WHAT IS A MEDICAL RECORD?

A medical record documents all of your important medical history throughout your life, it can include:

• Health conditions
• Treatments and medicines
• Allergies and past reactions to medicines
• Test, scans and x-ray results
• Specialist care, such as maternity or mental health
• Lifestyle information like whether you smoke or drink.

You can think of your medical record as a combined chart and log, telling the medical professional you engage with - where you have been before, what happened there, and the implications for your current "voyage".

WHY IS A MEDICAL RECORD ESPECIALLY IMPORTANT FOR YACHT CREW?

As yacht crew are itinerant and tend to have extremely fragmented healthcare, often with no continuity of physician, team or facility, within an emergency or acute episode, you can't rely on the treating hospital or clinic to have the necessary information about you. You may also be in a non-aligned time zone, to your usual doctor, adding additional delays.

Even if you've been fortunate enough not to have been treated for any significant injuries or acute or chronic illnesses, it’s still important to keep your medical record with you, as it contains details about your vaccinations.

While the focus in the last three years has been primarily on Covid-19, other illnesses that cause difficulties and occasionally deaths haven't gone away. Across the alphabet from Hepatitis A to Zika, there are useful time-tested vaccines that protect you, your crew members and your families and you are responsible for ensuring that you have the appropriate vaccinations for the locations you’re travelling around.

HOW DO I START COMPILING MY MEDICAL RECORD?

Keeping a medical record (including vaccinations and medications) used to be cumbersome, but these days it's straightforward, if you invest a little bit of time and effort at the beginning, and update over time.

There are three ways of doing this, they can overlap, and for each of them you can provide access to anybody you want or nobody unless you say so:

• Paper record: This works well, but can be bulky, difficult to index / place in sequence / summarise easily. You may also need to provide photocopies – which is not always easy - you can take pictures of the paperwork on your phone and email it, but that requires time, and will be a potential annoyance when you're ill or injured. Maintaining a physical copy of your medical record, means that you should consider securely locking it away, but this method potentially presents issues in accessing the document in times of emergency.
• Encrypted Cloud-based folder or email: You can maintain a digital medical record by uploading all hospital admissions and procedures, treatments, discharge summaries, prescriptions and medications, stored on an encrypted drive or as a draft email (having a draft email, means that if you’re in a hurry, it's always ready to be sent):
  • The advantage here is that all you need is access to your email/drive to provide a clinical summary with as much or as little detail as you are personally comfortable with. The disadvantage is that you will need: access to your email, a good level of consciousness, manual dexterity and maybe Wi-Fi if your phone provider doesn’t allow roaming, if you’re in the Galapagos for example.
• USB storage: The option above can be combined with a third option which can also be used standalone: scan everything you want onto a USB key; password-protect it; and keep three such keys.
  • One with you, so that if you want you can give it to a doctor or hospital so they have access to everything including high definition original cardiac, MRI and other scans, plus lab results, 100+ page clinical records - whatever is needed! All you have to do is give them a one-time password.
  • One key at home with your partner/parents and you can either leave the password with them or tell someone else the password for additional security.
  • The third key can be very useful if you need to submit an insurance claim for past medical history to go directly to your insurer, and you get to choose what is released from the records you carry.

Tip – sealed envelope system: When storing confidential guest and crew medical records, captains can seal the documents within an envelope, store within the yacht safe and only open if required. When the guests leave, the records can be handed back, still sealed (this same system can be used with a sealed email address/drive and password or key drive).

A NECESSARY TASK

Whilst these steps can be feel like an administrative burden, it helps to make sure that the people who you go to see for a medical problem, know your medical history better than you can recall it yourself. It may also help avoid both the risks and costs.