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When a parent sees doctors at several hospitals

· 5 min read · Vita Health Coach

The short answer

When a parent sees doctors at several hospitals, each one keeps its own record, and they do not always share. Make a list of every place your parent gets care, get access at each one, and put the results together by test and date. Then bring the full picture, especially the medicine list, to every doctor.

Why each hospital has a different piece

Hospitals and clinics in the US do not share one national record. Each health system keeps its own electronic health record. When your parent has a scan at one hospital, sees a heart specialist at another, and gets blood work at a local lab, the results land in three different places.

Some areas have a health information exchange, a network that lets hospitals look up records from each other. Many hospitals can also share records directly. But this sharing is not complete. A doctor may see some outside results and miss others, especially from small clinics or older visits.

That is why families often end up as the link between doctors. You do not need to be an expert. You just need a clear list and a way to see each record.

Your parent may also have records from years ago at places they no longer visit. Those can still matter, for example when a doctor wants to know when a problem first showed up.

List every place your parent gets care

Start by writing down every place, even ones your parent has visited only once. Insurance statements and pill bottles are good reminders of names you may have forgotten.

If your parent moved in recent years, include the doctors and hospitals in the old area too. Older results can help a doctor understand what is normal for your parent.

  • Primary care doctor and practice.
  • Each specialist, such as heart, kidney, lung or cancer doctors.
  • Each hospital where your parent stayed overnight or went to the emergency room.
  • Outside labs and imaging centers.
  • Urgent care centers.
  • Pharmacies.
  • Home health, rehab or skilled nursing providers.

Get access at each one

Most hospitals and large practices have a patient portal. Ask your parent to set up proxy access for you at each one, so you have your own login to see their records. Each health system has its own steps and forms, and access at one does not carry over to another.

For places without a portal, or for older records, your parent can ask the medical records office to send copies to you. Under HIPAA, the office generally must respond within 30 days. If your parent cannot make decisions, a health care agent or guardian can usually make these requests, depending on state law.

Keep a simple, secure note of each portal address and help desk number. You will need them more often than you expect, especially when a login stops working.

Line up results by test and date

Once you can see the records, put key results side by side. Group them by test, then sort by date. This makes it easier to see whether a number is steady, rising or falling.

Be careful when comparing results from different labs. The same test can be reported in different units, and each lab sets its own reference range, which is the range it treats as typical. A number that is flagged at one lab may not be flagged at another. Compare each result to the range printed beside it, and ask the doctor when results from two labs seem to disagree.

Note where each result came from. If a doctor asks, you can point to the source.

A simple table works: one row per test, one column per date. Write the result, the unit and the lab’s range in each cell, or keep the original reports together in date order.

Give every doctor the full picture

The most important thing to share across doctors is the medicine list. One doctor may start a medicine without knowing what another prescribed. Bring an up-to-date list to every visit, including vitamins, supplements and anything bought without a prescription.

Also bring recent results from other places, a list of recent hospital stays, and any new diagnoses. Ask each doctor whether they can see records from the other hospitals, and which results they still need from you.

After a hospital stay, ask for the discharge summary and make sure the primary care doctor gets a copy. That summary often holds the key changes to medicines and follow-up plans.

It can help to ask one doctor, often the primary care doctor, to be the hub who sees everything. Send that doctor copies of results and summaries from the other places.

Watch for gaps and repeats

When records are split, two things often happen. Some tests are repeated because one doctor cannot see another’s result. Other things fall through the gaps, such as a follow-up test that nobody ordered or a result nobody acted on.

If you notice a test being repeated, it is fine to ask whether the earlier result could be used. If you see a result that seems to have no follow-up, ask the doctor who ordered it. You are not second-guessing anyone; you are helping the team see what you can see. For anything urgent, such as chest pain, trouble breathing or sudden confusion, call 911.

Also watch for medicine lists that do not match. If one hospital’s list shows a medicine your parent stopped long ago, tell the care team so it can be corrected.

How Vita Health Coach helps

Vita Health Coach, an iPhone and iPad app from VitaMedas, Inc., lets you connect each of your parent’s hospitals through its own patient portal, from a list of about 96,000 US hospitals and clinics. Results, medicines and visit summaries from every connection come into your parent’s one file, and new results come in on their own. Paper reports from a small clinic can be added by taking a photo of each page. Connecting another person’s hospital is part of a paid plan in the App Store.

Questions people ask

Do hospitals share records with each other?
Some do, directly or through a health information exchange, but sharing is often incomplete. Ask each doctor which outside records they can see.
Does proxy access at one hospital work at another?
No. Each health system has its own patient portal and its own proxy access steps.
Why do two labs show different normal ranges for the same test?
Each lab sets its own reference range based on its methods and equipment, and some use different units. Compare each result to the range printed beside it, and ask the doctor about differences.
What is the most important thing to share between doctors?
An up-to-date medicine list, including supplements and anything bought without a prescription.

Sources

Vita Health Coach is an iPhone app that keeps a parent’s hospital results in their own file and explains each new one in plain words. Free to try; paid plans in the App Store.

Vita Health Coach on the App Store

General health information, not medical advice. Vita Health Coach explains; it never diagnoses. In an emergency, call 911 or your local emergency number. Read the medical disclaimer.