Admitting Registration

There were several hallway intersections on the way to the admitting desk. Lindsay and Elliott walked up and down the hallways looking for signs when Lindsay spotted a sign for the main lobby. They found the admitting desk and let the receptionist know they were checking in for 12:00pm MRI appointment. She asked for Lindsay’s home phone number, then grabbed Lindsay’s wristband and labels.

The receptionist checked with Lindsay to confirm the DOB on the wristband was correct. Lindsay confirmed. Elliott asked the receptionist to clarify which of the two ID numbers on the wrist band should he should refer to for his records. She said either would work. Elliott specified which ONE number should they use for their records, she then identified the primary ID number to reference.

Look for Registration

The imaging tech who spoke with Lindsay last night said that registration was “right by the waterfall.” Upon entry to the Piper Building lobby, neither Elliott nor Lindsay could identify a waterfall so they started walking towards the imaging registration lobby they started at during their last visit. It was closed, so they walked to the MRI reception area.

Go to MRI Reception

The MRI reception area had no receptionist on staff since it was the weekend, but there was a sign indicating who to call for assistance. Elliott started at the top of the sign and worked his way down until someone picked up. Nina picked up the phone and Elliott said they were their for their appointment, she asked if we had registered at admitting yet, to which Elliott replied no. She told them Lindsay can’t do the MRI until checking in with the admitting desk and said she would be right out to give them directions. 

 

Piper Care Coordination

Lindsay noticed that she had a voicemail from Lisa, her care coordinator, that she should call her back. Lindsay assumes this is a follow up to her request to have her medical and surgical oncology appointments scheduled for same day. Lindsay returned her call after finishing her call with imaging (see next step) and confirmed for the same day oncology appointments.

MRI Images Fail, Reschedule

Lindsay receives a call from the imaging department at Abbott Northwestern notifying her that there was an error in the scan and that she would have to come in for a second MRI. Lindsay wanted to ensure that the error was not based on anything she did while in the scanner. The technician informed Lindsay that the there was a technical error with 10 of the images slices that prevented the 3D scan from rendering.

The technician then asked if Lindsay could come in the next day to redo the MRI. Lindsay said yes and the technician asked if she was at the right time in her cycle to do the scan. No one had ever discussed this issue with Lindsay, so she let the technician know where she was at in the cycle and asked the technician whether or not that ok. The technician didn’t know.

They schedule the MRI, the technician gives Lindsay instructions on where to go for check in (near “the waterfall”), that she would not be charged for the MRI since it was a hospital error, and that she could validate her parking at checkin.

Mayo Care Coordination

Lindsay receives a call from Corey, a care coordinator at Mayo Clinic. Corey wanted to ask some clarifying questions, specifically relating to her health record. Lindsay explained that she was seeking multiple opinions before make treatment decisions. The coordinator asked Lindsay what kind of cancer she was diagnosed with, Lindsay explained she had DCIS and ICS, the care coordinator was initially confused but Lindsay clarified by reading the entirety of the pathology report, verbatim, to her over the phone. Lindsay and Elliott shared some confusion about the line of questioning since Elliott faxed the path report on Wednesday.

Corey expressed her concern that Mayo would need Lindsay’s biopsy slides and have enough time complete their own pathology analysis prior to her scheduled appointment (November 20th, 2015) at Mayo. She then makes the recommendation that Lindsay obtain the slides from Regions Hospital.

Corey then began asking some general health questions. She asked if Lindsay had any anxiety and had some calming words about it. She also asked about Lindsay’s support network and reiterated the importance of it. She then gave Lindsay an opportunity to ask questions and share concerns.

The call ends with Corey giving Lindsay instructions for the day of the appointment and lets her know that they may order additional testing on Lindsay’s biopsy (specifically Ki67).

The call lasted 48 min.

UMN Care Coordination

Lindsay received a call from Janine, a care coordinator at the University of Minnesota. She called to confirm Lindsay’s appointment with the oncologist and to ask Lindsay who ordered the mammogram. Lindsay informed her that her OB/GYN recommended the mammogram after completing an inconclusive breast exam.

At this time, Lindsay informed Janine that she had an MRI completed the day before and that she had an appointment scheduled with an oncologist at Abbott Northwestern, but that she will not be making any treatment decisions until she has had an opportunity to consult with each provider.

Pickup Car from Valet

Elliott scanned his valet ticket at the automated parking machine in the lobby. He inserted his credit card incorrectly, realigned it, paid, and the machine announced that the car will be pulled up shortly. Lindsay and Elliott calmly waited for their car, they were not entirely sure they did the right thing since the machine was dictating instructions for both value and self-park. The car pulled up after a short wait and Lindsay and Elliott went home.

