Now I use a fax machine almost daily, as well as other arcane technologies, such as the pager that has to be carried around at all times.
These rather quaint examples make for fun anecdotes to regale non-medical friends with, but they speak to something more profound: the generally abject quality of the communication tools employed by health care practitioners.
This is especially clear in our handling of medical records. It’s ironic, given that our profession takes so much pride in the ability to tell the story in a succinct and a systematic way, that we are so tolerant of platforms that obscure rather than illuminate the important points in a patient’s history.
Even within a single hospital network, the archive can be dense, chaotic and generally migraine-inducing. It’s not uncommon to find a crucial operation report hidden among a dozen computer-generated data logs or lost at the end of a digital cul-de-sac.
But the real problems start when records are scattered between public and private or across the territorial boundaries of local or state health networks. In this case, chasing the records feels like a fishing expedition, and there are days when the fish just aren’t biting.
Here’s a typical example. A patient who is cognitively-impaired is admitted with a vague history of a previous admission to another hospital following a fall, and it’s thought, reasonably, that retrieving those records may be useful to the current admission.
But on contacting that hospital, which is less than 100 km away, I find that I can’t even be told if those records exist, much less their content. The only way to find out is to start blindly faxing request forms out into the wilderness of medical records. That represents a dismal yield on an investment of considerable amounts of time.
These frequent trips down the rabbit hole in the search for records that may not even exist are really morale depleting. I was prepared by medical school for the stress of dealing with people who are sick. I wasn’t prepared for the task of cold-calling pathology labs around south-western Sydney on the off-chance of turning up an old blood test.