I have been sitting in the office plugging away at my Q2 budget since 11am and it’s almost 2:45pm now. The budget is due in a week for initial review. I’ve wasted countless hours struggling to constantly reload my internet browsers to access the financial information stored in the recently installed cloud-based system. The system was meant to integrate the IT infrastructure and enable a collaborative information exchange among the hospital, insurers, and pharmacy systems. However, things have been slow since the hospital was forced to negotiate a new deal with its internet service provider (ISP). Frustrated, I look over at my phone and it says, “phone not recognized.” With my limited VOIP (voice over IP) knowledge, I plug out the cords and plug them back in. Now the phone says “Resetting” and it does this for about 10 minutes.
While I wait for the phone to reset, anxious that it won’t work in time for my 3:30pm committee call with patient safety committee and clinical operations, I call the IT department to resolve the VOIP issue. I’m on hold for about 4 minutes and then IT transfers me over to Telecom. The rep asks me for my office phone number since I had to call from my cell phone. The telecom rep says, “you have departmental coverage for this service so call your department IT service.” Perplexed, I hang up and something is still wrong with my internet browser and the financial systems are still barely loading. I suppose the company that provides our financial systems is not a preferred choice for our telecom provider. Resolving to settle and take the conference call with my cell phone if the VOIP phone doesn’t work, I go back to finishing my analysis.
John, the finance manager, comes into my office to tell me his phone isn’t working and the budget information is so slow to load and they’ll need an extension on my budget deadline, which impacts my overall budget. I take a deep breath and explain the urgency and ask if he can work offsite. “Maybe the Internet elsewhere is faster?” He is happy to work elsewhere with the possibility of faster internet and assures me he will try to get things done.
Once I get to turn back to my work, my cell phone buzzes. I get a text that my old friend from high school has been admitted to the hospital. The hospital is in Des Moines, Iowa – the city where I grew up before leaving to NYC for college. I remember a few of the hospitals there, but I have to go online to search for hospitals. “Where could he be and why isn’t there an easy way to search for someone in the hospital?” I think to myself. The clock is ticking and it’s about 3:23pm, I have just enough time to search for and call a few hospitals. I search for hospitals in the zip code 50311 and call the first. The first person picks up and I tell her that I’m looking for someone and I’m transferred twice to the Emergency Department (ED). The ED nurse tells me that he’s not there. I ask, how many hospitals are in the area or what are the major ones? She says, oh there are several large ones in the area. I sigh, watch the clock and say “ok, thank you.”
Now it’s 3:30pm and I have to jump on the conference call. I call my colleague and the phone goes straight to voicemail. I dial again in a few minutes but the phone goes straight to voicemail. I check my email, but there’s no message of postponement. Wait, it’s now about 3:40pm and I know my colleague has the same VOIP phone as me and maybe she’s experiencing the same problem. The VOIP phones were installed about two years ago to reduce costs. I just decide to walk over to the office, it contributes to my 10,000 steps per day challenge. Shoot, my cellphone service seems to work well but my apps aren’t quite syncing at the usual speed.
Just as I start walking, Gina, the call center manager, texts me, “your phones in the practice are down and no one can get through!!” I know if the phones are down, the internet must be down. That means the doctors can’t access patient medical records, complete notes and submit entries for billing. It also means the front desk can’t check in/out patients, complete prior authorization requests, send e-referrals, set new appointments and other healthcare-intense online documentation. I text Cynthia, the practice manager, and ask her how she’s doing. She says, “everything’s fine.” I decide to skip the original meeting, figuring they’ve either not met at all or begun meeting without me.
In the halls I pass Rashad, the administrator for Surgery. He looks like he’s seen a ghost. He tells me that patients and doctors are saying the telemedicine services are slow and choppy. He’s concerned about the remotely-monitored medical devices and the rural satellite clinics are slow and patient care may be impacted. I grit my teeth and tell him good luck because I need to attend to my own crisis. Then, I remember to call the next hospital on the list. The attendant says, “he’s here, let me transfer you to his nurse.” She places me on hold for 8 minutes and 43 seconds.
At the same time, I observe the front desk staff in the practice trying to calm patients who have been waiting for hours. I’m still on hold waiting to be transferred and I exchange some conversation and strategy with the staff, while on hold. “Hello, this is the nurse, I can’t give you medical information, but he’s well enough to speak to him.” I speak to Thomas for two minutes and feel assured that all is well.
I apologize to everyone in the practice for being on the phone and explain the situation. They forgive me and 15 seconds later, we jump into the chaos that has ensued as a consequence of the net neutrality repeal which led to slower choppier internet services. The hospital’s ISP was now able to charge the same rate for slower internet speed, especially since there were now only two providers in the area large enough to support the needs of this large organization. The service also provided less customer support and the IT and Telecom departments were stretched thin. However, the hospital faced costs of over $800 million for an EHR (electronic health records) implementation over the next few years and funding was just not available for the added expense for telecom...
Fortunately, nothing in this story is true because the current net neutrality regulations have not been repealed. However, as a healthcare professional, I am deeply concerned regarding any slowing of the internet especially as it relates patient care. In healthcare, we rely on the internet for nearly everything we do: Telemedicine, Interoperability Requirements, Teaching, Revenue Cycle, Electronic Health Records, Medical Software Systems and Mobile Applications.
Our patients, providers and staff deserve a healthcare system that is fast, responsive and reliable. I hope this fictional event has shed light on the seriousness of net neutrality and why we need it in healthcare. Do you agree or disagree with this scenario?
Tsahia (like Tsunami - yes, the T is silent - Sa-hee-ah) is a healthcare enthusiast working to transform patient care for all of us while driving creative and innovative solutions with technology.