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  • feedwordpress 06:08:15 on 2014/08/13 Permalink
    Tags: , , Heath IT,   

    Interview in Fedscoop about Chuck Hagel and the Underground Railroad 

    Here is an interview from FedScoop that captures a lot of the dynamics of the VA and DoD health care systems.

    I get a kick out of seeing Chuck Hagel’s wry smile at 2:06 in the attached video, where he can’t quite admit to Congress that he is a card-carrying member of the VA MUMPS Underground Railroad.

     

     

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  • feedwordpress 18:52:11 on 2014/08/12 Permalink
    Tags: Heath IT,   

    Experience with the Kaiser/Epic Scheduling System 

    With all the attention given VA Scheduling nowadays, I thought I’d relate some of my experiences with a commercial, off-the-shelf (COTS) scheduling program that I use as a Kaiser Permanente member.  Kaiser has a multi-billion dollar agreement with EPIC systems, who provide their MyChart patient portal system.

    Bottom Line: Even COTS software does not necessarily lead to happy patients.  The Kaiser scheduling system is seriously messed up.  Figuring out when to call the central 800 number, the department, or submit an online request is quite a frustrating challenge.  And trying to book an online appointment for optometry, for example, is nearly impossible.

    Here is what it looks like to do an online optometry appointment request.

    First you have to choose a facility:


     

    provider step 0


    So far, so good.  I chose the Carlsbad offices.  The fun begins on the next screen, where I have to choose specific providers.   I can’t ask for “any” provider, nor can I just ask for the next available appointment.  I have to choose 1-3 providers specifically, and I have to choose a specific date range:


    kaiser step 1

    After about a dozen attempts to figure out providers and dates, I keep getting the same message:


    Kaiser screen 2


     

    No other feedback, just try again.  When I go back, I don’t see the providers or dates I tried, just blank fields to try again.  There are no hints, no “next available appointment” slots, no Help tab, customer support access, or ability to browse.  Just a blank screen to try again.

    So, I had to call their 800 number to wade through the key presses to select my language, listen to a “this call may be recorded” message (multiple times), then select my way though the appointment menu.  Depending on the particular clinic, I might get routed to another 800 number to call.  Some appointments I can make directly with my provider, others through the department, others through the central service.

    Of course, the problems with the VA scheduling system are far more serious than what I describe here.  But this also shows that, even with billions of dollars of software expenses and Commercial Off The Shelf products, things can be far from perfect (or even usable).

     

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  • feedwordpress 18:20:04 on 2013/07/25 Permalink
    Tags: , , Heath IT, ,   

    1993 GAO Report: Increased Information Sharing Could Improve Service… 

    Here’s an interesting link to a GAO report analysing VA’S DHCP (now called VistA), DoD’s CHCS system, and Indian Health Services’ RPMS systems.

    Seems that barriers to sharing were organizational issues, not technical.

    Not much has changed in the intervening 20 years, except that the systems have become 100x to 1000x more expensive (i.e. profitable to systems integrators who revel in the complexity of having lots of incompatible pieces).

    It’s like we are living in a time warp, doing the same thing, time after time, ignoring what has succeeded, and replicating what has failed.  And it just keeps getting more complicated.

    Someone should ask, “What’s the simplest thing we can do?” rather than continually shoot for gold-plated perfection.

     

    Tip of the Hat to Sam Habiel and Jim Garvie for digging this out…

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