How to protect yourself from the risks of fragmented care

You end up in the emergency department after breaking your ankle in a minor car accident. You tell the nurse that you take blood thinners because you’ve been diagnosed with atrial fibrillation. The doctor treating your ankle says he’s reviewed your electronic medical record, so you assume he’s aware of the medications you take. But when you mention the blood thinner, your doctor says that’s not in your record. In fact, there’s no medical information in the record from your cardiologist.

This is just one example of an ongoing issue in the American healthcare system—fragmented care. When people see more than one doctor and their medical records aren’t updated and shared amongst all the providers, it can result in fragmented care and can cause a range of problems:

• Misdiagnosis: Without access to your complete medical record and family history, the risk of a doctor misdiagnosing you increases. Doctors need to know about all your current and past health issues, medications you take, surgeries and other treatments you’ve undergone, allergies and side effects from medications, and the results of screening and diagnostic tests you’ve had.
• Drug interactions and overprescribing: All doctors who treat you need to know what prescription and over-the-counter medications and supplements you take to reduce the risk of a serious drug interaction. There’s also the risk that you could be prescribed medications for the same condition by two different doctors who are unaware of your current medications, increasing the risk for overdose and dangerous side effects. Another issue is being prescribed medications to treat a condition that’s really just a side effect of another medication you take. For example, a person who’s taking a medication that causes dizziness may be prescribed another medication to treat the dizziness if the doctor is not aware of the first prescription.
• Missed follow-up care and testing: When you don’t have a consolidated medical record, you can miss getting recommended follow-up care or testing. That can delay an accurate diagnosis and the start of treatment.
• Overspending: You may undergo duplicate tests or other services if all your treating doctors don’t have access to your complete medical record. The cost of those unneeded tests can be high. Some experts estimate that approximately $200 billion a year is spent on duplicate medical services. If you have a high deductible health plan or if your insurer denies your claim for the duplicate services, you could be left with an expensive bill.

Three ways to protect yourself against fragmented care

There are steps you can take to protect yourself from the fallout caused by fragmented care.

• Have a medical home. Choose one of your healthcare providers, usually your primary care provider, to be your medical home. This provider will act as your point person to ensure the care you receive from all the providers you see is coordinated and your medical records from all providers are consolidated and updated. You’ll need to let your provider know what other doctors you see and have those providers share your records and test results with your medical home.
• Be an active, informed patient. Make sure you’re familiar with your medical history and family history so you can share these details with every healthcare provider you see. Carry a list, either printed or on your phone, of all the medications you take, including names and dosages, and any medication or other serious allergies you have. Regularly request and review your medical records from all the doctors you see and check them for accuracy. Make sure you have a medical power of attorney who is familiar with this information and can provide it to doctors treating you in an emergency if you can’t speak for yourself.
• Get the support of an advocate. A health advisor can gather, review, and update your medical records; create a comprehensive, secure electronic medical record that can be shared with any doctor anywhere; and act as your advocate, providing evidence-based information about diagnoses and treatments, helping you connect with specialists, and ensuring you have the information you need to make informed medical decisions.