Waste Upon Waste: Misadventures in Getting Electronic Medical Records Transferred

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I know I'm not alone in being frustrated by something as simple — seemingly simple — as transferring electronic medical records from one physician's office to another.

I do have a more unusual situation, and forgive me if this is obnoxious to point out, but my wife and I have two homes and addresses. One is our permanent home in Texas, a house we own, and our secondary home which is located near her job in Ohio. We've been in that mode since about 2016, as her career and jobs have taken us to different states.

But I have valued the primary care physician that I've had in Texas since 2016. Maybe primary care has become a bit of a commodity, but he's fine and I've had no issues with him or his office (or the health system that the clinic is a part of). I've gotten my primary care from him when I've been back in Texas, including annual physicals and management of one medication.

Sometimes, in the second city, I have an acute care need that I can't fly back to Texas for. In August of 2021, I had a fever and went to a local “walk-in primary care clinic” that was part of UCLA Health to get a Covid test (I was negative). They call this “Immediate Care” and it doesn't come with Urgent Care billing. That seems like a nice model.

The First Failed Attempt

Last September, I had reason to visit a physician near our secondary home in Kentucky. I asked my Texas physician to send my records to the Kentucky physician. Both systems use EPIC / MyChart, so I figured this would be trivial.

I was wrong.

I filled out the authorization (an old-school PDF) that I sent to the Texas MD via secure messaging. A few weeks later, when I visited the Kentucky MD, they had not received the records.

They were able to use a bit of a workaround, within EPIC — the “Share Everywhere” functionality. The Kentucky MD was able to see enough of my records, but not everything. The access was limited and temporary.

Why Was I Kicked Out?

I later tried getting a refill of a medication (a statin) from the Texas MD. I was told, “We cannot refill this as you have moved and left our practice.”

Wait, what?

I explained to them, first through messages, and then via a phone call with the office manager, that I had not “moved.” We have a home in a second state. I also said I had never said that I was leaving the practice. I intended to come back for annual physicals.

I was told, “No, you asked for a records request, so you are no longer part of the practice.”

Um, OK. I guess they don't need the patients or the revenue??

I appealed and complained through the health system's patient relations department. I sent a website message and left a voice mail. A month later, I hadn't heard back.

So, I found a patient experience executive from that system on LinkedIn and sent a private message. Sure enough, I got a call from patient relations the next day. They couldn't help. They said that my “continuity of care” would be better if I only saw the Kentucky MD. That might be true in the short term, but not really over time… oh well. Good riddance.

I asked them to please make sure the full records had been sent over, since you were kicking me out of the practice.

So, Fully Over to the Kentucky MD — Eventually

The Kentucky MD is fine, so I started working on switching over to her and that office. Having my annual physical coming up, with her, in a few weeks, I asked to see if they had gotten the full records.

They had not.

The Texas MD told me that the records were being sent through a third-party company and to have the Kentucky MD contact them. The Kentucky MD told me to call the third-party. Sigh.

So, I called the third-party company who said they would send a FAX to the Kentucky MD (it's healthcare in 2023, so of course it's still a fax), with information about how they could download my records.

Here's a photo of a fax machine, for those of you who are too young to know:

fax machine
Fax machine (circa last century, but still used today because it's “Secure”)

The Kentucky MD office confirmed to me that they downloaded the records.

Get this — even though both systems use EPIC / MyChart, the Kentucky MD office will download the records and then SCAN them into their system. Again, they also use EPIC.

Is it implied that they will be printing the document so that they can scan it? It seems so.

That's the state of “interoperability” in 2023, apparently. Sigh.

I'd be curious to hear the thoughts and perspectives of those working in healthcare and EMR/EHR. One person said that EPIC is not to blame — it's a matter of the health systems not wanting to pay for certain functionality that would allow for a fully-digital transfer of records.

And this is the service we get in the world's most expensive healthcare system…


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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.

1 COMMENT

  1. I had a friend who was going through cancer care recently and it was equally as difficult to get her emr sent to the new doctors. It’s frustrating that in 2023 we can beam 4K images back from Mars but we can’t get electronic medical records from one health system to another.

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