Now you may ask what medical record errors are? Why does it matter?
I am glad that you ask. But before we understand more about it, let’s learn a bit more about the medical record.
What is a medical record? Do I need one?
Do you agree with me that no one ever lived healthily forever, we’ve got to get sick once at some points in our life?
And when sick occurs, you already know what will happen next.
If you only have some common symptoms such as flu or fever, you can visit a nearby clinic.
However, if you contract some other serious illness (which I hope you don’t), a hospital is where you will end up. But regardless of where you go, there will always be a record on every time you visit whether or not you need it.
A medical record is essential because this is where a doctor uses to keep track of your condition and progression.
This kind of document is called a medical record or also used interchangeably as a health record or medical chart.
Why there are medical record errors?
A medical history can serve several other purposes apart from tracking patients’ progress. They can be used for such things as billing or medical proof as requested in some cases.
Although the hand-writing record seems to be obsolete in this digital era, and a computer is a far better way to store information. Still, this does not make the process of recording less error-free.
Believe it or not?
Only people who work in a hospital will understand record keeping is not an easy peasy job at all.
So how error occurs during the recording?
There are many possible ways a mistake can occur in this process, either by a human or machine.
For example, some clinics in the US use voice recognition software to digitize their patients’ medical records.
But guess what?
Not all the time, a computer can make the right guess of the officers’ dictation and transfer them correctly, which can lead to some misspelling mistakes.
Doctors can also make mistakes sometimes too, of course, not during the surgeon processes, but later in a medical report.
This sounds very unpleasant, but it happens very common, especially after a long shift.
A computer system is surely a very powerful assistant. It can handle secondary tasks and leave a doctor more time with his patient, which is excellent.
But do you want to hear my advice?
No matter how effective it may sound, the more we rely heavily on technology, the more mistakes we found in the record.
A medical record with wrong information is of no use and could mislead patients. This is why you should always check your health record, especially of your kids.
Common medical record errors you should check
When it comes to mistakes, they will never be the same. Mistakes happen for many reasons, from minor to serious ones.
However, aware of these common errors can help you know where to check when receiving your medical record.
And please take extra caution on this matter, not only for yourself but for your kids.
#1: Wrong information
This is the most common error in a medical record. Misinformation can be minor from wrong contacts, personal information to a more serious case, such as misplacing a patient’s record in another one.
You might think a mistake like wrong personal information might appear harmless, but when it comes to emergency cases when the doctor wants to contact a patient, you may rethink.
#2: Unorganized record
People may not only visit a hospital once but several times during his or her life. Especially when a patient carries some disease or cancer that requires a long period of treatment.
The amount of medical record will grow in direct proportion over time, which cause a high chance of missing or inaccurate information. This will lead to a more complicated situation when that information are needed
Among other mistakes, misdiagnose is probably somewhat the worst case. It happens when there is a delay or failure in treatment caused by mistake in medical tests.
How to fix errors in the medical report?
Checking errors in your health document could save your life.
I am serious!
Mistakes such as mentioned above can lead to an incorrect evaluation and treatment, which further complicate the condition.
Let’s take this as an example.
Imagine a medical report of your kids has a mistake on their food allergy information. What worse could happen if you overlook it and feed them with the wrong food?
To check your medical report for errors mean to save yourself and your beloved family members.
So how can I check my medical report?
In most cases, you have the right to ask for a review of your medical records and have them checked with all the doctors for errors.
This is a very necessary step to do, and it won’t take you long. So please don’t be lazy for the sake of your health.
In some places, there will be a form where you can fill out a request to fix errors in your medical document.
And as far as I know, doctors or any professional cares must respond to that request in 60 days.
What if they ignore or deny my request?
Such a case can be further consulted with the state agency. And in the worst-case scenario, you can file a lawsuit to settle the issue.
A medical record is like a statement of your illness. Doctors will be mostly relied on that document to follow up with your condition and decide what treatment you may receive.
A mistake in a medical record may appear small and harmless, but the consequences could be fatal sometimes.
Now that you are aware of this issue, please share this article around so that everyone can understand and prevent such errors in their medical records.