A patient was recently discharged from an exceptional hospital after a 2-day stay. During those 2 days, he saw endless doctors, attendings, residents, fellows, interns, nurses, nurse practitioners, nursing students, TV and phone service staff, physical therapists, social workers, case managers, housekeeping staff, spiritual chaplains, food and beverage staff, transport staff and discharge planners. Forgive me if I’ve missed anyone. All of these hospital employees play an essential role in a patient’s care at the hospital. There was just one person missing: someone from the medical records department. It’s time to change the lens we are using to view the importance of medical records to patient success and health.
No one visited the patient to discuss the importance of having a copy of his medical records post-discharge and maintaining a personal medical history file. No one verified authorization for the release of medical records. No one asked what medical records the patient needed upon discharge. No one confirmed what doctors needed a copy of the patient’s medical records: like his primary care doctor, his cardiologist or his neurologist. There wasn’t a single person that walked through the revolving door of the patient’s room that mentioned anything that resembled “medical records”. As a private patient advocate, this is no surprise. I’ve accompanied clients to my fair share of hospitals, medical facilities and cancer centers. I’ve yet to see a medical records representative visit with a patient during their time at the hospital. Electronic Health Records (EHR) are not the answer as they weren’t designed with the patient as the priority. Patient portals, if a facility has them, aren’t effectively adopted or utilized and have many shortcomings.
Here’s what should be happening at hospitals. A medical records representative should visit patients in the hospital with a smart tablet. The representative should discuss a patient’s care goals and discuss care coordination with respect to medical records. Medical record authorizations should be pulled up on the smart tablet and patients should be able to electronically authorize releases from their bed. At minimum, the medical records representative should verify the contact information of doctors that should be receiving a copy of medical records for follow-up. All doctors who regularly treat the patient need to have a copy of the medical records for seamless communication, coordination of care, and patient success post-discharge. At discharge, patients should at least receive a copy of every test performed during their stay at the hospital. There is absolutely no reason any patient should be discharged without a basic copy of their records. None. Release authorizations and strategic planning of the use of records for patient success need to be done at the bedside while the patient is in the hospital. Medical record acquisition needs to become an active part of the discharge process, not a hunt thereafter. Let’s stop this insanity of needing to walk to the medical records office, usually in the basement of a different building than where the patient’s room is, to fill out a form or print one online and mail or fax it. We need to bring the medical records department to the patient’s room while they are in the hospital’s care: a simple change with potential for profound, patient-centric results.
Grace Cordovano PhD, founder of Enlightening Results, is dedicated to fostering private, personalized patient advocacy services, specializing in the cancer space. She is a firm believer in the continuous advancement and improvement of patient experiences through the infusion of empathic design and thinking into current healthcare paradigms. Follow her on Twitter @GraceCordovano.