A portable medical record system consisting of a bracelet and wallet card, was given to two groups of ambulatory, chronically ill, mentally clear, older patients. Group 1 included 23 patients discharged from a skilled nursing facility and treated in the community; group 2, 24 patients attending the outpatient department of an acute general teaching hospital. Biweekly follow-up telephone calls to patients and subsequent discussions with physicians demonstrated the usefulness of this system in predominantly nonemergency settings. Overall, the physicians noticed the bracelet during 46% of the visits and the wallet card during 28%. Group 2 physicians, however, noticed the bracelet and/or wallet card more frequently than did group 1 physicians. Reasons for the difference in recognition among the two groups and the implications for future use of a portable medical record system for the elderly are discussed.