Follow me through this path of incongruities. We live in this hyper-connected modern age, where larger than every managed before information is retrievable, sharable, around the world. All that Did You Know stuff. Standing at the precipice of the Web of Data possibly soon accessible via one of those hand flying Minority Report interfaces.

Perhaps.

The fly in the ointment, the kink in the gear shafts, is that, it feels, like almost on a daily basis, I face an increasing amount of inefficiencies in the things we have to deal with in daily life. Perhaps it is just taking longer, but I see so many places that are not taking advantage of all the savings of time, money, and human effort the cool tools can offer.

Look at Exhibit “A”…

med-records

This is a scan of a piece of paper that is a xerox copy of my immunizations as a child, a piece of paper from my pediatrician’s file. This was how doctors kept medical records in 1963.

On my doctor’s visit last week, 46 years later… they use the same technology. Scribbles on paper, analog records, data not connected to anything, not transmitted to relevant places, locked in yellow folders. It is not part of any web of data. It does not even KNOW there is a web of data.

Of course there are many technologies for electronic medical records, but how pervasive is it? On my check-in, the receptionist asks me to fill out (by handwriting into blank spaces of a form that is too narrow for the information they request) a yearly update of my records for their files.

“But I did that on my visit 3 months ago, are you sure you need this?” I asked.

AT first, there was that look in her eye of “You IDIOT, just do the F***ing form) but she flipped 2 pages back and found the same form I did fill out in August, and she mumbled something about them not noting it right on the folder.

Their method of notification for her was a hand written scribble on the outside of a manila folder.

All of the doctors offices I go to are full of walls of these manila folders, data that is stuck in the analog universe.

I’ve complained before about the continual irony of someone emailing you a form to fill as a PDF file, requesting me to complete them, and FAX them back. This requires me to waste my time, printing a digital document to paper (waste of resources), hand write in my information (most likely marginally legible), return it via the emerging technology of 1981 (Fax machine), where some poor sucker on the other end has to decipher a now badly printed document (analog), and manually retype that information into a computer screen (return to digital).

Multiply this waste of time, resources by a million, times it happens a day, and there is a massive amount of efficiency lost in the workplace– that has realy dollars on it, readers… because COMPANIES/OFFICES ARE TOO FRACKING LAZY TO LEARN THE SIMPLE PROCESS OF CREATING AN EDITABLE PDF.

Want more> How about those insidious automated phone menu systems when you call to get service from a company. This is what happens when I call my insurance company.

(me calling Human)

phone menu: “Welcome to Humana, please let us know if you are a patient, doctor, or something else”

me: “Patient”

phone menu: I see you are calling from a registered phone number, so we know who you are. For verification purposes, please enter your Humana ID.

me; (punching in numbers)

phone menu: please enter the last 4 digits of your social security number

me; (punching in numbers)

phone menu: please enter the zip code of your mailing address

me; (punching in numbers)

If they know who I am, why do I have to enter all this stuff? After about 4 more rounds of pressing buttons, I actually get to talk to a real human being!

Humana Rep: “Hi My name is Janna, can you please confirm for me your Humana ID?

me: (getting pissed saying the same numbers out loud I just punched in their stupid system)

Humana Rep: “thank, you, can you please tell me the last 4 digits of your social security number.”

me: (realizing I am in a Twilight Zone episode, saying the same numbers out loud I just punched in their stupid system)

Humana Rep: “Thank you, can you please confirm your mailing address?”

me: (looking for Rod Serling in the corner, so I can punch that cigarette down his throat), saying the same information out loud I just punched in their stupid system)

This is already 14 minutes into my contact with Humana, and feeling like I am close to getting service, I explain the full details of the reason for my call. Their response, “I will transfer you over to XXXXX where someone can handle your request.”

In my last case, I actually got passed around to 2 more departments, having to repeat the situation 2 more times.

I will not even mention the Chinese Water Torture syndrome when you are on hold, where the voice cuts in every 45 seconds to than me for waiting, letting me know how “important” my call is and how they value me as a customer. On my last call to a Walgreens Pharmacy where I got this, I was just about out the door, where I was going to drive 20 miles to Walgreens to yell at them “PLEASE STOP! I GIVE UP, I WILL REVEAL ALL THE STATE SECRETS”

Want another? I recently decided to take a 403b retirement account that had accumulated some funds (well a lot of them evaporated last year) from my years at Maricopa. I was not adding to it, my after an appointment with an advisor, we decided to roll that money over into an IRA I could control better. I had not added anything to it in 3 years, since I left Maricopa. Nationawide insisted I send them a “Separation” letter from Maricopa, something on official letter head, stating I no longer worked for them.

I’ll skip the WTF where I thought they could easily ascertain this from my tax records, but I figured this might be pointless. I thought it seemed, simple, call someone up at the Maricopa Community College HR department, and ask them to email/fax/tie to the leg of a pigeon a simple letter.

