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The reasons for this unethical and inefficient system are still being examined, but the consequences contain important lessons for every physician practice.
While the Veterans Affairs Healthcare System requires that patients be seen within 30 days of requesting an appointment, we have recently learned that up to 1,600 patients may have waited months or even a year.
It is still unclear how many veterans died while waiting for appointments, but it is becoming more clear that "secret waiting lists," meant to hide the fact that patients were not able to be accommodated within that 30-day waiting list, were rife throughout the VA system.
In fact, 10 such "secret waiting lists" were recently found in VA hospitals in Kansas, Missouri, Illinois, and Indiana. At least 96 veterans waited more than 90 days for treatment at seven facilities in those states, including 26 in St. Louis and 19 in Columbia, Mo.
The reasons for this shockingly unethical and inefficient system, in an age of speed and accountability through advanced technology, are still being examined, but the consequences contain important lessons for every physician practice when it comes to improving operations and patient care.
1. Health information exchange is critical. An integrated cloud-based system, which connects patients, their families (when appropriate), physicians, pharmacies, hospitals, and other facilities, is critical. Every practice needs the ability to view their patient charts, labs, medications, and scanned documents from any location, and they need to be able to work very closely with their physicians without any significant wait time.
2. Preventive health and disease-management systems can help prevent avoidable problems. Preventive health and disease management systems can provide patients and their families essential alerts based on their age, gender, medical conditions, diagnosis, current medications, allergies, family history, and medical history. Practices should employ these systems to help prevent any serious diseases or deaths due to lack of awareness. These alerts should also include behavioral compliance to stay on schedule for medicines, exercise, follow-up appointments, and more.
3. Alerts and reminders should be timely and automatic. No physician or facility should wait for the “next appointment” to communicate with a chronically ill patient. Instead, practices should set up ongoing patient automated communication through portals or established mobile reminders regarding appointments, refills, and regimens via calls, texts, e-mails, and approved social media. Every practice should use an automated system that is timely and useful.
4. Accountability needs to take center stage. Accountability must be an indispensable part of every physician practice's EHR implementation. Managers and practice administrators should be able to identify any irregular usage, incomplete documentation, pending appointments, incomplete or unsigned charts, and make appropriate decisions.
Divan Dave is CEO of OmniMD, a meaningful use Stage 2 certified EHR, practice management, and medical billing services solution provider. E-mail him here.