Fragmented Care & Poor Coordination
The average American sees 18.7 different physicians in their lifetime — across systems that rarely talk to each other. Here's how to take control of your own care coordination.
The Coordination Crisis
$935B
Annual waste from poor care coordination
JAMA 2019
1 in 5
Patients experience a medical error from poor handoffs
WHO 2023
34%
Of hospital readmissions are preventable with better follow-up
AHRQ 2022
80%
Of serious medical errors involve miscommunication
Joint Commission 2022
The US healthcare system was built around individual providers, not patients. EHR systems from Epic, Cerner, and Meditech are designed to retain patients within their networks — not to share data. The result: duplicate tests, missed diagnoses, and patients left to manually coordinate their own care.
Solutions & Resources
Access & Control Your Complete Medical Records
Under HIPAA and the 21st Century Cures Act (2021), you have the right to access all your medical records electronically, for free, within 30 days. Providers cannot block information sharing.
Action Steps
- Request your complete medical records from every provider you've seen in the last 5 years
- Use your patient portal (MyChart, FollowMyHealth) to download records in standard formats
- Under the 21st Century Cures Act, providers cannot charge for electronic records or delay access
- File a complaint with HHS OCR if a provider refuses or delays your records request
Resources & Tools
Build Your Personal Health Record (PHR)
A personal health record is a complete, patient-controlled summary of your health history. Bringing it to every appointment eliminates duplicate testing and prevents dangerous drug interactions.
Action Steps
- Maintain a document with: current medications (name, dose, frequency), allergies, chronic conditions, surgical history, and family history
- Include your vaccination records, recent lab results, and imaging reports
- Share this document with every new provider at the start of each visit
- Update it after every significant health event, new diagnosis, or medication change
Resources & Tools
Use Care Coordination & Navigation Services
Care coordinators, patient navigators, and case managers help patients manage complex conditions across multiple providers. Many are available at no cost through insurance, hospitals, or nonprofits.
Action Steps
- Ask your insurance company if they offer a care coordination or case management program — most do for complex conditions
- Hospital discharge planners are required to help arrange follow-up care — ask for one before leaving
- Disease-specific nonprofits (American Cancer Society, American Heart Association) offer free patient navigation
- Chronic Care Management (CCM) is a Medicare-covered service for patients with 2+ chronic conditions
Resources & Tools
Leverage New Interoperability Standards
The 21st Century Cures Act mandated that all EHR systems support FHIR (Fast Healthcare Interoperability Resources) APIs by 2022. This means you can now connect your health data across systems using apps.
Action Steps
- Connect your patient portals to Apple Health or Google Health to aggregate records in one place
- Use FHIR-enabled apps to pull records from multiple hospital systems automatically
- Ask your providers if they support 'care everywhere' or 'CommonWell' — national health information networks
- Report information blocking violations to ONC at healthit.gov
Resources & Tools
Medication Reconciliation — Preventing Dangerous Gaps
Medication errors at care transitions (hospital discharge, specialist referrals) are one of the most common and preventable patient safety events. Active reconciliation prevents harm.
Action Steps
- Bring a complete, current medication list to every appointment and every hospital admission
- At hospital discharge, ask the nurse to review every medication change with you before leaving
- Ask your pharmacist to perform a medication review — they can identify dangerous interactions across prescribers
- Use one pharmacy for all prescriptions so the pharmacist has a complete medication history
Resources & Tools
Getting Second Opinions & Specialist Access
Second opinions change the diagnosis or treatment plan in 21% of cases. For serious diagnoses, a second opinion is not just acceptable — it's standard of care.
Action Steps
- Request a second opinion for any serious diagnosis, major surgery, or complex treatment plan
- Academic medical centers and NCI-designated cancer centers offer formal second opinion programs
- Virtual second opinion services allow you to get expert review without travel
- Your insurance cannot deny coverage for a second opinion — it's a protected right under most plans
Resources & Tools
How MedTrack Helps with Care Coordination
- Maintain a complete medication list across all your prescribers in one place
- Find pharmacies that offer comprehensive medication therapy management (MTM) services
- Identify pharmacies with clinical pharmacists who coordinate with your care team
- Compare pharmacy services including medication synchronization programs
Continue the series
Next: Social Determinants & Logistics Barriers