77% of patients in health centres are not given their files

77% of the patients attending the Floriana Health Centre were not handed a file containing their medical records before being examined by a doctor.

A total of 529 patient visits were included in a study conducted in September 2013 by medical doctors Jurgen Abela from the Department of Primary Health and Michelle Bugeja from Mater Dei.

The standard practice is that as soon as a patient enters  a health centre, the patient is registered at the reception after providing an identification card. His or her file is then retrieved by healthcare assistants from the records section, and the patient is provided with a file which the patient presents to the GP during the consultation.

Since the Maltese healthcare system does not yet allow patients to register with their own GP in the health centre and patients are seen each time by a different doctor, keeping good patients’ medical records is considered vital to ensure proper continuity of care between one doctor and another.

The study also found a noticeable difference in the percentage of medical records which were given to patients in the morning (from 8am to noon) and in the afternoon (noon to 5pm).

According to the study, this difference between files handed over in the morning and the afternoon might be attributed to the start of recreational breaks of the healthcare assistants in the afternoon, which leads to fewer staff on the shop floor to register patients, retrieve and distribute medical records.

The researchers ensured that there would be different healthcare assistants working during the different days of the study to ensure that any results were not linked to the practice of one healthcare assistant only.

The study also found that 75% of GPs wrote notes on the patient’s file when medical records were provided. 

The “erratic nature of file availability” could be one of the reasons why 25% of GPs did not write any notes on these files. Other reasons could be lack of appreciation of the importance of keeping good medical records; insufficient space in the file where to write down notes, and fatigue.