Medical Records

In Kenya, one can imagine that the system for keeping medical records differs somewhat from the US. Americans are data gluttons, and for every doctor visit, and especially hospital admissions, reams of data are collected, both paper and electronic. Most of this goes into the Black Box of American medical records, never to be seen again. How many of you have actually seen your medical record? If a doctor wanted to see your medical record, would you be able to produce it? I would guess that the answers are “not many” and “not easily”.

See the women below:



They’re holding small notebooks just like the ones that E wrote exercises in for her kindergarten kids. This is a portable medical record. If the patient sees a nurse at a local clinic, they write a summary of the visit, diagnosis, medications, etc in the book. The same goes for a hospital visit or admission. While it’s not a comprehensive record, it’s a very good summary that allows any caregiver to at least get some sense of the patient’s medical history with just a few minutes of reading. How much sense does this make?! I don’t see doctors too often, but when I do, it always feels like I’m starting over, and I don’t have much in the way of records to give them.

Patients here are given responsibility to keep their books and bring them to health care visits, and providers are charged with writing vital information in the book during the visit. What vaccines has the patient received? Do they have a severe allergy to amoxicillin? The system is admittedly rudimentary, but at least there’s a system. Where is this personal responsibility in US healthcare? We’re floundering over how to “protect” patients, and at least right now, protection means circuitous access to completely disjointed records. How about an encrypted medical records flashdrive that each person takes with them everywhere? Naysayers would point to security risks, but it is up to the patient themselves to protect their records, which I think everyone deserves to have the opportunity to do. Would these flashdrives be occasionally misplaced and someone might find out that Jim was prescribed Prilosec in 2007? Sure, but I also know that medical records rooms at a hospital are no Fort Knox, so what we have now isn’t much more secure.

Addendum: Right before posting, E and I went to lunch and happened upon this scene:





That's right, medical records being burned in the courtyard. Kenya: For every thing that it does well, it does two things badly.