***4月1日更新:我目前正在接受外部監測,而我的主要生育診所在賓夕法尼亞州(比我這裡晚3小時車程),我一直遇到傳真延遲和失敗的問題。每次發生這種情況,我都被告知唯一的解決辦法是重新傳真,沒有其他替代方案。考慮到生育治療的時效性,這給我準備冷凍胚胎移植(FET)帶來了極大的壓力。
我向前臺代表Joy解釋說,雖然我理解他們的政策要求使用傳真,但HIPAA(健康保險流通與責任法案)允許使用安全加密的醫護人員之間的通訊。由於傳真反覆延遲和失敗,我詢問是否可以靈活地接受我的醫生直接傳送的安全電子郵件。我還特別要求與經理通話。
然而,我被轉接給了休假的行政人員Rachel A.,後來我被告知她並非經理,這與我之前向Joy提出的要求相悖。我還被告知,真正的經理Shauna在4月1日不會回覆我的電話。瑞秋甚至在我還沒完全聽完我的擔憂之前就斷然說道:“規矩就是規矩,喬伊第一次就說得很清楚了。”她拒絕考慮任何替代方案。她還錯誤地聲稱,安全的醫護人員間電子郵件不符合HIPAA(健康保險流通與責任法案)的要求。天哪,我明明有醫療保健背景,而且我也說明過。她卻變本加厲,說我的職業無關緊要。瑞秋顯然沒有接受過處理此類事務的管理培訓,從她跟我說話的方式以及我得到的錯誤資訊就能明顯看出這一點。她更關心的是讓她的同事們回去上班,而不是想聽我為解決影響我整體治療的運營瓶頸問題而提出的建議。
最令人擔憂的是她缺乏同理心和專業精神。當我表示即使作為一名外部監測患者,我仍然是患者時,瑞秋回應說,“外部”這個詞而不是“患者”這個詞似乎“觸動”了我。對於一個正在接受生育治療的人來說,這種說法既不恰當又輕蔑。對方告訴我,通話已經12分鐘了,所以她要結束通話電話。儘管我多次以不同的方式請求特殊照顧和理解,但規則和結果都一樣。我是一名來自賓夕法尼亞州的外地病人,因軍令調動而來到這裡,之前也多次收到傳真,但都出現了問題。而且,我需要接受緊急的冷凍胚胎移植(FET,包括來曲唑)治療。
儘管我解釋過我是軍屬,回原診所就診不現實,但對方還是反覆強調,外地監測只是“一種便利”。當政策在緊急醫療情況下造成障礙時,應該努力尋找解決方案,而不是一味地重複僵化的規則。我的配偶後來也打了電話,對方說不行,仍然沒有收到傳真,讓我重新傳真,或者我們可以聯絡我的原診所。但是,聯絡原診所並不能阻止傳真延遲或失敗,只有提供其他安全的溝通方式才能解決問題。訂單是在週二發出的,作為週四的緩衝時間,而週四是明天,也是我的第三個週期日。週二訂單已經傳真出去了,但週三一整天除了反覆傳真什麼也沒收到。我們到底什麼時候才能解決問題的根源?這個問題從二月份就開始了。總的來說,在原本就艱難的治療過程中,這次經歷無疑加劇了我的壓力。我的冷凍胚胎移植(FET)需要服用來曲唑,所以時間安排至關重要!我真希望當初選擇了另一家外部監測機構。我完全沒想到他們的傳真系統以及缺乏同理心和批判性思維來改進流程,竟然會成為就醫的一大障礙。我要求見經理,但被拒絕升級處理(正如Rachel A之前所說——很遺憾,事實的確如此)。他們給我的HIPAA資訊是錯誤的,而且他們所謂的“以尊重、同情和誠信為本”的核心價值觀也完全沒有得到體現。我知道他們的政策是傳真,但他們拒絕接受。目前的流程對我這個異地就醫的人來說根本行不通,因為我的家庭診所在另一個時區,而且傳真訊號也不可靠。這簡直是災難性的,他們卻毫不在乎,而我卻要為這種低劣的監測服務支付超過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.