Objective: To study whether real-time monitoring system of medical quality can improve the writing quality of medical record. Methods: We reflectively analyzed the writing quality of medical records in the total four years before and after the real- time monitoring, and inspected randomly 960 medical records from before the monitoring and 24 255 after it. Then, we summarized and analyzed these medical records in three aspects of timeliness, integrity and connotation. Results: Before monitoring, the respective up- to- standard rates of timeliness, completeness, connotation of medical record were 79.4%, 94.9% and 91.8%, respectively. After monitoring, the respective up- to- standard rates of these three indicators were 85.2%, 98.2% and 93.6%, respectively. The timeliness and integrity of medical record showed a significant difference (P < 0.001), but connotation of the medical record writing (P=0.114) had no noticeable change. After monitoring, with time passing, the up- to- standard rate of integrity increased as a whole, the rate of connotation increased mildly, and the rate of timeliness increased first and then decreased. In 2013 after the monitoring, substandard of medical record timeliness mainly concentrated in superior doctors’ records of their first round, surgical security verification records, and hospital admission records. In 2013 after the monitoring, substandard of medical record integrity mainly concentrated in hospital admission records, 24 hours admission and discharge records, and surgical records. 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.