One of the things that I like about the Baylor Scott & White Health system is their use of Epic, an electronic medical record-keeping system for mid-size and large medical groups. Every time a doctor, nurse, therapist, dietitian, or any medical professional enters the patient’s room, that person logs on to the computer and updates the patient’s records. Epic also has a patient portal, which means that patients can contact their doctors, view test results, schedule appointments, and more.
Every morning after I arrived at the hospital during Dad’s stay, my father’s nurses logged on to Epic and provided me with the results from 4:00 A.M. labs and updated me with information about his night. Using my trusty iPad, I kept detailed notes about everything that I witnessed and overheard and about conversations with my parents and friends. I also kept track of comings and goings of visitors and hospital personnel. I also kept track of the weather and some current events. When the entourage of doctors, pharmacists, residents and fellows, and the so-called patient advocate stopped by, I logged the information they presented, as well as comments that they made among themselves outside my father’s room.
When my father eventually left the Baylor Scott & White hospital system, my mother and I wanted to obtain his medical records. Some disturbing events had happened near the end of his stay and we wanted to see what had been charted so that we could reconcile that information with what we had been told. Also, I had heard comments from therapists and nurses that didn’t always jive with what we had heard from doctors, and we wanted to know the truth.
During our second trip to the Release of Information office, we were finally able to request Dad’s records. I learned that I needed all of my Medical Power of Attorney documentation when requesting records, which was interesting because I needed only my word when authorizing surgery and tests. I can appreciate the difference, however. The release form contained several check boxes that enabled me to choose the type of information that I wanted included in the report. I could also choose whether I wanted a printout or a PDF on CD. The form indicated that there would be a fee.
According to the “Patient Rights & Responsibilities” document that was included in his welcome package, he or his medical advocate had a right to “obtain a copy of his/her medical records at a reasonable fee and within a reasonable time frame after submitting a written request to the hospital.” I assumed that a PDF on a CD would be the simplest and least expensive option, plus it would be searchable and I could add notes as comments. I was still living at my parents’ home at the time, so I had the CD mailed to their address.
Several days later I received the CD in the mail. Enclosed with the CD was an invoice for (wait for it…) $732.46. The hospital contracts with ScanSTAT Technologies, who charges $0.22/page to push a couple of buttons, write a report to CD, put the media in an envelope, and mail it. Our report was in excess of 3300 pages.
I’ve had a little experience with scanning companies and their charges. One of my best friends owned a scanning company in the 1980s-90s. Back in the last millennium when you used an expensive system like a Kurzweil scanner, someone had to monitor the scanner, feed in paper reports (although you might be able to use a sheet feeder), and then the scanner program wrote the scanned pages to disk or tape. Now that we’re well in the 21st century, technology has changed significantly. Unless Epic is a totally bogus system, and I’m pretty sure that it isn’t, it should be able to output a report based on selected criteria. Based on the “Generated on 10/26/2015 9:14 AM” footer on every page, I strongly suspect that’s what happened.
While I understand that Baylor Scott & White and ScanSTAT Technologies are not charitable organizations, I think that this invoice is far from what I would consider reasonable is closer to shocking and unacceptable. I used to own a business, and I understand overhead costs involved to run and sustain a business. While most businesses must find the pricing sweet spot so that they can make a profit and remain competitive, patients have no choice when it comes to acquiring medical records.
I happened to be back in Houston this week and had the opportunity to visit with my personal physician. When I told her about the price of the CD, it took her a moment to close her mouth. My husband is from Michigan and by state law, hospitals and their contractors can no longer charge more than $35 for medical records. Heck, I wouldn’t have balked at $50, but $732.46 bordered on the obscene.
On occasion, I make comments in my posts to the effect that I didn’t know something at the time that I now know. In all cases, this new-found knowledge was derived from these medical records. It’s been an interesting and sometimes shocking exercise to compare my notes with the notes in these files. I intend to keep sharing many types of interesting information.