Sunday, January 22, 2023

How to Transfer Medical Records - A Tale of Frustration and Madness

A patient came to see me recently for a second opinion on an abnormal blood test result.  He was accompanied by his parents.  They had driven a considerable distance for this visit. 

The patient’s mother announced at the outset of the visit that she had been assured that all of the relevant records had been transferred.  My forthcoming comment will shock neither patients nor medical professionals.  Nary a single page of records was anywhere in sight.

This vignette illustrates two incredibly frustrating and recurrent realities.

Medical records that referring offices promise they have sent me often never arrive. They are dangling somewhere within a extraterrestrial black hole.  On a regular basis, conscientious patients see me in the office assuring me that they were told that their records have been forwarded.  They may have been forwarded somewhere, but all I know is I don’t have them.  This drives patients to a state of apoplexy, and I don’t blame them.   There are variations on this madness. For example, I may have requested a colonoscopy report but receive a mammogram report instead, which is somewhat less useful to me.  I can’t pinpoint where the breaks in the chain of custody are.  There are occasions when I must dispatch a patient directly to the referring physician’s office to assume possession of the medical papers and to deliver them into my hands only.  Only the strongest among us could take on a challenge of this magnitude. 

The second inexplicable frustration is why I cannot (with a patient’s permission) access other electronic medical record systems from my office computer.  I regularly see patients referred to me from an area emergency room (ER).  If that facility is not in my system, then I can’t access the records.  Conversely, if one of my patients is seen in that ER, they can’t see my records.   Does this sound like best practice in 2022?  It’s downright ridiculous.


Are we still in the age of the abacus?

But this particular case had a fortuitous twist.  The patient’s mother, using her sixth sense, brought a complete copy of the patient’s records with her.  She passed the dossier to me which allowed me to perform the task at hand.

She was the hero of the day, if not the week or maybe even the month.  But should patients and their families have to work this hard?  Shouldn’t the system be designed to facilitate and not hinder their care?  When will this perennial conundrum be resolved?  Why does the medical establishment tolerate this?   If medical billing were similarly flawed, and payments arrived late or not at all, do you think that the medical establishment would remain indifferent?

2 comments:

  1. It’s the free market capitalist system, VHS and Betamax hundreds of times over. We don’t need that many EMR choices. In Maine we have a statewide data repository where most EMRs upload at least labs, imaging and procedures…

    ReplyDelete
    Replies
    1. Hans, good hearing from you. I understand your point regarding competition among EMR vendors, but as an end user, I would enthusiastically support something closer to universal access. It's insane that we are blocked out of so many systems which adversely affects patient care. MK

      Delete