Last week, I had an appointment with a new endork in Pittsburgh. I wrote about that visit last week and mentioned that I would write more about the nurse that should not have been entering drug information into the computer. That article is here.
Prior to my appointment, I received a packet of information to fill out. I have a one-page medical history sheet typed up that contains health problems, medications and supplements plus surgeries I have had. Because I have both neuropathy and Dupuytren’s Contracture in my hands, my hand writing is not exactly very neat so having it typed up is easier for me and ensures that they can actually read my answers. I write “see attached” for the questions that are on my typed up sheet and staple it to the back of their form.
After the nurse took me back to the room and checked my vital signs, she sat down in front of the computer and went over some of my answers. Their office is part of a large hospital in Pittsburgh and because I once saw a doctor related to that hospital, some of my information was in there but was very outdated.
I have my Levemir and Apidra insulin written at the top and did not put dosage information in – I wrote “varies” next to the Apidra. I do carb counting so it does vary by what I eat and even what time of day I eat. I got tired of trying to explain that to people so took that stuff out. Right now, I am taking a little more Levemir than normal because I had an infection but that is starting to go back to normal. Usually my Levemir is pretty stable and doesn’t change much but I did not want to put “wrong” doses in so did not put that on my sheet either.
She asked about the Apidra and said, “do you use a sliding scale?” Keep in mind, this was a diabetes center, not someone at a PCP or other specialist! My response was “No, I do carb counting, sliding scales are from the dark ages.” She looked at me like I was nuts. After I got home and was thinking about what happened at that appointment, I pulled up the medication information on my account and she typed in “per scale.” You would think a diabetes center would understand carb counting!
I take Proventil for asthma and I typed “2 puffs 4 x per day.” For that, she said “as needed.” My sheet did not say as needed, it said “2 puffs 4 x per day.” At least that one she did enter correctly.
I take Furosemide, which is the generic Lasix. Some drugs have gluten in and one brand of Furosemide that my pharmacy started using had gluten in. I want to make sure that I don’t get that brand again so I have that on my sheet under allergies. I typed “Furosemide by Roxanne (has gluten).” That confused her. I thought that she understood when I explained that it was only that particular brand of Furosemide that contained gluten that was a problem because of the gluten. When I got home and pulled up my account, she has Furosemide listed in the allergy section but no reference to the brand or that it was only Furosemide with gluten – there is a spot for notes, she just did not use it. If anyone looks at that, they will think I am allergic to Furosemide and that is not the case.
I saved the fun one for last! My thyroid medication is Thyroid manufactured by Erfa in Canada. It is similar to the Armour Thyroid sold here – they are both desiccated thyroid medicine. I take two 60 mg tablets per day and one 30 mg tablet per day. First she asked me if I took the 30 mg weekly – not sure where that came from. Then she tried to add up my total dose per day. I said 150 mg and she did not think that was right so I said, “60 plus 60 equals 120 plus 30 equals 150.” She still looked confused and I don’t think she believed me. Then she tried another approach to tally up the morning dose and was not able to add 60 and 30.
I did a screen shot to show what was in my account. I swear when I looked on Thursday, it had 60 mg in the AM and 30 in the PM. On Friday, I got a survey about my appointment so I put what she did in the comment section and said that if someone looks at the sheet I handed her and what was typed in, they would see it was wrong. When I pulled this up to do a screen shot, it now has 90 mg in the AM and 30 mg in the PM. I was tired on Thursday because that is a long trip for me, but I do think it was changed. Even if it did say 90 and not 60 on Thursday, it is still wrong because I take 90 mg in the AM and 60 in the PM.
I have mixed feelings about electronic records. I have always thought the bad part is when someone makes a mistake, it is going to carry forward. I am not going back to this doctor so I doubt that they are going to fix their screw-ups. I have two appointments coming up in the next couple weeks with other specialists in this same hospital system that will pull these records up. This screw-up is just going to perpetuate if no one fixes it.
What happens to people like my mother or my aunt and uncle that don’t have a computer? How will they know that their prescription information is screwed up? These programs are used to send the refill to the pharmacy so it is not like they are handed a prescription and can see that it is wrong.
I think if doctor’s offices are going to have someone sit and enter this information in the computer, they need to screen their employees better and make sure someone capable of understanding and doing some simple math are the ones doing the entering.