Even after 3 years being out of the system, I still knew the URL by heart http://www.maricopa.edu/hrweb/. But I will give anyone 50 bucks if they can look at that opening page, and find (a) a phone number one can call to ask an HR question or (b) which one of the 65 links is the department that might provide this service of generating a separation letter.

The problem with this web site was the same as it was when I was there, and for that matter, the entire district office- they defined themselves, and their presentation of their organizational structure, as they saw themselves, not as an outside customer. Each one of those separate main links for the HR web site, is a different small island, each has a different web site design and structure (and I know some of those web pages have not been changed in design since 1997).

So I took the only logical route. I clicked at random links, trying to find the right person to call. The first two numbers I found (at these sub department levels, they give phone numbers to named individuals, there is no switchboard, or single line to answer questions) I got someone’s voice mail.

The next strategy got me farther, I saw a name of someone I knew (the task I was asking was not really her domain), someone who had been dragged like me when I worked there to some professional development retreat in Colorado. So I explained to her what I needed, I forwarded a form that Nationwide had sent me (it was a PDF that I would need to print out, complete by hand, lather rinse repeat from above) that seemed to be a possibility in place of a letter.

A few hours later, I got an email from someone in another part of the HR web, who sent me ANOTHER PDF that I would need to print, complete, etc, and FAX BOTH forms to a third party company that generated the separation letter. Oh, and that it might take 10 business days to process.

At this point, I was numb, and likely writhing in spasms on the ground, with droll running down my chest. I gave in, and played the inefficiency game, and printed/faxed and flipped birds to all of these basttards (actually they did process it in about 2 days).

I write this knowing that other people will share their similar experiences. Multiply this gross inefficiency again and again, and you can literally see giant piles of money burning, and the economy engine of this “great country” drifting up in smoke and ash.

I dont know what to do beyond continually pointing out the insane idiocy of our society, one that as a larger whole, seems very far far far away from any sort of science fiction utopian future. It is much more Brazil we are headed to than anything

The post "Suffer Me No Inefficiency" was originally pushed out of the bottom of a purple jar of Play-Doh at CogDogBlog (http://cogdogblog.com/2009/11/no-inefficiency/) on November 9, 2009.

7 Comments

  • I agree completely.

    What to do about it is another question.

    I typically call on education to solve problems like these. You know, get people to think better, and they’ll do better. I still believe that’s true, but brother, my faith gets sorely tested at times like these.

    Keep blogging the good fight, my brother.

  • We have electronic health records now, and it’s even worse. I won’t even go into the mistakes they’ve made with my prescriptions. A few appointments ago the doc asked if I had been losing weight. I told her maybe a few pounds. She said, “A few, it looks like 60 pounds!” Hello? 60 pounds in one month? She couldn’t make the change, because the typo was input by someone else, so I became part of their learning. I’ve also had my B/P entered incorrectly, and it’s now impossible to say, “Remember when I had that cough, 18 months ago? This feels just like it.” They used to be able to just flip through the chart and easily grab stuff like that. The doc says she’s been working 18 hour days since they implemented the system in May.
    Of course, the instructional material I’m working on right now is in HealthIT, so it’s nice to have case studies :) In case you’re interested, there’s a lot of activity around this on Twitter. Just search for #HealthIT #EMR #EHR #PHR

  • Alan levine

    Obviously (at least to my simple mind) the problem/solution is not technolgy alone– I’m already seeing a Pogo cartoon line here.

    I fail to grasp how businesses can tolerate such wasteful amounts of inefficiency

  • As long as we’re set in the 40 hour work week model of employment, we’ll make up stuff for people to do during the 40 hours :)

  • Rachel

    Rats… I tried for the fifty bucks… No luck!

  • OK, I’ve got one for you, Alan. Just yesterday, I took my high-school-aged son to the pediatrician for a check up. As I signed him in the receptionist handed me a sealed manilla envelope. Hmmm….what’s this? I opened it to discover my son’s immunization records sent from Palo Alto, California. Or, I should say a really bad copy of a fax of his immunization records. Attched to it was a bad copy of a letter that I had sent to the California doctor’s office in June of 2008 (!) requesting the records, in order to fill out a required form (a pdf that I printed, and filled in by hand), for a school trip he was going on. Aiyiyi.

  • Harriet

    OK, I have to weight in…Electronic medical records was one of the projects I worked on in my previous life. Trying to standardize information across the medical profession so that it can be exchanged is a nightmare. Believe it or not, they’ve made a lot of progress in the past 10 years. Unfortunately, a lot of the redundancy (why they ask you for the same info many times) has to do with lawyers and privacy issues. While everyone wants information to be easily accessible and exchangeable, the other side wants to protect your information and keep it private. I think they’re more comfortable with faxed/scanned documents since they can more easily prove that you completed the info (if needed) than data entered on in PDF format. I was encouraged the last few times I saw new (younger) doctors who actively used technology while taking my information and sharing test results. Believe me, I’m equally frustrated when dealing with my insurance company–maybe a bit more sympathetic knowing about the challenges…

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