***4月1日更新:我目前正在接受外部监测,而我的主要生育诊所在宾夕法尼亚州(比我这里晚3小时车程),我一直遇到传真延迟和失败的问题。每次发生这种情况,我都被告知唯一的解决办法是重新传真,没有其他替代方案。考虑到生育治疗的时效性,这给我准备冷冻胚胎移植(FET)带来了极大的压力。
我向前台代表Joy解释说,虽然我理解他们的政策要求使用传真,但HIPAA(健康保险流通与责任法案)允许使用安全加密的医护人员之间的通信。由于传真反复延迟和失败,我询问是否可以灵活地接受我的医生直接发送的安全电子邮件。我还特别要求与经理通话。
然而,我被转接给了休假的行政人员Rachel A.,后来我被告知她并非经理,这与我之前向Joy提出的要求相悖。我还被告知,真正的经理Shauna在4月1日不会回复我的电话。瑞秋甚至在我还没完全听完我的担忧之前就断然说道:“规矩就是规矩,乔伊第一次就说得很清楚了。”她拒绝考虑任何替代方案。她还错误地声称,安全的医护人员间电子邮件不符合HIPAA(健康保险流通与责任法案)的要求。天哪,我明明有医疗保健背景,而且我也说明过。她却变本加厉,说我的职业无关紧要。瑞秋显然没有接受过处理此类事务的管理培训,从她跟我说话的方式以及我得到的错误信息就能明显看出这一点。她更关心的是让她的同事们回去上班,而不是想听我为解决影响我整体治疗的运营瓶颈问题而提出的建议。
最令人担忧的是她缺乏同理心和专业精神。当我表示即使作为一名外部监测患者,我仍然是患者时,瑞秋回应说,“外部”这个词而不是“患者”这个词似乎“触动”了我。对于一个正在接受生育治疗的人来说,这种说法既不恰当又轻蔑。对方告诉我,通话已经12分钟了,所以她要挂断电话。尽管我多次以不同的方式请求特殊照顾和理解,但规则和结果都一样。我是一名来自宾夕法尼亚州的外地病人,因军令调动而来到这里,之前也多次收到传真,但都出现了问题。而且,我需要接受紧急的冷冻胚胎移植(FET,包括来曲唑)治疗。
尽管我解释过我是军属,回原诊所就诊不现实,但对方还是反复强调,外地监测只是“一种便利”。当政策在紧急医疗情况下造成障碍时,应该努力寻找解决方案,而不是一味地重复僵化的规则。我的配偶后来也打了电话,对方说不行,仍然没有收到传真,让我重新传真,或者我们可以联系我的原诊所。但是,联系原诊所并不能阻止传真延迟或失败,只有提供其他安全的沟通方式才能解决问题。订单是在周二发出的,作为周四的缓冲时间,而周四是明天,也是我的第三个周期日。周二订单已经传真出去了,但周三一整天除了反复传真什么也没收到。我们到底什么时候才能解决问题的根源?这个问题从二月份就开始了。总的来说,在原本就艰难的治疗过程中,这次经历无疑加剧了我的压力。我的冷冻胚胎移植(FET)需要服用来曲唑,所以时间安排至关重要!我真希望当初选择了另一家外部监测机构。我完全没想到他们的传真系统以及缺乏同理心和批判性思维来改进流程,竟然会成为就医的一大障碍。我要求见经理,但被拒绝升级处理(正如Rachel A之前所说——很遗憾,事实的确如此)。他们给我的HIPAA信息是错误的,而且他们所谓的“以尊重、同情和诚信为本”的核心价值观也完全没有得到体现。我知道他们的政策是传真,但他们拒绝接受。目前的流程对我这个异地就医的人来说根本行不通,因为我的家庭诊所在另一个时区,而且传真信号也不可靠。这简直是灾难性的,他们却毫不在乎,而我却要为这种低劣的监测服务支付超过1200美元。
***Update 4/1: I am currently undergoing outside monitoring while my primary fertility clinic in PA (3 hours behind) , and I have been experiencing ongoing issues with fax delays and failures. Each time this happens, I am told the only option is to refax, with no alternative solutions. Given how time-sensitive fertility treatment is, this has been extremely stressful as I prep for a FET .
I explained to the front desk representative, Joy, that while I understand their policy requires fax, HIPAA does allow for secure, encrypted provider-to-provider communication. Due to repeated fax delays and failures, I asked if there was any flexibility to accept secure email directly from my provider. I also specifically requested to speak with a manager.
Instead, I was directed to Rachel A. from administration leave, who I was later told was not a manager, per my request to Joy. I was also informed that the actual manager, Shauna, would not be returning my call on 4/1. Rachel immediately stated, before fully hearing my concerns, that “the rules are the rules Joy made it clear the first time,” and refused to consider any alternatives. She also incorrectly stated that secure provider to provider email would not be HIPAA compliant. YIKES, I have a healthcare background which I stated. She doubled down and said my occupation doesn’t matter. Racheal clearly has not been trained as a manager to handle such matters, it was very clear by the manner in which I was spoken to, and the wrong info I was getting. She was more concerned with having her co-workers back and not wanting to hear my concerns for a solution to an operational bottleneck impacting my overall care.
What was most concerning was the lack of empathy and professionalism. When I expressed that I am still a patient, even as an outside monitoring patient, Rachel responded by saying it seemed like the term “outside” and not a “patient” was “triggering” me. This is an inappropriate and dismissive comment to make to someone undergoing fertility treatment. I was told she was ending the call as it been 12 min and the rules and results are the same despite how many times and different ways I ask for an accommodations and understanding as I am an outside patient from PA, moved via Military orders, have repeated faxed issues with them, and have time-sensitive treatment with FET (including LETROZOLE).
I was repeatedly reminded that outside monitoring is considered a “courtesy,” despite explaining that I am part of a military family and traveling back to my home clinic is not feasible. When policies create barriers in time-sensitive medical situations, there should be some effort to find solutions, not just repeat rigid rules. My spouse also latter called and they said nope, still no fax, re-fax or we can call your home clinic . Calling the home clinic can’t stop a delayed or failed fax, having alternative secure methods would. The orders were sent on a TUESDAY AS A BUFFER FOR A THURSDAY , which is tommorow AND would my third cycle day, Tuesday the orders were faxed and nothing but re-fax re-fax on Wednesday all day, at what point do we address the root of the issue? This has been ongoing since FEB. Overall, this experience has been unnecessarily stressful during an already difficult process. My FET includes letrozole , so timing is EVERYTHING! I wish I had chosen a different outside monitoring provider I HAD NO IDEA THEIR FAX SYSTEM and lack of empathy or critical thinking to improve processes would be such a barrier to care. I asked for a manager, was denied escalation ( As Rachel A advised I would be - SADLY TURNED OUT TO BE TRUE), I was given incorrect HIPAA info ,and was not met with their core values of " leading with Respect, Compassion, and Integrity". I get fax is their policy, but they refuse to get that, the current process has not, is not working for me as a outside patient with a home clinic in a different time zone and unreliable fax. It’s a recipe for disaster and they don’t care yet I’m paying over 1,2000 for monitoring with this level of gross.