D
deb193
Guest
Hi all -
I have several conditions (prolactinoma, diabetes, ulcerated colitis, incisional hernias, and some general inflammation issues), the point being that my care is spread across several specialties. I would really like to find a large clinic, practice, or system that could provide more integrated care. Let me explain.
Since moving to Kansas I have been struggling to find a provider that delivers good integrated services. When I lived in Central Pennsylvania, I used Geisinger Health Systems, which had a regional hospital, a large medical office building in my town, and several small satellite primary care offices around town. There was also a great website where I could message doctors, and read lab results, check upcoming appointments, or see lists of current medications.
It was great because whether the endocrinologist or the family med or the internal med people prescribed something, the list of current medications was available to all other providers. When I needed to get clinical summaries or recorRAB for consulting doctors, attractive and intelligible printouts could be easily provided. This was not an HMO, but a well integrated network of providers that accepted my Blue Cross/Shield insurance.
When I moved to Oregon, I found similar integration by using the Kaiser Permanente HMO. Working within the HMO presented a few limitations, but again I really enjoyed the centralized medical recorRAB, and the great website where I could message, check appointments, or read lab results.
Here in Lawrence KS, I have one guy for primary care, one guy for the colitis, and another doctor for the prolactinoma. I use the Quest lab provided by my BC/BS of Kansas because the cost savings is considerable. I have been sent to see a urologist and a cardiac guy for consultations, and it is a real challenge to have the lab send copies of reports to the primary care guy as well as the specialists who ordered it. They are all supposed to be sending notes to one another, but they frequently get lost or buried in my medical file, and I have taken to handcarrying summaries from the endocrinologist or GI doc when I go to the primary care doc. I have to work very hard to keep all parties informed when one doc changes a medication or dosage.
The primary care office has a lousy computer system. For example, when he prescribes a new med, it does not get automatically added to my list of medications, and on my next visit, when reviewing medications upon arrival, I have to tell the nurse that I am also taking because it was prescribed on my last visit. The endocrinologist is always asking if I saw the urologist or the cardiologist, and then stringently insisting (like I did something wrong) that she neeRAB copies of those tests/reports. When I say that they sent a note, or I had her copied on the lab results, she eventually finRAB the information scanned in somewhere off the main screen. Apparently only stuff ordered by herself or other doctors from her clinic automatically get onto the main screen.
My primary care guy is following the diabetes and he wanted me to try getting back on metformin, which was stopped last year just prior to my colitis diagnosis. He prescribed the lowest dosage, and I am supposed to ask the GI guy if this is OK when I see him in 3 weeks. My primary care guy will not know until my next 6 month followup if I am actually using metformin again or not. In my previous settings the primary care guy would call (or message) the specialist and check if it was OK, and then the nurse would send the prescription to the pharmacy if it was OK. It was just integrated. Folks were talking to each other.
Sorry for the long description of how disorganized things seem, but I would really like to find a large clinic, practice, or system that could provide more integrated care. Can anyone suggest a provider or network near Kansas City that would fit the bill? Perhaps one affiliated with one of the larger hospitals. Definitely one that has the kind of web support I am describing. Since I have BC/BS I can't afford to ditch it and join an HMO out of pocket, but many providers are "in network" for BC/BS Kansas.
There does not seem to be anything in Lawrence, but Kansas City and Topeka are just 40 minutes east or west on I-70. I am willing to do a bit of driving to get more integrated care.
Does anyone have suggestions?
I have several conditions (prolactinoma, diabetes, ulcerated colitis, incisional hernias, and some general inflammation issues), the point being that my care is spread across several specialties. I would really like to find a large clinic, practice, or system that could provide more integrated care. Let me explain.
Since moving to Kansas I have been struggling to find a provider that delivers good integrated services. When I lived in Central Pennsylvania, I used Geisinger Health Systems, which had a regional hospital, a large medical office building in my town, and several small satellite primary care offices around town. There was also a great website where I could message doctors, and read lab results, check upcoming appointments, or see lists of current medications.
It was great because whether the endocrinologist or the family med or the internal med people prescribed something, the list of current medications was available to all other providers. When I needed to get clinical summaries or recorRAB for consulting doctors, attractive and intelligible printouts could be easily provided. This was not an HMO, but a well integrated network of providers that accepted my Blue Cross/Shield insurance.
When I moved to Oregon, I found similar integration by using the Kaiser Permanente HMO. Working within the HMO presented a few limitations, but again I really enjoyed the centralized medical recorRAB, and the great website where I could message, check appointments, or read lab results.
Here in Lawrence KS, I have one guy for primary care, one guy for the colitis, and another doctor for the prolactinoma. I use the Quest lab provided by my BC/BS of Kansas because the cost savings is considerable. I have been sent to see a urologist and a cardiac guy for consultations, and it is a real challenge to have the lab send copies of reports to the primary care guy as well as the specialists who ordered it. They are all supposed to be sending notes to one another, but they frequently get lost or buried in my medical file, and I have taken to handcarrying summaries from the endocrinologist or GI doc when I go to the primary care doc. I have to work very hard to keep all parties informed when one doc changes a medication or dosage.
The primary care office has a lousy computer system. For example, when he prescribes a new med, it does not get automatically added to my list of medications, and on my next visit, when reviewing medications upon arrival, I have to tell the nurse that I am also taking because it was prescribed on my last visit. The endocrinologist is always asking if I saw the urologist or the cardiologist, and then stringently insisting (like I did something wrong) that she neeRAB copies of those tests/reports. When I say that they sent a note, or I had her copied on the lab results, she eventually finRAB the information scanned in somewhere off the main screen. Apparently only stuff ordered by herself or other doctors from her clinic automatically get onto the main screen.
My primary care guy is following the diabetes and he wanted me to try getting back on metformin, which was stopped last year just prior to my colitis diagnosis. He prescribed the lowest dosage, and I am supposed to ask the GI guy if this is OK when I see him in 3 weeks. My primary care guy will not know until my next 6 month followup if I am actually using metformin again or not. In my previous settings the primary care guy would call (or message) the specialist and check if it was OK, and then the nurse would send the prescription to the pharmacy if it was OK. It was just integrated. Folks were talking to each other.
Sorry for the long description of how disorganized things seem, but I would really like to find a large clinic, practice, or system that could provide more integrated care. Can anyone suggest a provider or network near Kansas City that would fit the bill? Perhaps one affiliated with one of the larger hospitals. Definitely one that has the kind of web support I am describing. Since I have BC/BS I can't afford to ditch it and join an HMO out of pocket, but many providers are "in network" for BC/BS Kansas.
There does not seem to be anything in Lawrence, but Kansas City and Topeka are just 40 minutes east or west on I-70. I am willing to do a bit of driving to get more integrated care.
Does anyone have suggestions?