When you suddenly find yourself caring for an elderly loved one, coordinating medical care seems like a daunting task. This is doubly true if you’re caring for a senior with dementia or any other condition that limits their ability to effectively communicate with others.
Working with medical care professionals is necessary, but you’ll have to get access to your family member’s medical records first. If you’ve had any experience working with medical paperwork, you already have some idea how challenging this process could be.
Requesting someone else’s medical records
If your elderly loved one is still in decent enough medical condition to write and communicate, you can have them fill out paperwork granting you access to their medical records.
Typically this form has a name along the lines of “authorization for release of protect health information” or something similar (here’s an example from California’s Health and Human Services Agency). An individual is entitled by law to release their health information to anyone they choose, but the process has yet to be standardized, varies between facilities, and often leads to burdensome bureaucratic delays.
“I’m now going through this with my 97-year-old mother,” said Michigan resident Kathleen Best. “I call and ask and then you have to put it in writing. That takes time and then you have to schedule appointments further out to accommodate the doctor receiving records and she just gets sicker.”
The Health Insurance Portability and Accountability Act (HIPAA) requires facilities to furnish copies of requested medical documents within 30 days. Fortunately, California’s medical record access requirements are much more patient-friendly: facilities have five working days to facilitate record inspections, and 15 days to transmit records after a request is made.
You’ll want to retrieve an elderly person’s medical history as soon as you can because, if they become incapacitated (for example, if they’re in a persistent vegetative state), this process becomes much more difficult.
In the state of California, you’ll need to be included in what’s known as a person’s advance health care directive, a set of instructions delineating who will be entitled to make healthcare decisions for a person in the event that person becomes incapacitated.
This document is composed of two parts: the living will and power of attorney for health care. The later designation is what will give you legal access to the records. Likewise, you could convey power of attorney status to your lawyer, who will then act on your behalf.
If you’re not already included in these documents, it would be in your best interest to contact a lawyer who could help you navigate difficult end-of-life and elder law issues.
Problems in the medical records industry
Even if your loved one still has the ability to get into their own records, the retrieval process can be overwhelming and place undue stress on individuals with already frail health.
“It’s common for chronically ill patients to have multiple binders filled with papers, scribbled notes, and imaging CD-roms,” said Noga Leviner, co-founder and CEO of PicnicHealth, a San Francisco-based startup that retrieves and neatly organizes medical records for consumers. “Try finding your white blood cell count from four years ago on the spot – it’s like looking for a needle in a haystack.”
According to Dr. Bruce Ruben, Founder and Medical Director of Encompass HealthCare and Wound Medicine, the volume of individuals’ complete medical histories varies widely, and “could range from three pages to 3000.”
You’re not alone in this struggle — even physicians and the specialists they work with have trouble exchanging patients’ medical information, according to a report published on Archives of Internal Medicine.
“For example, 69.3% of [primary care physicians] reported ‘always’ or ‘most of the time’ sending notification of a patient’s history and reason for consultation to specialists, but only 34.8% of specialists said they ‘always’ or ‘most of the time’ received such notification,” the report’s abstract reads. “Similarly, 80.6% of specialists said they ‘always’ or ‘most of the time’ send consultation results to the referring PCP, but only 62.2% of PCPs said they received such information.”
Glitches in electronic health records (EHR) systems
Even with the rise of electronic medical record systems, hospitals and other healthcare facilities are still chaffing under a record keeping system that’s cumbersome, messy, and has a risk for creating fatal mix-ups.
“One problem with medical record keeping is that some records include incomplete or incorrect information,” said Roberta Carson, president of Zaggo, a company that sells stationary and accessories to aid medical record management. “If ‘bad’ information is put in someone’s record, it is then seen by other medical professionals and the issue snowballs.”
For example, when Contra Costa County, California adopted the EPIC medical records system in 2012, the program began producing a series of errors and discrepancies that, in at least one case, recommended what would’ve been a fatal dose of heart medication to a patient.
The design and implementation of a universal EHR protocol remains one of the most frustrating and complex issues plaguing the American healthcare industry. To date, the U.S. government has spent $28 billion on rolling out EHR systems across the nation.
Although $28 billion may seem like a drop in the bucket of a healthcare industry valued at $3 trillion, it still presents a significant challenge to families and senior citizens searching for accurate and timely medical advice.
Note: the content of this article and website are for informational purposes only, and should not be construed as actual legal advice. Always consult your attorney with regards to legal concerns.