HIPPA and the patient follow-up

Does anyone else have a problem with getting a patient follow up so you know how they are doing, or for quality assurance purposes? We are supposed to be caring and compassionate, but I guess that ends when we leave the hospital.

It seems that every time we drop a patient at the ER and try to get a follow up later in the day, they act like we are complete strangers. Why is ems not looked at as part of the patient care process? We obtain the info and perform an assessment on the patient, we provide care and treatment, we give all the information to the hospital, and two hours later, we don't exist. We are at the very beginning of the "paper trail".

The patient chart goes from the ER, to multiple units/floors of the hospital, to billing and records. Sometimes this patient is transferred to another facility and the whole process is started over. All of these people are apparently part of the process because they work in the hospital, right? EMS on the other hand is exempt from obtaining this information.

What if when we arrived, we gave no report to the ER staff? Can you imagine what would be said? What if we told them that because of HIPPA, we could not release any information to them? Now…don't get any ideas people. This would be a bad idea in regard to the continuum of patient care.

OK…enough with my ranting.

Instead of just complaining, what can be done to fix this problem? Well…I might have a few ideas. Stay with me here for a few. To start with, do all of you leave a report with the ER when you turn the patient over to them, or at least prior to leaving the hospital? Do you do this every time? For every patient? For those of you that are fortunate enough to be able to do your EPCR during the call, this is easy. You arrive at the hospital, turn the patient over, go back and finish entering the information, have the accepting nurse of physician sign the screen, and you print. Maybe it prints to a printer at the hospital, or a printer in the truck. Done! Or, if you are like me, I leave a brief written report, and fax a copy of my EPCR to the hospital when it is finished. By doing all of this, we are part of the patient care process, and there is a copy of a report attached to the patient record to prove it.

From here we might be able to call back later, speak with a nurse who can look at the report and see that you were the medic treating the patient, and give you an update. After all…you are a part of the treatment process, right?

In a perfect world, we could have access to the hospital system and we could see what was going on with the patient. I had a long talk with a friend at EMS Expo in Dallas about just this problem. Apparently, his service exists in that perfect world. They have a system like this set up with the hospital. They are able to see the outcomes of most of their patients.

So, I ask you…what can we do to make this work? How can we improve the communications and actually be recognized as a medical professional that provided care for the patient?