A first person view of today's medical records system. It's not pretty
The cardiologist walked in to the hospital room and handed me an envelope. “My notes and his test results are in there,” he said. “Don’t lose that – it’s gold.”
Gold? Sure. But that envelope was also a textbook example of why the broken medical records system has left interoperability in healthcare elusive.
Last month, my husband – a long-term kidney cancer patient – had a heart attack. He ended up in our local community hospital, where kind staff did their best. But he’s complicated and then some – on a clinical trial for metastatic renal cell disease, diabetic, and on and on.
In a world with interoperability, access to the medical records system and his data should have required no more than his consent and a few clicks of the mouse. In a world without interoperability, well, it became complicated quickly.
No one had heard of his medication (which has potential heart side effects) and they relied on both of us to outline his issues, his treatments and his many scripts. Then it was up to me to call his oncologist, get recent EKGs and records faxed from that particular medical records system, and to grease the wheels in case actual phone conversations needed to happen. And even though his primary care is located in the same town as the hospital and in the same network (meaning they should be on the same medical records system), I had to reach out to her for results of a recent nuclear stress test. In the end it took four calls back and forth to the oncologist and two to the primary to get the eventual flood of faxed paperwork to arrive.
When he was discharged, that envelope was handed to us and eventually presented to the big city cardiologist, who said he took the time to read it and literally enter the information in to his medical records system (which made him late for our appointment). He took copious notes on his computer though, and sent us to the major hospital across the street for a heart catheterization test.
While I’d like to say that was a paper-free (and seamless) process, it wasn’t. The sheet with his list of medications wasn’t up to date, even though they’d been revised across the street 24 hours previously. Nursing staff used a computer next to his bed to tie in to their medical records system, but a binder, and the ubiquitous clipboard, were probably more in use. One loose piece of paper in particular caught my eye – it had a detailed drawing of a heart and was apparently meant for the cardiologist’s reference. We both laughed about that, but if I’m honest, it was nervous laughter. If you need a line drawing of the heart, should it really be on paper?
Heart-wise, he’s going to be ok. But I’m a lot less optimistic than I was previously that true healthcare interoperability across every medical records system will be achieved any time soon.