Four hundred miles or 400 feet, it doesn’t matter
I was initially involved with the care of my mother. Now it’s my
wife’s turn. Her elderly parents live in Omaha and they have frequent
medical appointments. We end up serving a lead role, but we also live 400 miles away from Omaha. And although we have little to do with day to day issues, we are looked upon to sort out anything medical. Being 400 miles makes it impractical for us to tag along for their doctor appointments. But even
when an adult child lives a mere 400 feet away, if time doesn’t permit physically being there, four hundred feet may as well be 400 million light years. The task of sorting it all out after the appointment can be daunting as the two following vignettes demonstrate.
A New Pill?
After a three week delay, Mom finally gets in for the specialist’s appointment. Later that day you get the update: “Mom was started on a new pill.” It happens that the new med is almost identical to one that she’s currently taking. Did the specialist know she was currently taking a similar med? Is this new med
an addition or in place of the old? What else did the specialist have to say? Only questions and no ready answers are available.
What Operation?
Dad is back from the surgeon’s office. He’s not sure why he had been referred, but he’s talking about some operation that needs to be done—and soon. What operation and for what problem and anyway, what did Dad actually complain about? What did the surgeon have to say? And again, that’s all of the information that is available.
As with the first vignette, the problem is that we don’t even know if there is a problem, let alone how to resolve it. Trying to track down the answers is not easy and they both need to be sorted out immediately to avoid potential harm. There are no efficient ways to sort this out if you weren’t there. Better communication than the telephone is required unless you enjoy phone tag!
A Patient Portal and Meaningful Use to the Rescue
Ideally, what’s needed is a system to securely and remotely access your mom or dad’s medical records when it is convenient for you. This is a perfect application for a patient portal. The Meaningful Use provisions of the 2009 American Reinvestment and Recovery Act could impact this process as well. Meaningful Use stipulates that medical providers make medical history and clinic visit summaries available electronically, same for medication and allergy lists. Content of this type could immediately provide answers and avoid hours of playing phone tag with providers.
HIPAA will create some impediments to accessing the information, but they’re not insurmountable.
Language in medical power of attorney templates can be used to authorize access to a parents’ personal health information (PHI) via a patient portal—kind of analogous to being a Face Book Friend or in this instance a “Medical Friend”. In either of the two vignettes, the Meaningful Use required summaries would quickly resolve the questions and if any questions lingered, they could be addressed with secure messages.
Currently, participating in the care of an elderly parent is very difficult and time consuming. Memory and comprehension
limitations in the elderly often create safety issues, adding an element of urgency to resolving these issues. An efficient means of communicating with medical providers is imperative. A patient portal can provide a ready-made system for designated “medical friends” to securely access a family member’s PHI. This would improve care and make it much easier for designated family to be involved.
Stay tuned.
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