Luke’s Health System, now known as Aspirus.

Getting back to SMC was easy. It still had our medical records from the late 90s, and some of the same doctors,  and I hand-delivered about 80 pages of recent records from an Illinois doctor who’d been treating my annoying recurrence of prostate cancer. 

Within a year or two of returning to “the shore,” I experienced what the doctors like to call a “complicated” medical situation that went on for over a year. It involved, at one time or another in 2018, NSH emergency and diagnostic care, the St. Luke’s Urology practice, St. Luke’s hospital for surgery, and days of recovery and follow-up, and referral to Mayo for diagnostics and “complicated” surgery with weeks of recovery in its hospital, ending with a couple of weeks at NSH for further recovery. 

As you might imagine, there were hundreds, if not thousands, of pages of records that were left behind. SMC, as my primary provider, had most, maybe all, of those on file when they started an online portal. 

Eight years later, with an appointment with an Aspirus doc in hand, I thought it’d be a brilliant idea to get those records transferred to Aspirus. So I called SMC and left a message asking them to do so. When I didn’t hear back within a day or two, I went to my online portal and sent a message in mid-July.  “It would help greatly to have my medical records transferred to Aspirus as soon as possible. What do I need to do with SMC?”

The timely response: “SMC is now on epic care everywhere and so is Aspirus St. Lukes. St. Lukes can click to find outside charts and pull in your SMC records into epic chart at St. Lukes…St. Lukes should be able to see your records when you go for your visit through epic.”

Then I messaged Aspirus and was told that if I wanted the Aspirus doc to have access to my records before my visit, I should go to the section on the portal titled "Sharing" or "Share Everywhere" to give them access to the outside records electronically. 

So I completed the authorization on the SMC portal to transfer those records within this intertwined health network. And when I showed up for my appointment, Aspirus had received nothing. Trying to explain a “complicated” health history in a half-hour appointment ain’t easy.

Now when I go to the SMC portal, I see that there are no records predating 2023,

If patients were customers, this would be a clear example of poor customer service facilitated by brain-dead technology. But since the customers are really the corporate payers of medical bills, the rest of us don’t count.