Abstract Objective: Study whether real-time monitoring system of medical quality can improve the writing quality of medical record. Method: Reflectively analyze the writing quality of medical records in the total four years before and after the real-time monitoring. Inspect randomly 960 Medical records from before the monitoring and 24255 after it. Summarize and analyze these medical records in three aspects of timeliness, integrity and connotation. Results: Comparison of rates of reaching the standard of writing the medical records in operation: the rate of reaching the promptness standard increased from 79.4% to 85.2% (P<0.001), and the rate of reaching the integrity standard increased from 94.9% to 98.2% (P<0.001). The rate of reaching the connotation quality increased from 91.8% to 93.6% (P=0.114); in the second year of monitoring (2013), writing medical record in operation below promptness, integrity and connotation quality standards were mainly observed in critical cases with delayed progress note, incomplete admission record, and poor connotation quality of routine progress note, respectively; Influencing factors over the writing quality of medical records in operation include: gender, educational background, professional title and department of the record writing personnel. Conclusion: Medical quality real-time monitoring and control system is an effective method to improve the timeliness and integrity of medical record writing but has no obvious influence on connotation of the medical record writing.