How to De-Frag Your Health Care

If your computer has ever slowed way down you may have been adefrag 2 2.8.16dvised to “defrag,” which puts all parts of a file together in the same place on the drive, enabling it to run faster and more efficiently.

In much the same way, your health care needs to be de-fragged. For most people, health care is extremely fragmented, creating errors, delaying diagnoses and treatment, and increasing
costs.

Even for the very healthy, the burden of keeping even two or three different doctors apprised of what you’re experiencing is typically on you. No one else is doing it.

When I had a small skin cancer removed from my back by my dermatologist, no one told my primary physician or sent a copy of the pathology report to that office. So I did.

If you break a bone snowboarding, no one automatically tells your physician back home. If your ophthalmologist sees signs of cardiovascular disease during an eye exam, he or she is unlikely to ask if it’s OK to send the information to your physician.

Chief Health Communicator? That Would Be You

The more complicated your problems, the more fragmented your care will be. The average Medicare patient sees two physicians and five specialists a year (according to The Fragmentation of American Health Care: Cases and Solutions, edited by Einer Elhage). Those with a chronic illness see an average of 13 physicians a year. A Medicare patient with coronary artery disease sees 10 physicians in six distinct practices annually. Indeed, the more physicians following someone after a heart attack, the lower the survival rates.

It’s important you know that there is no little Tinkerbell picking up your medical records and automatically delivering them to the physicians in your life who should know what’s happening with you. Consider yourself the the person most responsible to collect written updates, copies of test results and lists of new and changed medications and get them to all your other healthcare providers.

When you get a test result, procedure or have surgery,  get the summary in writing, keep a copy, and send or bring copies to all your other healthcare providers. Attach a simple note: “Wanted to keep you up- to-date on my health status. Please put this in my chart.” If it’s an important healthcare issue, be sure to bring up the data or  problem at your next visit and mention that you sent a written summary for inclusion in your medical record. Keep a master list of all your medications and update it any time a healthcare provider adds or deletes a drug or changes a dosage.

Bring a copy of that list to your medical appointments and to the emergency room if you end up there. Don’t leave your dentist or your optometrist/ophthalmologist out of the loop. They need to know the details of your general health status. It will help them diagnose and treat any issues they may identify with you. Be sure they know if you have any infections, immune issues, heart problems, chronic conditions or are taking blood thinners or antibiotics, as well as other medications.

Call the healthcare provider who ordered the test and ask the office staff to email or send you a written copy of the test summary. Keep a copy in your own “medical updates” file. If the test was indeed OK, you still should have copy for reference at a later time, if needed.

If you or someone you love ends up in the hospital, your role of communicator will be even more vital. Often specialists are called in to evaluate problems that are detected or develop while you’re in the hospital. Specialists don’t always talk to each other, or to a hospitalist, or even realize who has changed or added a medication, who has ordered a test, or what results are in. The more you can communicate, the better. If you are being asked to go back for a test you already had or if you have questions about what is happening, don’t assume someone has it all managed. Ask questions and be sure you understand what tests you’re getting and why. If you are being discharged from the hospital, it is an especially important time to ask for the results of any tests or procedures you had in the hospital.

De-fragging your health care may sound overwhelming. Just remember: get written copies of every test, procedure and surgery, keep a copy of each for yourself (you’ll be the only person on earth with a complete copy of your own medical record, by the way), and give copies to your healthcare providers. Ask questions when you don’t understand why someone wants to order a test for you. Bring a knowledgeable person along with you to healthcare appointments, if you like.

Be the hub of the wheel. Of everyone involved in your health care, you’re the one with the most at stake.

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About Barbara Bronson Gray, RN, MN

I'm an experienced healthcare and science editor and journalist. But most of all, I'm a registered nurse with many years of experience working in hospitals. I've learned what patients and families need first hand. But I've also worked to improve hospitals and educate people about their health. I'm committed to helping people take charge of their health care and get what they need from a complex and often discouraging healthcare system.
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