Primary portal

We now move from the “personal” aspect of my recent primary care experience with the practice associated with Virginia Hospital Center. Let’s look at the systems side.

Naturally, this practice has a patient portal. You’re meant to go there to find results of tests, keep track of your immunizations and so on. This is a whole Thing in contemporary healthcare—they tout it as putting the patient in charge, but what it effectively does is keep the patient out of the provider’s hair. It’s also a massive saving in labor costs. If you want information about your care, the first step is supposed to be to go to the portal and look it up instead of calling them.

That would be fine if the portal was easy to use, well organized and contained accurate and understandable information. The VHC portal does none of these things.

Not having heard anything from the nurse practitioner in the couple of weeks since my office visit, I went through the kludge of logging on to the portal (which is a white-labeled site run by an outfit that shows up as eClinicalWorks). Obviously what VHC chose was the least amount of customization possible, because the interface is as generic as they get.

The disdain for the user exhibited by this site is encapsulated in one design feature: you cannot use it to initiate contact anyone in the practice. Partly, I’m sure, because to have that capability the site would need to have an underlying database with contact details, which involves the expense of custom development, and partly because you’d also have to have providers who would be willing to be contacted. Either way, it would represent an investment in providing customer service, which would in turn eat into profits.

Note the message screen:

You cannot create and send a new message; you can only reply to one. (You can try to make an appointment, but that's an entirely different thing from communication.) It’s essentially push-respond. What does that say about the provider-patient relationship?

Back in the day, I bitched about the limitations of the portal run by Palo Alto Medical Foundation: you’d get an email whose sole purpose was to drive you to the site, so you had to log in and navigate to the message page to find out that they were confirming your appointment, or the like. PAMPF: I apologize. I had no notion how bad these portals could be; as they go, you are aces.

Because I could send questions and get responses from my providers throughout the system. It actually was a bi-directional communication system, not a freaking wall. I’d also receive notifications of lab test results (via the email-and-login route; but still…), which is better than hearing nothing but post-office visit crickets.

(Case in point: I used the portal three times in January and February to get interim prescriptions faxed to local and mail-order pharmacies, and to get a referral to physical therapy while I was still trying to find a PCP here. Each time, I originated a message online and my PAMPF PCP responded. It was like magic compared with this VHC nonsense.)

After receiving nothing in the nearly two weeks after my office visit, I soldiered through the kludge of logging into the portal and tried to understand the results of roughly $1100 worth of blood work. Want to know what I found?

Why yes indeed: a block of boilerplate covering liver-kidney-glucose-cholesterol-thyroid-vitamin D…and the X-ray results. All lumped together and pasted five times into the five individual tests. I wonder if they billed my insurer for that?

Okay—I believe that three days is enough of a rant. But if you’re in the NoVa-DC area, I’m still looking for a primary care provider.