a doctor on a computer, medical records, electronic medical records

Electronic medical records have been widespread for more than a decade. Hospitals and clinics nationally have put effort, investment and training into getting such computerized records up and running.

They were supposed to improve patient care and make prescribing safer. Patients should have their electronic records with them wherever they need care. This portability was supposed to improve efficiency, lower costs and reduce medical errors. For example, if a patient has a scan in hospital X but undergoes surgery in hospital Y, the scan along with the prior medical records should be available to the surgeon.

Are Electronic Medical Records a Giant Disappointment?

Billions of dollars have been spent converting paper records to digital formats. How well has the new system worked? Not as well as we might hope.

According a new report based on data from the American Hospital Association, less than a third of the hospitals surveyed were able to exchange electronic medical records with other institutions. Even fewer hospitals (almost one in five) actually used data from another institution in planning and providing patient care.

As a result, patients and their families needed to access records and carry them from one medical facility to another. The bottom line seems to be that hospitals are not sharing information in a usable fashion. The public may need to exert pressure on these institutions before they make the effort to truly utilize electronic medical records as originally intended.

Holmgren, Patel & Adler-Milstein, Health Affairs, online, Oct. 2, 2017 

How Patients Use Medical Records:

A five-year-old study shows that patients who have access to their medical records do better. The study, called OpenNotes, was carried out in three large health care systems in Boston, Seattle and Danville, PA. Over 100 primary care physicians and more than 13,000 of their patients participated.

Patients were offered the opportunity to review their medical records including the clinic notes their doctors wrote after every visit. Clinic notes are detailed descriptions of the encounter, including diagnosis and treatment plan.

How Patients Reacted:

Some doctors worried initially that the notes would frighten or offend patients, but very few patients reported that they were confused or upset. More than three-fourths of the participating patients said that reviewing the notes made them feel they had better control over their own health care and were more conscientious about taking their medicines. Some patients spotted mistakes in their medical records and asked to have them corrected.

Although very few patients in this country have access to their complete medical records, this study published in the Annals of Internal Medicine shows that the OpenNotes system improves patient safety. (Delbanco et al, Annals of Internal Medicine, Oct. 2, 2012)

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  1. Greys Anatomy

    Verdict is out. Exists as a Watchdog so Conglomerate can track in-network referral patterns, insurance mix, revenues, workflow and coding issues, and looming legal record. 24/7. Most interfaces are not written intuitively for doc and they are frustrating, distract from patient care, and every week there is another “thing” to remember!

    Expensive, non-diagnostic, thorn in side.

  2. sura

    It is really annoying to not be able to correct mistakes on the numerous patient portals I am forced to use. Also, few have data that is printable in a usable way, if I wish to keep my own records. then suddenly they update their EMR provider and all the previous info is lost anyway. We need a one portal system, that is correctable. I am not allergic to Vitamin D, I have to keep insisting. Etc.

  3. Frank

    I am a patient at a humongous hospital conglomerate. After each visit, I am offered a summary, some of which is useful. I was disturbed by a remark made during an appointment made by a physician’s assistant (PA) reading off of a hospital laptop. An ER charge nurse and I had argued about whether or not I had hit my head, falling. I complained to the hospital administration about her conduct. The PA informed me that she accused me (in a hospital note I was not privy to) that I was overdosing on a psychiatric medication (Xanax) which I’ve never taken or been prescribed. She was doing it to discredit me.

    My problem with these medical records is that anyone (qualified or not) can make any entry they are inclined to make. My summary is inaccurate, contains duplication, and lists prescriptions I have never been given. Unfortunately, the drive for hospital profit has lowered the standards for hiring. You might find that the “nurses” trotting around in “scrubs” are actually untutored/untrained clerks who are making entries in your record.

  4. Paul

    “Equally important, the pharmaceutical industry needs to develop safe and effective pain relievers to replace opioids. NSAIDs, antidepressants and anticonvulsants are not the answer. And regulators need to make sure that their policies do not punish people in severe pain unfairly.”

