Bert,
I commend you for being so thorough in following up this patient and arranging specialty care. It seems more often than not, that just does not happen anymore. Such physician behavior can save lives and lawsuits, but of course it is uncompensated care.
To answer your question about what happens elsewhere, we don't even receive notification when one of our patients winds up in the ER or is admitted to the hospital, despite being listed as the primary care physician. We rarely receive discharge summaries. Even rarer do we get a call from the discharging hospitalist. Patients often show up in my office wondering why I don't know anything about their trip to the hospital. I've talked to various ER docs, hospitalists, IT, etc. to no avail. I have served as chairman of medicine and chief of staff - irrelevant.
To get any information about these patients, I have to go into Cerner (ugh) and suck the information out which takes forever, whereas it should have been automatically pushed out to me. The ER docs tell me that if I really wanted the information, I can go into Cerner and get it. Even if that were the case, the problem is that I don't know that I need to go into Cerner to get it because I don't know the patient was at the hospital in the first place. There are a couple of hospitals in Denver that send me information without asking for it, which is a breath of fresh air. As others have mentioned, there is a lot of potential liability with these poor practices. One of the ironies is that the hospital is reported to have over $150 million in reserves, which I'm guessing is not all that common these days.
There is a lot of talk these days about EMR interoperability. The issue which you raised is so much more basic. It seems that it is just being ignored.
You have spurred me to schedule a call to my malpractice insurance company which insures most of the doctors in the state, as well as the hospitals. They may be able to get someone's attention better than I can. Perhaps a flood of similar calls around the country may get the ball rolling to improve handoffs in patient care.
