Every time I get to go to a doctor myself or with a family member, I kind of have something inside me that starts immediately evaluating the experience. Not from an ordinary patient point of view but rather from a purely technical and electronic point of view. As if Mr. CPHIMS inside starts asking what if they did it this way? What if they had that? What if.. What if?
Usually I can't resist asking questions to the registration officers, doctors, nurses, even the admin staff sometimes. Not in a criticizing way, but rather I try to make it in an educative way because it wasn't their decision to work this way; most probably.
I recently had this hospital experience with my wife, she was admitted at the government Orthopedics hospital in Kuwait - Al-Razi Hospital, for a frozen shoulder operation. At first I must mention that we had the option to do the operation at well-known private hospital in Kuwait, but we choose to do it at the government hospital because we knew that she will get better quality of care during the operation, post operation, and the physiotherapy period; for free. Otherwise, we would have had to pay around $6,000 and she would have enjoyed a more quality stay in her sea side view room at the private hospital, but that did not weigh much in our decision because we are insured so money wasn't really an issue, and the stay in Kuwait government hospitals wasn't that bad from a personal experience.
My wife was referred to take an appointment with the doctor in mid October. She took a queue number and waited. When her turn came, the nurse came out of the doctor’s room and called her "number". She went in and because she doesn't have an electronic health record, had no file in the hospital, and the doctor had no access to her EHR if it existed; he asked her for the whole one year old history of her shoulder symptoms and other doctor's visits, reports, prescriptions, and opinions. Then he examined her and looked into her MRI and asked her to go open a file and come back. We left the room and went to the Medical Records office and opened a file and went back, waited outside tell the nurse came out and called us again. The doctor decided to operate on Oct 28th and asked her to be admitted on 27th.
We went on the 27th straight to the ADT office. The officer told us that we have to go to the doctor's office first to get the admission request. Back to the car and to the doctor's office which is in another building, we had to take a number, wait (it's a busy clinic BTW), see the doctor, out to get the file, back to the doctor, and got the request paper. Then back to ADT then finally admitted.
My wife was successfully operated and back to the word. She had an excellent treatment during her whole 5 days stay. So good that my wife – who is a very very picky person, upraised the quality of care she received and didn't blame her stingy husband for not doing it at the sea view private hospital :)
The doctor started the physiotherapy immediately after the operation because it was necessary. And before she was discharged the physiotherapist gave her an appointment to be back for physiotherapy session on Nov 4th. Of course we had to take the paper request from the word, go to the physiotherapy department, and register the date and time. But that was fine because we're going home.
On Nov 4th my wife took a taxi and went to the physiotherapy appointment because she wasn't allowed to drive. She went with all the good impressions about her experience so far, till she faced the true medical paper record experience.
She took a number and waited. While she is waiting they are supposed to get her paper file and put it ready for the physiotherapist. After a while an officer approached my wife and asked her: WHERE IS YOUR FILE? My replied how could she know where is her file! It should be in the hospital. WE CAN'T FIND IT AT THE MEDICAL RECORDS, GO CHECK IF IT'S AT THE WORD. My wife went to the word and found that they didn't have it, so she told the officer. IS IT WITH YOU? DID YOU TAKE IT? How on earth would I have it! Since when you let patients take their medical file? OK, GO CHECK IF IT'S AT THE DOCTOR CLINIC. How I am supposed to go, my wife replied. I don't have a car. OK, WE WILL SEND SOMEBODY TO CHECK IF IT'S THERE.
Of course my wife had to wait longer and her number was passed. After a while the officer came back to my wife again and told her that they can't find her medical record but she will see the therapist anyway. When my wife saw the therapist she had to tell her whole frozen shoulder history till she was discharged from the hospital, and yet! She couldn't do her therapy because there is no file. They decided to reschedule the session till they find the medical file.
Two days later the hospital called my wife telling her to come tomorrow for a physiotherapy session because they found the file at the doctor's office. Is that end of story? Or is it just the end of scene one? We don't know.
It's amazing how such a good healthcare experience take such a long and unnecessary time and turn into a total frustration because of ancient problems that could easily be solved by implementing an EHR or a document management system at least. Everything has advanced in the hospitals in terms of workflow and business process, equipment, quality, appointments efficiency, and medical staff, except for the paper work which has been the same since they opened the first hospital in Kuwait. This is a typical example how healthcare delivery can be improved by saving the very precious time of patients and medical staff by implementing Electronic Health Record. Not just at the hospital we visited, but at all the healthcare system in the country.