    Raising awareness about potential shortages of specific medicines is good but absent suggestions as to what we can do about it leads only to frustration. Should we be writing letters? To whom? Contacting our elected representatives? What are the most effective efforts we can take to find solutions to the apparent upcoming shortages? Guide us, Joe!

    • Terry Graedon


      First, we are in total agreement about development of better and safer pain relievers. The pharmaceutical industry and research institutions have let us all down.

      As for shortages, it is time for the government to do more than just publish a list of drug shortages. We need coordinated national action. there are now several hospital systems that are uniting to manufacture generic drugs in short supply. That is a first step.

      Never hurts to write to your representative. Just do not hold your breath waiting for a positive response…

  5. Jen
    Middle America

    I absolutely hate them. I have my family doctor in one system. (Not affiliated with any particular hospital) My endo and arthritis in another (affiliated with a big hospital) I literally have to have the previous two doctors’ records sent to family doctor. Half the time they aren’t scanned in. If I were to go to hospital they won’t have all my records. I remember when it started about 20 years ago. I had a fairly young family doctor that had to learn to type, use computer, etc. I personally don’t like having a doctor looking at a keyboard and typing instead of me.

  6. dave

    I know of doctors and RNs who were on the verge of retirement and who retired a few years earlier because of the electronic medical record. The costs for a solo provider are enough to be decisive for someone at the tipping point.

  7. Marla

    When my grandmother was alive and I was taking her to medical appointments mistakes in the electronic records were prevalent. She had never been diabetic but one office (I believe an opthamologist’s office) nearly insisted that not only was she diabetic but that she was taking medication for diabetes. We had to get firm (almost ugly) with them several times. If it hadn’t been serious, it would have been comical how firmly they believed their little tablets.

    Many family members experienced the same issues when they would take her to appointments. I feel for elderly people who don’t have family members advocating for them.

  8. Nancy
    New Jersey

    Doctors are not really using the electronic records; they mostly ignore them while you are there for your ten minute visit. Plus when mistakes are added into the records, they are usually not corrected. A recent visit to an endocrinologist showed I was 5 inches taller than I have ever been in my life. Not sure what any of the docs would make of this. Another visit to the family practitioner made me 50 pounds heavier. I did not see this until I looked at the patient portal days after my visit. I did point it out the next time I was in the office. I know it was totally wrong because the next week I had a visit to the OB/GYN and my weight was 50 lbs. less than it was the week before at the GP’s. It also appears most offices do not read reports sent to them by other doctors.

  9. Diane

    Electronic records are a joke. You must be your own advocate & ask for a copy of test results & carry them with u when u see another Dr. If your lucky your primary care Dr will put them in a paper file for u if u give him/her a copy. Guess they might cut down on Dr’s terrible hand writing so fewer mistakes

  10. Laverne

    Very important to get copy of Doctors notes for all the reason stated above. Most people do not know they exist. I had a great doctor back in 1990 who sent his notes to all patients. He used them as a communication tool to reinforce what was discussed and even added a bit.
    I got rid of one doctor when I read his notes. It is an important patient tool to see if the doctor understands and respects you. Now these notes are very secret, unread or passed to other doctors filled with errors and sometimes inappropriate opinions they are unqualified to make. Needs to be required to be given to each patient.

  11. Sue
    Independence, OH

    Have not experienced any difficulty with the transfer of medical records from one institution to the other, however, have concluded that the availability has completely destroyed second opinions.

    Second opinions always seem to go along with the initial doctor’s report. I experienced a serious misdiagnosis but, thankfully, in my case, a situation arose that required a different specialist who proved that the primary and secondary opinions sought were completely wrong.

  12. Michael
    NW Washington

    I have seen no doctors actually use records from either myself or other sources.

  13. MLP

    My frustration with the electronic records system is that every one of my doctors is using a different patient portal program and getting and keeping access is almost like going to Ft. Knox. Too many portals, too many passwords. I thought docs would be entering data into the same database for each patient.

