I spent most of today in the deposition of a nursing expert. I retained this wound care and rehabilitation nursing expert in a medical malpractice lawsuit involving healthcare at Mainland Medical Center, in Webster, Texas.
During our lunch break, the nursing expert and I discussed some of the challenges involving electronic medical records.
Nursing documentation that used to be made on a few pages of flowsheets now consumes hundreds of pages. Even worse, most of the things noted in medical records are based on clickable boxes and cutting and pasting prior entries, rather than having a doctor, nurse, or therapist writing a detailed narrative note about what is going on with patient.
In other words, the typical patient chart has many more times the documents, but much less information than old-fashioned paper medical records contained.
The nursing expert shared that one benefit of electronic medical records is a new medical records-sharing system that allows healthcare providers to review medical records from different member facilities instantly.
As a Houston, Texas medical malpractice attorney, I knew that this was already implemented in some of the local hospital systems, like Memorial Hermann. If a patient is seen at one hospital in the Memorial Hermann system, providers at another hospital can instantly access the records. The same is true for physician and clinic offices that are affiliated with Memorial Hermann.
Epic’s Care Everywhere system dramatically expands on that. The following Texas hospitals are currently members of the Care Everywhere system, meaning that healthcare providers at any one facility on the list can instantly see medical records and imaging done at another facility on the list.
- Ardent Health Services
- Austin Regional Clinic
- Baylor College of Medicine
- Baylor Scott & White Health
- CHI St. Luke's Health
- Children's Health System of Texas
- CHRISTUS Trinity Mother Frances Health System
- Cook Children's Healthcare System
- Driscoll Children's Hospital
- Harris County Hospital District
- HCA Central and West Texas Division
- Heart of Texas CHC
- Houston Methodist
- JPS Health Network
- Kelsey-Seybold Clinic
- Mercy Health- NWA, OK, KS Area
- Methodist Health System
- Molina Healthcare
- OCHIN
- Parkland
- Premise Health
- Prime Healthcare
- Providence Health Network - Waco, TX
- Select Medical
- Shannon Health System
- Texas Children's Hospital
- Texas Health Resources
- Texas Scottish Rite Hospital for Children
- University of Texas MD Anderson Cancer Center
- UT Health San Antonio
- UT Southwestern Medical Center
- UTMB - Health
- Walgreens Healthcare Clinic
Hospitals in five other countries, all 50 states, and Washington, DC are also part of the Care Everywhere system.
I must admit that I have mixed feelings about this type of system because of the competing interests of patient privacy and safety through immediate access to healthcare information. In the balance, though, I think it is a good development.
In my practice, I have handled myriad cases where physicians misdiagnosed and discharged patients, allowing serious injury or death to occur. In many of those cases, having access to medical records and diagnostic imaging from a prior facility would have likely led to proper diagnosis and treatment.
I expect that we will see more and more hospitals become part of the Care Everywhere and similar systems. In the meantime, you can help improve your own safety is a patient by keeping a healthcare diary, along with copies of medical records, radiology reports, and CDs containing radiology images. When you need follow-up care, whether in an emergency room or with another physician, be sure to bring those materials with you.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. In 2017, H Texas magazine named him one of Houston’s top lawyers. In May 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.