After a minor bike accident, you go to the emergency room with a broken wrist. While you’re being triaged, you tell the nurse you take blood thinners because you had deep vein thrombosis a few years ago. The doctor treating you says he’s read your medical records, so you assume he knows what medications you take.
When you tell the doctor about the blood thinner, however, your doctor says that’s not in your record. In fact, there’s no medical information in the record at all from the doctor who prescribed it. You wonder what could have happened if your accident was more serious and you weren’t able to speak for yourself. You could have faced a dangerous medication interaction or a complication during surgery because your doctor didn’t have the complete picture.
This is just one example of the potential risks of fragmented medical care. When you see more than one doctor and your medical records aren’t updated and shared with all the providers who treat you, it can result in fragmented care. This fragmentation can lead to several serious problems:
Misdiagnosis. When physicians don’t have access to your complete medical record and family history, the risk of misdiagnosis increases. Every physician who treats you, including your primary care provider, specialists, urgent care providers, and emergency room physicians, need complete, up-to-date information about all your current and past health issues, medications, surgeries and other treatments, drug allergies and past medication side effects, and screening and diagnostic test results.
Drug interactions and overprescribing. All your treating physicians need to know what prescription and over-the-counter medications and supplements you take to reduce the risk of drug interactions. Without this information, you also could be prescribed medications for the same condition by two different doctors, increasing the risk for overdose and dangerous side effects. Another potential issue is being prescribed medications to treat symptoms that are actually side effects of another medication you take. For example, if one of your medications causes dizziness, a physician who’s not aware you take that medication may prescribe an unnecessary medication to treat the dizziness.
Missed follow-up care. Without a consolidated medical record, you run the risk of missing recommended follow-up care or testing, which can delay an accurate diagnosis and treatment.
Unnecessary medical expenses. Fragmented care increases your risk of undergoing duplicate tests and other services. The cost of that unneeded care can be high. By some estimates, around $200 billion a year is spent on duplicate medical services. While some of the cost may be covered by your health insurance, if you have a high deductible or if your insurer denies your claim, you could end up with a sizeable bill.
Be proactive and prevent fragmented care
These three proactive strategies can help lower your risk of fragmented care and the problems it can cause.
Choose a medical home. A medical home is a health care provider who serves as your point person. Many people choose their primary care physician to fill this role. This provider makes sure the care you receive from all the providers is coordinated and all your medical records are consolidated and updated. You’ll need to tell your medical home provider which doctors you see and have those providers share your records with your medical home. And if you’re hospitalized, let the hospital know to share your records with the provider who coordinates your care.
Be an informed patient. You should be familiar with your medical history and family history so you can provide this information to every health care provider you see. Keep a list, either on your phone or a hard copy, of all the medications you take. The list should include names and dosages of the medications and any medication allergies or significant side effects you’ve experienced. Review the records from all the doctors you see regularly and check them for errors. If there are errors, contact the provider to get the information corrected. It’s also wise to have a medical power of attorney who can provide your medical information to physicians if you can’t speak for yourself.
Create an electronic medical record. Another strategy to lower the risks associated with fragmented care is to create a secure electronic medical record. This puts all your medical information into a format that can be easily and quickly shared with any health care provider who treats you. There are apps you can use to gather and manage this information. Some providers and health systems also offer online tools like MyChart and Epic. No matter what tool you choose, remember to review your records regularly to make sure they’re accurate and up to date.
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