It's in the computer...

There is no doubt that computers have had a tremendous impact, improving the efficiency of almost every aspect of daily life. Electronic Health Records (EHR) in particular have helped transform the delivery of health care. Gone are the days of wasting time looking for charts, faxing records between satellite locations, waiting for results to be filed and deciphering illegible handwriting. However, there are some limitations; I can't quickly skim through an EHR in the way I could flip through a paper chart. Additionally, entries in the computer record are still vulnerable to user errors. I usually like to take a few minutes to review some important sections in the EHR before entering an exam room, but especially if it is a patient who is new to me, I always want to verify the history myself. Occasionally, I'll have a patient who find this process frustrating and will give a sigh or an eye roll (sometimes both) and answer my questions with the response, "it's in the computer..." It sometimes amazes me how some very young or much older patients expect that their entire health history is at my fingertips (and that I've read it entirely). I simply explain that I don't blindly accept everything in the database, just because it's in the computer.

Case in point: I was sitting at my desk when my iPhone started to vibrate. It was an unknown 1-800 number. I would normally let it go to voicemail, but I had recently received some calls from an 800 number to coordinate the order and delivery for my Ovidrel, which arrived yesterday. Figuring it was someone from the pharmacy calling to follow up, I answered.
"Hi, this is Blah-blah from [my insurance company]. Do you have a few minutes to talk?"
"Sure" I replied and moved into an empty exam room, feeling a bit nervous. I feared she would tell me that my upcoming IUI wouldn't be covered or something else infuriating.
"We have an educational mentoring program and I wanted to see if you would be interested in participating" she asked, to my relief.

Cool, I thought to myself. I've seen some insurances who have their own special programs for members with certain conditions; newly diagnosed diabetics, heart attack and stroke survivors, but this is the first time I've heard about a program for infertility. Awesome! My insurance rocks! 

"Well," she began "Congratulations on your pregnancy! How are you feeling?"
"I'm feeling fine." I replied flatly "Especially since I'm not pregnant." My heart sank a little.
"Oh my!" she exclaimed, obviously flustered "I'm so sorry...I'm not sure why I had a prenatal referral for you"
"Me neither -especially as I am dealing with infertility."
"Oh, well I do apologise and I do hope I'll be calling you soon." She couldn't end the call fast enough.

I thanked her and didn't bother telling her that because of my profession I probably wouldn't need to enroll in the mentoring program if I were to become pregnant. I know she was embarrassed just by calling on me when I wasn't pregnant and I felt a little guilty about making her feel even worse about the situation by bringing up my infertility. I did so with the hope that she'll inform her supervisor of this error and the glitch can be corrected before another coordinator invites an infertile woman into their expectant mothers program.

Seriously, it doesn't fill me with much confidence that the left hand at my insurance company doesn't know what the right one is doing. I know they don't have access to my actual medical records, just procedure and diagnosis codes. I had two beta tests in November with the code "possible pregnancy, not yet confirmed", followed by a visit for "threatened abortion" and more labs for "complete spontaneous abortion". There should be plenty of charges from my hysteroscopy which was performed for "uterine anomaly contributing to pregnancy loss" and most recently, billed expenses for my IUI meds, which obviously carry the word 'infertility' in the associated diagnosis. Yet, somehow their computer system has me listed as being pregnant. If only it could be that easy. It's in the computer -therefore it must be so.