In Our Fragmented Health Care System, Access To Information May Be The Biggest Risk

It's easy to assume that your doctor will have access to your medical records when they visit you, especially since electronic medical records are the norm. But in fact, these records are not always interpreted among health professionals, and this can lead to all kinds of problems.

"One of my patients may have been treated at a facility near me, but when she goes from that facility to my office, I don't always have access to the medical records stored there," said Dr. Ilana Yurkevich, a primary care physician and oncologist at Stanford Medicine. "Currently, our electronic health records are very fragmented."

Yurkevich writes about the challenges health care providers face in accessing information and how it affects patients in his book Fragment: The Doctor's Quest to Unite American Health Care. When records are imperfect, it's often up to the patients themselves to fill in the gaps, Yurkevich says.

"I write about medical errors and mistakes that can happen to patients, especially patients who can't tell their stories straight," he told Marketplace host Kimberly Adams. "In my opinion, patients and their families will undoubtedly receive much worse care when they have to reconstruct their medical history."

Finally, Yurkevich hopes that the system can be improved, but advises on what information patients should have in order to effectively report their case history when necessary. Below is an excerpt of this information from the book.

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In our broken medical system, you are the only guaranteed continuity of care. Here's some information to keep on hand.

personal information

• Last name
• date of birth:
• phone number:
• Address:
• Emergency Contact:
• height weight
• Blood Type:

Care team

• My family doctor:
• My experts:
• My other providers (eg, psychotherapists or nutritionists):
• My health insurance company:

The main complaint

• I'm here today because (eg "My chest hurts"):
• It comes from (e.g. “little
  months").
• The problem is felt strongly (eg, "I'm taking two strength Tylenols"):
• The problem worsens (for example, "I sleep at night"):

Disease history

• Medical conditions (eg, diabetes, cancer, heart disease, arthritis)
• Activities (when, where)
• Hospitalization (when and why)
• Past treatment (eg, chemotherapy, radiation therapy):

Medicine

• Prescription drugs (name, dosage and frequency of use)
• Over-the-counter medications;
• Other nutritional supplements, such as vitamins or herbs:
• Pharmacy where I buy medicine:

Allergy

• Allergy to drugs;
• Allergy to another substance prescribed by the doctor (for example, an intravenous contrast agent).
• What to do if you have an allergic reaction (for example, "itching"):

Vaccination

• Vaccines in the past ten years;

Confirmation

• Recent blood tests;
• Imaging procedures (eg, X-ray, ultrasound)
• Abnormal findings (eg, Pap smear, biopsy)
• Interventions (eg stress test, colonoscopy):

Healthy habits

• Alcohol (how many drinks per week)
• Tobacco (how many packs per day and how many years in total)
• Medicines (what and how to take):
• My training schedule;
• My Diet:
• my dream
• My cure:

Family history

• Diseases of first degree relatives (parents, brothers, sisters and children).

my wish

• In the event of a medical emergency, can I have a will with my will?
• what's up
• Durable Power of Attorney (shows who I want to make medical decisions if I am unable to do so)

Reprinted from Broken: A Doctor's Quest to Unite American Health Care. Copyright (c) 2023 Ilana Yurkevich, MD. Used with permission of the publisher, WW Norton & Co., Inc. all rights reserved.

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