Quick recap
In my last post (Down the patient portal: the world of healthcare tech serving you data about you) I introduced the back end of patient engagement from the patient’s perspective. While you can’t choose the digital patient engagement tools your provider uses, you can often choose your provider— and different providers may be part of different health systems, using different healthcare tech platforms and different healthcare records.
Those software platforms typically include a care management suite that integrates with the rest of apps your provider uses, but one of those apps is especially important here.
Alongside the other solutions dedicated to preventative care, patient safety, and care coordination, patient portals (under patient engagement) are the tool the provides direct access to your medical records. So I focused first on explaining EHRs and the problem of interoperability, because of the real and significant impact that these disputes, barriers, and tangles in communication have on you, the patient.
You need to know that background to understand what’s happening now, and what you can do.
Remember patient empowerment? This is it.
Looking out for yourself
If you’re lucky, you’ve never had to think about what healthcare system your doctors use. But if you’ve ever had to track down missing medical records, repeat a test you know you already did, or explain your own medication history to a doctor who should already have that information, then you’ve already felt the consequences of America’s EHR interoperability problem.
Your healthcare experience isn’t just about whether your doctor is good at their job. It’s about whether they have the right information at the right time to make the right decisions for you. If you’re bouncing between healthcare providers who use different systems, that information might not transfer correctly—or at all.
This isn’t just annoying; it’s dangerous. A lack of complete medical history can lead to misdiagnoses, medication errors, redundant tests, unnecessary procedures, and gaps in treatment. Even if you assume doctors are double-checking everything, the burden of making sure they have all your medical information often falls on you. And unless you’re carrying around a personal medical file at all times, mistakes are inevitable.
Example Scenarios:
- A patient switches primary care doctors to one in a different system. The new doctor doesn’t see a past MRI that ruled out a neurological issue, so they order another scan unnecessarily.
- A specialist prescribes a new medication, but the new primary care doctor can’t see it. The patient is prescribed two medications that interact poorly, leading to side effects.
- A patient undergoes an outpatient procedure at a hospital in one system, then follows up with a specialist in another system. The specialist doesn’t see the records and repeats the same procedure.
While interoperability has improved in recent years, it’s still far from seamless, and you’re the one who pays the price when systems don’t communicate.
It’s not one weird trick
You might not be able to change how hospitals and EHR vendors operate, but you can make smarter choices about how you navigate the system. Here’s what you can do:
- Learn which EHR system your providers use, and stick to providers within that same system when possible. If your primary care doctor, specialist, and hospital all use the same EHR, they’ll have instant access to your records instead of relying on faxes, manual transfers, or patient memory.
- Use patient portals aggressively. Download your records, test results, and medication history. Keep a copy for yourself and bring it to new providers.
- Request a full record transfer whenever you switch providers. Don’t assume it will happen automatically—it won’t. You’ll likely need to sign paperwork and follow up multiple times.
- Know your medications and history. Keep a personal record of your prescriptions, past procedures, and major diagnoses. If a provider doesn’t have your full history, you’ll be able to fill in the gaps.
By the way– don’t confuse this with in-network vs. out-of-network
Just because a provider is “in-network” for your insurance doesn’t mean they use the same EHR system as your other doctors. You could see five in-network doctors and still have each one struggle to access the others’ records.
What does matter is whether they’re part of the same health system—a term that refers to hospital groups and affiliated practices using the same EHR. For example, a doctor at a hospital using Epic will likely have an easier time accessing records from another Epic-using provider than from one using Cerner or Meditech.
Zooming back out
Until the U.S. healthcare system makes full interoperability a reality, patients have to think strategically about where they get care. Your choice of providers can make a massive difference in the quality, efficiency, and safety of your care for reasons that go far beyond the time you spend sitting in the waiting room next to the fish tank.
And if you’ve ever thought, why isn’t there a single app where I can access all my health records in one place, no matter where I go?—you’re not the only one. That’s a problem a Healthcare Unifying Portal (HUP) app could solve, and it’s past time we had one.