I recently finished a course of fairly expensive medications for a condition I'm dealing with. The medication was quite expensive, but fortunately my insurance covered it. However, my insurance company would only cover the prescription if it was ordered from one particular pharmaceutical supplier. That's all fine with me and I was just happy to be able to get my medication when I needed it. Except, that's not what happened.
About once a month I'd go to see my doctor to get my condition checked on. If it persisted, he'd renew my prescription via fax and (in theory) the pharmaceutical supplier would call me to arrange for delivery. Well, that was the theory, anyway. I would sit in my doctor's office and watch him order my medication using an electronic medical record (EMR) solution. This meant that that the new prescription would be noted in my medical record and a fax would automatically be sent from the hospital's fax server to the pharmaceutical supplier. Often a 'fax received' confirmation would show up in my electronic medical record before I even left. It's a nice, secure, efficient solution: there's no paper generated, meticulous records are kept and my private healthcare information is never accessible by anyone other than my doctor and the pharmacist. The problems kicked in when I got in touch with the pharmaceutical supplier.
Notice that I said that I got in touch with them - they were actually supposed to call me within 24 hours. They never did. So I called them to arrange for the delivery of my medicine and I entered a strange world of inept bureaucracy and miscommunication. When I talked to the agents at the supplier's call center, they didn't have the information they needed to fulfill my order: the original prescription. The faxes came in to another department somewhere else (they could never tell me where) and the information was manually put into their system. Eventually. Most of the time if I called the next day they hadn't ‘received' the fax yet. The first time I heard this I couldn't believe my ears - I'd seen the fax confirmation of the original prescription order! But the call center agent didn't have the information because someone else hadn't ‘put it in the system.' No prescription, no medicine. I just had to wait - sometimes for several days.
Even when the order did come through to the call center, it was still clear that the agents weren't getting the information they needed to help me. I had a prescription for three different medications, but the agents usually only offered to send me one of them. It got to the point where I had to tell them to scroll down to their next screen to see the rest of my order - and I didn't even know what sort of application they were using! If I hadn't known exactly what medications I needed and in what dosages, I would have received incomplete orders almost every time. As it was, for well over a year I had to wait several days after my appointment, call the pharmaceutical supplier, tell THEM what they needed to send me and then wait even longer for the medicine. Needless to say, this didn't exactly speed my recovery.
So what went wrong? It wasn't the physician's fault - I'd seen him send the order myself and we got the confirmation it went through. It also wasn't the fault of the agent at the call center - they had a faulty system that didn't show them the information they needed. The problem was that this particular pharmaceutical supplier didn't have a simple way to move information from a fax to an electronic application quickly and reliably. What hurt me most wasn't the fact that I didn't get my medicine; it was the fact that my employer provides a solution tailor-made for just this sort of problem!
Biscom's Workflow solutions (Workflow Express and Workflow Enterprise Edition) were designed specifically to take electronic document images (faxes, PDF files, Word documents, etc.) and route them through a business workflow. In this case, a fax would come in and Workflow would automatically extract the identity of the patient and the ordering physician via OCR. By cross-referencing this with the pharmaceutical supplier's own database, the application could append a wealth of additional information (address, phone number, order history, etc.) and electronically submit the document to a pharmacist for review. The pharmacist could approve it with a single click and the system would automatically forward the order to an agent so they could call me and arrange for delivery. Best of all, at every stage in this process the user would be able at all times to view the original fax from my physician! Everything would have been tracked and audited. Everything would have been HIPAA-compliant. Everything would have been fast, simple, secure and not a single piece of paper would have been generated. If they'd had a Biscom Workflow solution. They didn't.
So, I spent several hours a month on the phone trying to get medication delivered on time and in the right amounts. I was sometimes successful; I always got it eventually and they only sent me the wrong amount once. Fortunately, my problem wasn't critical and I was smart enough to double-check the order each time. I shudder to think of the potential liability, however, should this company have sent the wrong dosage to someone who didn't know what they were supposed to be taking. Neither my physician nor I were very happy with the service we got from this pharmaceutical supplier and we got the impression that customer satisfaction wasn't a very high priority for them. I'd like to think that human life (or at very least the expense of a lawsuit) would be a bit more important.
What is it that they say about an ounce of prevention?