Is the doctor always right? Not if the information in your health record is wrong!

By Dave deBronkart, Chief Patient Officer

Have you or your family ever been affected by a mistake in your medical records? Perhaps you don’t even know that it has happened. My own mother discovered that one doctor thought she was diabetic! Another had her thyroid condition wrong. Yikes! How can they do their jobs right, if the data in your chart is wrong?

Well, a speech by the CommonWell Alliance this month at the big HIMSS health IT conference shared this eye-popping slide, about mistakes patients found when they reviewed their medical records:

Yes, one in five patients who looked at their records found a mistake, and 40% said they found something serious! Serious, as in, “No, doctor, I don’t have that diagnosis!” or “No, I haven’t had that surgery!” The data is from the OpenNotes movement, which we’ve covered here before.

Fortunately we’re entering a new era of “health data transparency,” where  patients are increasingly able to see the same information as their doctors and nurses. In the past we couldn’t do that, because our health data lived only in the medical office. But times are changing, patients now have access to more information and they’re even spotting errors. 

It’s another example of how knowledge is power: without this knowledge you have no power to identify and help fix mistakes. Doctors have many patients to see, and nobody’s in a better position to spot mistakes than you. When you’re active, educated and engaged in your healthcare journey, better outcomes can be achieved.

The original article was in the Health Informatics journal of the prestigious Journal of the American Medical Assocation (JAMA) network. Titled Frequency and Types of Patient-Reported Errors in Electronic Health Record Ambulatory Care Notes, it includes these thoughts, which we think make a great case for why everyone should know what’s in their medical records:

• “Errors in electronic health records (EHRs) are common.^1,2 
• “At least half of EHRs may contain an error, many related to medications.^2–8
• [Causes of errors:] “Overburdened practitioners may import inaccurate medication lists, propagate other erroneous information electronically by copying and pasting older parts of the record, or enter erroneous examination findings.^2,8,9 
• “Older and sicker patients were twice as likely to report a serious error compared with younger and healthier patients, indicating important safety and quality implications.”

In summary, the article encourages that sharing notes with patients may help practitioners improve record accuracy and healthcare safety.