My health journey continues with multiple focuses. And my journey through digital front doors continues as well. I wrote part 1 on this topic in early November when I was in the middle of various health and dental
appointments and scheduling more. I also wrote about what I thought was an awesome example of how technology has evolved in “Patient friendly testing – yes, a positive story!” in September. The end of that story was not so positive. More on that later.
Here are a few anecdotes from my recent experience:
Cataract surgery – I had my initial consultation appointment the end of November and have surgery scheduled for mid-February. Specialized eye drops were prescribed to start taking a few days in advance of the surgery. As soon as I left the doctor’s office, I received a text message that my eye drop prescription from my doctor was pending payment with this special pharmacy – for immediate delivery to my home I should click the link to pay $82.50. I was a little suspicious of a text asking for payment like that and knew I didn’t need to have the eye drops until February, certainly not immediate home delivery. I called the doctor’s office to confirm the text was legitimate and asked how to handle the timing of delivery. I was told I could just text back regarding delivery timing which I did and got a reply that they could do that. I thought great, there’s a person on the other end. But then I received several more automated text reminders to click the link so they could ship right away. Then they called me. I talked through the timing and gave them my payment info. Their proactive communication (and persistence) was a plus, but I was more comfortable with real-time communication to coordinate specific delivery schedule and payment.
Bone health – I had a virtual visit with a Nurse Practitioner from the Bone Health clinic at my primary hospital. This was part of follow-up from my fall and pelvic bone fracture in August. The virtual visit was easy to get into and very thorough. I learned that more and more elders are asking to be seen in person – not this one unless there is a reason to “lay hands on me”. The only quasi in-person aspect was that she needed to see my gait which was doable when I got up and walked away from the camera and back. I was sent a visit summary including additional information and instructions via the patient portal that day and a scheduler called me to book the follow-up appointment. After some additional lab work, my follow-up visit will be virtual as well, at my request.
Portable bone density test at home – The positive story I mentioned earlier didn’t have such a positive outcome. Prior to the bone health virtual visit, the NP needed to see the bone density test results. But the results had not been sent to my physician as the insurance company who did the test said they would. The NP called them and couldn’t track down anything. I called them and finally learned that there were no results to share since Medicare denied it – a portable home bone density test didn’t meet their criteria. So, the insurance company just zeroed it out and dropped it. They made no contact with me to explain or to inform me that I would have to get the test the standard way. Clearly a coordinated care issue between payors and providers. So, I lost several weeks of time, had to reschedule the bone health visit, and ended up getting the bone density test with the standard scan equipment at an outpatient location an hour away. So much for the patient friendly home testing in this case.
Physical therapy – I “graduated” last week having met the goals established. I have a set of exercises to do several days a week. The old school in me happily accepted printouts of the exercises over the course of my PT sessions. They are all available to me through an app called MedBridgeGO or on their website. Now that I’m expected to maintain on my own, having an app where I can log my exercises will be a motivator and keep me honest. There are videos to ensure I have the right technique for each, and I can set reminders for myself. The tag line when you open the app says it all, “Your health is in your hands”.
Shingles shot – I scheduled my shingles shot at the pharmacy I use. I wasn’t sure they gave them at that location, so I called them. After waiting on hold for 15 minutes, I went online to see if I could find out and schedule it like I had the COVID booster and flu shot. Turns out I could. I stayed on hold another 15 minutes (just in case) while doing everything online – scheduling and completing a consent form. Turns out the online form is not available to the pharmacists when you go in for the shot. Unless you know to print out the completed online form and bring it with you, you must manually complete the same form at the appointment providing the information all over again. That seems like a simple user access fix – let the pharmacists access the portal where the completed forms are stored. One more observation – masks were not required yet there were many people getting vaccine, booster, flu, and other shots. All waiting in a makeshift waiting area set up down the closest aisle. If retail pharmacies are going to act like primary care providers with vaccines and other shots, they should have the same standard that every doctor’s office does – masks required.
What are some takeaways from all this? Some of us at times will want/need real-time person-to-person communication despite all that can effectively be done leveraging technology. Virtual health is here to stay, and it needs to be easy and appropriate to the situation. CVS, Walgreen’s, and Walmart will continue to expand their primary care offerings and that is a positive development for our health ecosystem – more on this in a future blog post.
Your health journey is yours to own. How easy and accessible it is will depend on those providing the services.
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On the other side of the digital front door