In a previous post, I outlined how Friendship Village of Dublin has mishandled my father’s medical information, to the detriment of his medical care. Expanding on that story, here are some other complications or screw-ups in the same series of medical events. In these other cases, the blame clearly falls more on the information-flow system itself, rather than on some particular medical care provider such as Friendship Village of Dublin, Riverside Methodist Hospital, or the paramedics who transported my father from one to the other.
1. When his nurses say my Dad continues to be unresponsive, what they mean is that he doesn’t respond to their verbal commands, nor does he seem to visually understand his surroundings (as might be judged from, say, his eye movements). Well, my Dad is extremely hard of hearing, is effectively blind in one eye, and doesn’t see too well out of the other one either. His hearing aids and eyeglasses didn’t wind up at Riverside Hospital until last Friday, 11 ½ days after his initial hospitalization. They wouldn’t have gotten from Friendship Village to Riverside Hospital even then without my intercession. Of course, I’m hardly saying that the paramedics who rushed my unresponsive Dad to the hospital should have stopped to gather up his glasses, hearing aids, or current New Yorker magazine. But I do think there’s something wrong with a medical records system in which doctors and nurses can be desperately trying to communicate with a man, yet not even know that he is unable to hear or see them.
2. There are multiple nursing staffs at Friendship Village of Dublin. The two my father interacts with are Friendship Village of Dublin Home Services, who take care of independent living residents during day shifts (“independent living” is Friendship Village of Dublin’s term for what some facilities might call “assisted living”), and the Friendship Village of Dublin’s Health Center group. The Health Center actually plays multiple roles at Friendship Village of Dublin:
- It’s the nursing home part of the facility. Friendship Village of Dublin residents who no longer can live in their apartments move into the Health Center instead.
- Friendship Village of Dublin residents who temporarily cannot live in their apartments stay in the Health Center for rehabilitation.
- When the Friendship Village of Dublin Home Services nurses are unavailable (e.g., night/weekend shifts), the Health Center nurses are who independent living residents call when they need medical help. I gather this is what my father did two weeks ago.
- From what I can tell, the Health Center staff plays a central role in determining whether or not residents are capable of remaining in independent living, or whether they have to move to, say, the Health Center.
Pretty slick system, actually, at least in theory. But do those two Friendship Village of Dublin nursing staffs communicate freely with each other? No. I am told that the reason is HIPAA. And I believe that multiple glitches — not to mention inefficiencies — arise in medical care or medical decision making as a result of this impaired information flow.
In previous posts, I’ve noted that:
- Restricting information flow is not the best way to go about protecting privacy
- Improved electronic health records could have huge medical benefits
- Elder care raises a variety of privacy concerns
And so this is all just one more part of what I regard as the crucial discussion around privacy and liberty issues.