I DON’T KNOW IF ALL HOSPITALS in Israel are alike, but departments in a hospital in which I recently was a patient don’t share information.
In a country that is as technologically advanced as Israel, this comes as a shock.
All my medical information at a Florida hospital where I had several stays could be accessed by all departments, the patient’s personal doctor, and the patient. That hospital is “semi-private”; that is it gets some taxpayer dollars. It is not associated with a university. The Israeli hospital is funded by the Israeli government and foreign donations and is a training hospital for a central Israel university/
When I was a young Air Force enlisted man, I hand-carried my medical records from base to base. This was c 1960, before computers were ubiquitous.
THIS RANT STRICTLY IS ABOUT inter-department communications at one Israeli hospital. I don’t know if other facilities are as bad, but this lack of inter-department communication is dangerous to a patient’s well being.
For the record, this hospital used to be in Time magazines’ Top 10; it has fallen to the Top 20 worldwide (but the Top Ten brag still hangs at the entrance).
Because I first was admitted for “observation,” I was lodged in one department.
Aside from the fact that the food was inedible and no one bothered to test for blood sugar after a meal — despite being on a diabetic meal plan — things were “OK.” The personnel were good to great.
I got a 25 hour pass and had to return to a different department.
My records (apparently) never left the first department. There was no continuity.
To be fair, almost all my test results have been promptly forwarded to my PCP; when he fails to receive an expected report, he chases it down.
A specialist determined that I needed an operation to remove a blockage in my left ureter. (https://tinyurl.com/93b6jnze)
When he was unable to do what he assured me he could do, he managed a biopsy on the blockage and discovered it was malignant.
I was told to do some tests and get back to his secretary.
We did.
We were instructed to see a kidney specialist. We did. She was not part of the hospital so the initial surgeon may, or may not, have received her report. My family doctor, a/k/a PCP, did.
The surgeon’s secretary said he wanted another test, an MRU(cq) for the next cutter; hopefully one who will remove the cancer.
My wife contacted the hospital to arrange for the MRU.
Hospital: We don’t have an order from a radiologist.
Wife: The test was ordered by the surgeon.
Hospital: We don’t have an order from a radiologist.
This closed loop continued for several minutes before the clerk wisely escalated the issue to her boss.
Someday we will get an SMS that the test is authorized by someone and meanwhile, there is this cancer in my left ureter. (As this is keyed, we still are waiting.)
I had an abdominal aortic aneurysm (AAA) repair at Memorial Hospital in Hollywood FL. PCP orders ultra sound. Ultrasound tech comes to the PCP’s office the next morning. Ultrasound confirms the PCP’s suspicion. PCP sends me to a vascular surgeon. Surgeon sends me to the hospital for a test to see exactly how big is the aneurysm and its exact location. Next day, the surgeon and the patient decide how to deal with the “bubble.” Shortly thereafter, the patient is recovering from surgery. One hospital. All records in one place, even the surgeon’s. The PCP can see all the records. I can see all the records. My insurance company can see all the records.
Not so in Israel.
First there are multiple departments, each needing its own tests (since nothing is shared). This necessitates numerous trips to labs and xray facilities, then to an EKG location, and finally, to wherever the MRU may be done.
In Hollywood, if I needed an MRI, an EKG, xray, or similar test that did not require an overnight hospital stay, the test was performed at a stand-alone diagnostic center. A few doctors’ offices also could provide some testing. Blood could be drawn at a doctor’s office or at a local lab.
Israel needs stand-alone diagnostic centers. (https://tinyurl.com/ahyjraj9) There are a few but most are limited to xrays and EKGs.
SURPRISE
In the effort to get the MRU authorized by a radiologist (whom I’ve never seen), we discovered that the insurance carrier limits the number of referrals over a specified time period.
We also learned that once referred to a specialist, we can self-refer to that specialist, skipping the family doctor. Hopefully the specialists will keep the family practitioner informed. (So far, this has been the case for doctors in my health plan — but NOT for physicians at the hospital.)
Before anyone comments “Yep, that’s socialized medicine,” realize that almost every place you go, including the USA, you have, or are getting “socialized medicine.” For seniors, it’s called Medicare. It WAS easier to navigate for this scrivener.
One number for everything
The really disappointing thing with Israel’s health care system is that every Israeli has a unique ID. It is used for EVERYTHING, including ALL government offices AND the hospital.
Go into any government office, recite your ID number (like your phone number, it’s “memorable”) and no matter in what office your sitting, the clerk can almost instantly call up all government-related information . Own a car. The government knows. Own property, even a postage-stamp apartment, the government knows. Have a family? The government knows the names of your spouse and children.
Americans would go ballistic if they realized how much the U.S. government knows about them; Israelis seem to take it in stride.
In any event, the government seems technologically aware and the departments are interconnected.
It boggles my mind that a hospital, even one with multiple buildings on a huge campus, cannot get a patient's records from Point A to Point B, and one specialist seems unable to communicate with another specialist.
When I first lived in Israel (1975-79), I thought first level care was bad and hospital care was good. I had experience with the former, but not the latter.
Now I know that, for the most part, first level care is as good as the family doctor, and hospital level care, at least with this particular hospital, is, IMO, sub-standard.
TO BE ABUNDANTLY CLEAR, most of the medical and ancillary staff are highly competent and personable. That includes everyone from senior doctors to cleaning crews. The demerits all came due to the lack of inter-departmental communication.
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