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A couple of days ago, I retweeted the following tweet from @Lilly_COI, the Twitter account for The Eli Lilly Clinical Open Innovation team that promotes open innovation in clinical development.
So the url goes to a blog by KevinMD.com on MedPageToday. This blog is really good and addresses what constitutes meaningful patient engagement.
@Lilly_COI took it one step further, and applied it to clinical trials. Which is so true, as clinical trials is just one small slice of the healthcare pie. But they also need to engage patients, so as people are pretty much the same everywhere, engagement too spans the healthcare spectrum.
Here’s my personal experience patient engagement experience, as a not-high utilizer of healthcare services. I made an appointment with my general practitioner, who I last saw in March, to get a prescription refill. Also, I had (finally) in August had the blood work done for my labs and my annual mammogram, so wanted to check in on those results.
Wait, I mean, I tried to make an appointment with the GP. I called, got the normal, dial 3 for scheduling, but went into voice mail. OK, I left a message that I wanted to make an appointment. A week went by, no call back. Unfortunately, my prescription was running out and it was my last refill. The pharmacy wouldn’t refill without a doctors authorization. So I called again. Pressed 3. Got the same voice mail. So I left a message. Then called 2 other departments (via 1 and 4) and got their voice mails! So I left 3 voice mails asking for a doctor authorization and someone to call me back for my appointment.
In the meantime, I was so annoyed about this voice mail circle that I decided to change physician’s offices. It wasn’t a hard decision as this is office has a difficult front line. Once you get past the receptionists, the nurses and doctors are great. But the front lines are tough. I went to the front line to get my medical records a week later to take to my new physician. (Which, btw, the new physician’s office gave me a prompt appointment and, guess what? They actually answered their phone.) She said I had to call to request my medical records. I said, “The reason I’m leaving this practice is because I go into voice mail every time I call. Can I just put in the request while I’m here?”
As I’m filling out the request form, two other patients come in. A mother with her young son who said she tried calling for an appointment and couldn’t get through, so she came in to make the appointment. That experience is not helpful, but she is obviously highly engaged in her son’s care. The other patient said the same thing happened to her. She ended up in the emergency room because she couldn’t get her physician—or anyone--on the line. Can someone say negative patient experience and higher payer rates?
Fortunately, they let me take my lab results to the new doctor. (BTW, that’s my next blog. How in the world do people really want their lab results sent directly to them? Really, the average person cannot understand these things. At All. I can’t imagine being in a clinical trial and never finding out the results, as happens so often http://bit.ly/SLKg0A)
I had to see two new doctors yesterday. I filled out an amazing amount of paperwork, though not a detailed medical history, they took that during their time with me. The first doctor entered directly into my medical health record, and the second into paper.
No need to elaborate further, as I’m sure you all have your own experiences about the physician’s office. But experiences equal engagement. They equal how the patient is going to feel about communicating with their physician, or choices they make about a clinical trial.
And I consider myself fortunate in that, 1) I am healthy so I don’t need to go and fill out forms and wait a lot; 2) I understand healthcare and terminology just based on my education and work, so I can do research on the internet, and I can understand and ask the right questions if need be. But I admit I get so frustrated with the front lines. I know they deal with rude, uninformed and thoughtless people constantly, that’s why they are the way they are. Truth be told, when I meet a nice receptionist or patient care coordinator or whatever the correct term is, I am so happy and nice in return. I even try to be nice to the rude ones, sometimes even they can turn it around.