Is online medical visit UX bad where you are as well?

Scheduled an online doctor appointment today @ 8:00. Their procedure for making these appointments is that they schedule the appointment, and then the nurse types in your email address. From scratch. Every. Single. Time. Even if they already have it on file for online patient portal access and such.

Then you get a confirmation email. NOT to the email address you told the nurse - to the email address that’s on file for your account. Which should theoretically be the same as the one you told the nurse, plus or minus transcription errors. But transcription errors happen - and they can be kind of a Big Deal.

The day of the appointment you get a phone call from the nurse 5 minutes ahead of time. They run through the pre-appointment stuff. And then you wait for the doc.

Notice how I haven’t mentioned “you get the link to the meeting via email” yet?

That’s because the link for the meeting doesn’t come until the doc is ready. At which point you have to click the link right away to join the meeting.

How do you know if the doc is late, or if you missed the link? Well, if you haven’t gotten the email by 5 minutes or so after the appointment time, you call on the phone. And go through their phone tree. And get somebody who needs to figure out who you are, and figure out what’s going on, and track down the doc to see what’s happening.

Which I did just now. And found out that the doc is still finishing up with somebody else, but he should be done “soon”. If I haven’t seen the link in the next 5-10 minutes, I’m apparently supposed to call back.

Y’all have no idea how much I would love the ability to get a link the day before (just so I know I have it ahead of time), click it after I talk to the nurse for the pre-appointment check, and just sit there staring at a “somebody will let you in shortly” screen on my computer.

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My health system uses MyChart. You get a link in your account that becomes active 24 hours before the appointment time, so you can log in early and get familiar with it.

I haven’t ever used it yet. But that’s how it’s supposed to work.

Welcome to the pain of healthcare IT, @webwalrus. We didn’t even start using computers until 2009 when Obama forced us via the HITECH act. Till then many of us were using paper. PAPER! I remember writing patient information in a giant ledger (a la 1950) in 2006.

So while banks, lawyers, bakers, and the rest of the world had decades of UX maturity we were just getting our feet wet. Even now, 12 years later, the system is clunky. It has gotten significantly better, though has a long ways to go.

The primary motivation for this is to maximize billing – not patient convenience, ease of information retrieval or entry. The virtual visits I think you’re describing were hastily thrown together in May last year due to the pandemic. Insurance companies relented that they’d reimburse virtual visits so this was thrown together quickly.

There’s really no motivation for the big companies to improve their systems… until Amazon comes in.

The clinic where my doctors practice use a horrific thing called “Follow My Health”, that looks like it was brand shiny new when DOS 3.1 was in wide use.

Slightly off topic, but when this happens it should be reported to the appropriate governing body as breach of patient information. Mistakes happen, but when repeated mistakes are the result of a poor process, it’s negligence.

Somewhere I have a MyChart account for my provider - but these routine visits apparently don’t run through that for some reason.

I’d definitely believe that. It just kind of surprises me that certain things that are “best practices” - and could potentially be intuited from office practices - apparently didn’t make the list of considerations.

Wait…something being mis-entered into a system is a “breach”?

If it results in confidential information being sent to the wrong email address, then yes it is. (I may be making an incorrect assumption that the email transcription errors were resulting in that happening. That may be due to bias on my part due to having had to have been on the uncomfortable side of that conversation a few times :grimacing: )

One of the issues most doctor offices have is they are run by one or two doctors whose real focus is on the medical care vs everything else. Unfortunately they aren’t spending much on their support staff nor the systems they use. Maybe as the older generations of doctors retire out and younger more connected doctors start running their own practices better connected experiences will happen.

Just the other day I was commenting how the form the pediatrician gave us to fill out was obviously a photo copy of a photo copy who knows how many times over. Made you wonder why its not just a file they print out in mass every so often so you don’t get the copier artifacts on it.

Yeah, I’d get it if they were a smaller provider. In this particular case though it was a GP working at a large campus of a major hospital system. :slight_smile:

Not sure. I got a new primary care that’s part of a big hospital system and I was fairly impressed with the whole experience. Though my doctor is closer in age to me as well as studied computer science for his first undergrad so he may also be more motivated to have a more connected experience.

My pediatrician for example is the same doctor my parents took me to as a baby so you can see my point of it may be more up to the individual doctor how much they use it.

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In our case the appointment is made by phone. Then a few minutes before the appointment time the receptionist makes a FaceTime call. I don’t know what they use for Android or people with just a Windows computer. We usually just answer from an iMac unless we need to use the phone to allow clossups of the issue.

Email is never used.

Since we have been fully vacinnated, we go to the doctors office and they scedule things so there is never more than one person in the waiting room. Same thing applies to the dentist, and of course there is no way to have a dental appointment online!

I agree with @ACautionaryTale. In the US HIPAA does allow health care providers to use email to discuss health issues and treatment “provided they apply reasonable safeguards when doing so. . . . For example, certain precautions may need to be taken when using e-mail to avoid unintentional disclosures, such as checking the e-mail address for accuracy before sending, or sending an e-mail alert to the patient for address confirmation prior to sending the message”

So, IMO, at the very least it is a breach of protocol.

I’ve noticed usually I have to sign that and confirm that phone numbers or emails are correct. I’m sure most practices made us sign away liability for wrong numbers or emails being used by making us confirm it.

In this case they take down the email over the phone every. single. time. Despite the fact they have it on file elsewhere. I’ve never had them mess it up, but (a) the fact that you have no confirmation they even typed it correctly until 5 minutes before your appointment is…unsettling, and (b) making people transcribe things over the phone when you already have the data elsewhere is a process almost designed to introduce errors into the system.

I would also think that the only way to release them from liability in an enforceable way would require that you confirm the information as entered into their system. You could never release them from all liability after reading an email address over the phone or writing it on a form, because the only real point of failure on the provider’s side would be them typing it improperly.

Not completely related, but my insurance didn’t get a claim from a doctor’s office this week because the office sent the bill electronically and my insurance only accepts claims by mail or fax. So the doctor’s office just sent me the bill saying my insurance denied it when in reality my insurance never got it. Now I have to spend my time trying to sort out what should have been an easy process.

I’m lucky. I’ve been going to the same doctor for close to 20 years. He shares an office and clerical staff with another doctor, but each has their own patients. For the past several years I’ve been making appointments, seeing test results, all the usual EHR stuff, using an app or website. But patients can still do everything over the phone if they choose. And while I do receive appointment confirmation emails, they still call all patients a day or two before their appointment. Old school, with iPads and apps. Nice.

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