The Need for Centralized Medical Records   by Carolyn O’Keefe

Consolidating your family’s medical records is one important step you can take to help insure your loved ones receive the best health care. In this era of medical specialization, the availability of centralized medical records can make a crucial difference in outcomes.

Accurate, centralized medical records can yield better care anywhere in the world
If you’re like most people, you receive your health care from more than one doctor—a family medicine specialist, an OB/GYN if you’re a woman, perhaps a dermatologist, an orthopedist, or a cardiologist. That means the records each physician gathers on your health and treatment are scattered across offices all over town, perhaps even all over the region. Of course, you do your best to inform each doctor of all of your conditions, tests, and treatments, but it’s hard to remember everything during an appointment and sometimes you may not know what information is germane.

Not having access to your complete medical record has consequences, some simply a nuisance, others potentially life-threatening. You have to repeat your health and family history to each new doctor you see. Tests may be unnecessarily repeated, wasting your time and money. Symptoms may be overlooked leading to an inaccurate diagnosis. Dangerous combinations of medications may be accidentally prescribed and cause serious health problems.

There’s a solution to the problem of scattered medical records that’s receiving a good deal of attention from health professionals and insurers as well as from President Bush—the consolidation of medical records to create a complete personal health profile.

Americans want centralized, accessible health records
The Markle Foundation, a private foundation that focuses on accelerating the use of information and communication technologies to improve people’s lives particularly in health and national security, has studied the question of whether Americans would like to have centralized medical records accessible via the Internet. The study found over 70% of those questioned believe these records would improve the quality of care they receive.

Physicians would also like to have access to more complete centralized records. With all of a patient’s medical history in one easily accessible place, physicians could work from more complete data, speeding the pace of diagnosis and getting treatment underway sooner. A consolidated record would also provide the physician with “the big picture,” including family history, medications prescribed and any reactions or potential interactions, lifestyle factors such as exercise, diet, and smoking, and more. The end result would be safer, more effective, more efficient care.

“In this day and age, it’s all about communication,” believes Dr. William Queale, an internist who treats patients in his concierge practice in suburban Maryland. “As a primary care physician, an important part of my job is to coordinate the care my patients receive. Most see a number of sub-specialists and I need the information from those other doctors consolidated and readily available to me to make decisions. Otherwise the information remains fragmented and details could fall through the cracks and make the delivery of health care less efficient.”

For most, consolidated medical records are still years away
There are a number of public and private projects just getting underway designed to create consolidated medical records. Last year, Former U.S. Secretary of Health and Human Services Tommy Thompson announced a 10-year plan the government hoped would speed up the creation of online health records by kicking off several pilot programs through Medicare. HMO giant Kaiser Permanente is halfway through a $2 million initiative to put members’ health records on a network that can be accessed by Kaiser’s health care providers and hospitals. Even a private group of entrepreneurial physicians have entered the field, creating a membership-based service that allows patients to input health information into an individualized web site.

Perhaps the largest and most ambitious project is being undertaken in academia. In March 2004, Duke University announced its Fuqua School of Business and School of Medicine had joined forces and created a non-profit foundation to investigate and eventually develop what the foundation calls a Health Record Network. In a press release last summer, the foundation described the project this way: “In designing the Health Record Network, Duke leaders envision a service that will provide to clinical systems across the country anywhere/anytime access to patient health information. This, in turn, is expected to improve patient outcomes and reduce health care costs.”

The Duke project envisions the establishment of an online personal electronic health record where patients input their own health information. That information could then be accessed, with the patient’s permission, by any health care professional treating him or her as well as by the patient. The goal of the project is three-fold—to improve health care outcomes, to empower people to understand and more actively manage their health and health care, and to lower costs.

The development of the Health Record Network is still in the earliest stages, however, with pilot programs being designed to test the concept in Toronto and Wyoming.

Centralized medical records and the careful attention of an advocate bring better treatment and peace of mind
While there are a number of medical records centralization projects on the drawing board around the country, members of PinnacleCare are reaping the many benefits of centralized records today.

Members’ records are carefully gathered, compiled, and scanned into a computer to create a digital record to which Members and their physicians have fast, secure access. Each member’s original paper records are stored in a locked, fireproof vault.

When a PinnacleCare Member recently saw a specialist for kidney problems, the physician was amazed that he had brought his complete medical history with him. The doctor commented that with the full records immediately available, he was able to provide a much better, more efficient level of care to the Member.

Because the information is in a compact digital format, it can easily be transferred at any time to any location around the globe if the need arises. The firm currently is in the process of developing a medical records flash drive keychain device that will allow Members to carry their health history with them and present the flash drive at a physician’s office or even in an emergency room. Plans are also underway for the creation of a highly secure online site that allows access to a Members’ complete health record anywhere there’s Internet access.

That around-the-clock, around-the-world access is especially valuable to people who travel. Two PinnacleCare Members who live on their yacht for several months each year off the coast of Panama and Costa Rica feel more secure knowing their medical records are always within reach. PinnacleCare compiled complete medical records for each member of the family and also provided them with information on the best doctors and medical facilities near their ports of call. The couple now travels with the knowledge that, should they fall ill or be injured while away from home, they can easily and promptly be connected with the best health care available.

In addition to centralizing each Member’s medical records, PinnacleCare offers something none of the other medical records consolidation projects provide—the attention, expertise, and advice of a personal PinnacleCare Advocate teamTM. This specialized and professional team reviews Members’ records at the beginning of the Membership and they often note important conditions or symptoms Members forget to mention to their physicians or find out that needed follow-up testing has not occurred.

That was the case for a healthy, active 24-year-old PinnacleCare Member who recently broke his collarbone and had surgery to repair it. During his recovery, he fainted. After reviewing his medical records, his PinnacleCare Advocate noted the Member had a longstanding history of fainting and informed his surgeon. Instead of assuming the one episode of fainting was related to taking pain medicine on an empty stomach, the Member was seen for a complete neurological evaluation to determine whether the fainting was related to the surgery, or was, in fact, a separate issue.

Another PinnacleCare Advocate found a physician’s note in a Member’s records recommending follow up for elevated cholesterol levels, but found no further follow up had been completed. After checking with the Member and learning that the issue was never resolved, the PinnacleCare Advocate immediately scheduled an appointment with the Member’s physician for testing. The physician then prescribed the appropriate medication and the member’s cholesterol is now under control.

By combining the benefits of complete, centralized medical records with the personal attention provided by a PinnacleCare Advocate, PinnacleCare Members are years ahead in their quest for the most effective, efficient care for themselves and their families.