 

MRI Scan

The procedure consisted of a two person team. They were very courteous and respectful. They were very communicative about the procedure and the process, as well as over the duration of the scan. Lindsay could tell one of the specialists was undergoing training since he was given instructions on how to adjust the machine. The room was kept at a higher temperature for comfort.

Check-in at MRI

Lindsay checks in with the MRI receptionist and hands her the label pack. The receptionist directs Lindsay to the waiting area and asks her fill out the MRI check list.

Drop off Medical Records

Lindsay was told to drop of her medical records at the Piper Center receptionist before her MRI and that they were on the fourth floor. Lindsay and Elliott quickly find the elevator bank to the receptionist desk but chuckle at the post-it note taped over the Code Blue elevator button.

Lindsay tells the receptionist that she is there to drop off her medical records prior to her MRI. The receptionist calls the imaging department to determine who should take the image CD. Lindsay asked if they wanted the pathology report as well. Neither receptionist knew what to do with the pathology report, one receptionist recommended calling the imaging department again to ask just as the women they were originally on the phone with walked up to the desk to grab the CD. The receptionist asked what to do with the pathology report and the woman took it along with the image CD.

After dropping off the both images and path report, the receptionist tells Elliott and Lindsay to return to the first floor lobby and get directions to medical imaging from the information desk in the lobby.

Register at Medical Imaging

Lindsay checks in with the receptionist at medical imaging. They ask for her ID, enter some information in the computer, then direct Lindsay to the registration desk. Lindsay is guided through and signs the following forms:

Consent for Release of Information
Assignment of Benefits
Consent for Release and Combining of Health Records Among Health Providers

After signing the forms, Elliott asks for copies which the woman at the registration desk quickly provides. She puts on Lindsay’s wristband, hands her a label pack, then walks Elliott and Lindsay towards the MRI reception are and instructs them where to take the final turn into the MRI department.

Arrive at Abbott Northwestern

Elliott pulls into the valet but sees a long line. He noticed a bank of parking meters just in front of the Piper building, so he backs out of the valet line and into street parking. Just as he puts the car in park, he notices a parking attendant wave and point at the no parking sign (during rush hour) and waves Elliott back into the valet line. An attendant efficiently offers Elliott a valet ticket and both him and Lindsay enter the main lobby of the Piper Building.

MRI Scheduling

Lisa, Lindsay’s care coordinator at Piper Breast Center, calls to inform Lindsay that she can move Lindsay’s appointment with the surgical oncologist up a week (from November 16th to November 9th), but that she would like to get Lindsay in for an MRI before the 9th. Lindsay was at work when she took the call, but had planned on taking a half-day and said she would be available whenever worked best for them. They scheduled an MRI for 3pm that day. Lisa gave Lindsay the direct address for the Piper Breast Center at Abbott Northwestern, directed Lindsay to drop her pathology report at the Breast Center Receptionist area on the 4th floor, and gave her a “pro-tip” to just use valet parking since it only costed $1 more and the parking lot is typically very crowded.

 

MyChart Registration

When scheduling her appointment, Lindsay was asked if she wanted to register for Allina Health's online portal. Lindsay said yes and the receptionist emailed an activation code.

Lindsay attempted to activate her access to the portal by copying and pasting the registration code, entering her DOB, and the last 4 digits of her SSN.

After submitting the form, she gets an error message stating she entered an incorrect SSN. She retypes it several times to ensure she didn't have a typo but still gets the error message. She is eventually locked out without an ability to resolve the issue. There is no help number or link.

Parents Plan Trip

Lindsay goes back and forth with her parents about visit timing. There is a lot of uncertainty at this time and the appointments are a moving target.

In the end, it just makes sense for family to be present. The purchase tickets to fly from Arizona to Minneapolis on Saturday November 6th.

Pathology Report Retrieval

Once Lindsay signed the consent form (after amending the form to include both Mayo Clinic & Piper Breast Center), the receptionist walked her towards the Medical Records Department, leading her to an intersection in the hallway then pointing towards the final destination at the end of the hallway.

Medical Records Department

Lindsay and Elliott entered the Medical Records Department reception area and Lindsay requested her path report. The receptionist asked Lindsay for her identifying information, entered the info into her computer, but did not understand the request and asked a clarifying question: “You want your medical records?”

Lindsay specified she was looking for the pathology report. The receptionist told Lindsay to go back to the Breast Center to fill out forms and request the image CD for her full health record. Lindsay informed the receptionist that she had already signed the forms and received the image CD and that she was in the Medical Records Department to get the path report. They now understood her request and asked Lindsay and Elliott to have a seat in the reception area while they pull her report. After a short wait, they hand Lindsay a blank white envelope and send her on her way. After exiting the Medical Records Department, Lindsay and Elliott open the envelop to verify its contents. After quickly skimming the pathology report they begin to realize the true gravity of the situation.