  14. Howard

    Online availability of medical records is extremely valuable to me. I can review past appointments, my medical history, and test results at my leisure and at my desk. I am able to email providers with questions and receive timely responses. I can usually schedule visits with providers online. During recent visits with my doctors they have been able to quickly call up tests including x-rays and MRIs to compare past and current results to help with diagnoses and treatment. After visit followups usually do not contain thoroughly detailed descriptions of the encounter including diagnosis and in plain english! BTW this sketchy information does not allow me to review online descriptions of visits, treatments and charges presented to my medicare advantage insurer as the data comes from the original provider!

    Treatment plans are usually detailed and comprehensible. The system within which I receive assessment and treatment consists of several medical facilities across a wide urban-suburban area. I can visit a provider in any of the system’s locations and my complete medical records are available at any computer! Very helpful especially when I visit a provider for the first time. My primary care physician can access all visits and tests with anyone in the system. Extremely useful to him and to me.

    Except for two occasions in the past two years I have not had the necessity of seeking treatment outside my network. In both instances records of diagnosis and treatment were not provided to my network. I had to send electronic scans of after visit summaries to my network. I do not believe that in either case this data has been entered into my medical record. Oh well.

  15. Tom M

    I thought that this was always a good idea…to make information readily available. Now, in the wake of numerous major hacking events, now I am not so sure. What will stop hackers from breaking into the system and altering data? Or perhaps even stealing it for some wicked purpose? Seems like I can’t get through the year without a major data breach occurring that puts valuable info at risk…like the recent Equifax breach which affected about 140 million accounts. Not to mention that it is likely that many of these medical records are inaccurate, much like so many credit reports have become.

  16. Merrilyn
    South Carolina

    I agree that there is potential for electronic records, but I have seen a lot of nurses and doctors spending time agonizing over computers. I still remember when my mother was dying in the hospital a number of years ago and we could not get anyone to answer the buzzer for care, they were too busy on the computer. I believe in intermediate technology– use computers for what they are good for and use people for the rest of it, paying them a decent wage.

  17. Sally
    Charlotte, NC

    I have been upset/angry more than once with my electronic records. No matter how often I’ve said I’m no longer on a medication or taking a lower/higher dose, some institutions didn’t make the changes. One wrote my father and brother were deceased. . .I have four brothers, all alive, thank you. I was informed I could only make that correction on my next visit (no guarantee there will be a “next visit”.

    A female PCP at a large, local institution was miffed that I brought her research indicating why patients should not take a particular OTC herbal supplement, product wasn’t regulated and could cause liver and kidney failure. I brought the paperwork after the product had made me sick, vomiting, weak. . .she tossed my research aside and told me to keep taking it (I didn’t & got better). Upon receiving my records, I saw the Dr. made a point of saying I was taking the product for cholesterol and added “patients idea”. A total lie. I was told your file can’t be changed. . .all they could do was attach my complaint to my file. FRUSTRATING!!!

  18. Cheryl
    South Carolina

    I have at least six different patient portals and none of them communicate with each other. If we had single payer health care, our records would be accessible to all our providers. Our healthcare (and I use that term very loosely) system is irretrievably broken.

  19. Dave
    Williamsburg, va

    I think the electronic records is a great idea and all my medical professionals have adopted them. However there is no sharing between the medical professions in my area. So I have separate sign on id’s and passwords for each and everyone. I have just given up on using them for netting except looking at blood test results.

  20. Jim

    I think unless Cyber Hacking is brought under control I will not compromise my information but rather keep my own records that I can give my doctor. There have been too many breaches of this information and there is no sense anyone of us to take a further risk to our person information that seems to vulnerable.

  21. Karen

    Unscrupulous physicians use EMR’s to trash patients, in order to subvert a lawsuit, and negatively impact her future care. I’m thankful for yelp.com, which is a website that cant be bought!

  22. Ruth

    Find access to medical records but list of allergies and side effects duplicated and incorrect
    Have tried to correct
    I ask for copy of each visit to review and have on hand in case EMR crashes

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