Look at the Patient or the EHR Screen?
Technology has brought countless innovations to the practice of medicine. But each innovation comes at a price. In the case of electronic health records (EHRs), that price is distraction during the patient-physician interaction.
Patients value the attention you give them during an office visit. In fact, often it's the only time someone pays close attention to their physical and psychological needs. It's not surprising, then, to hear some complain when they have to share you with a third "person" in the room.
Taking a patient history while sitting in front of a laptop, filling out check boxes, and navigating drop-down menus often forces doctors to pay more attention to the screen than to the patient sitting in front of them. Patients notice that.
And make no mistake about it: With all of the new meaningful use regulations, computers are becoming a major presence in the exam room. How you handle that presence will determine whether the computer disrupts the doctor-patient relationship or supports it.
"It really is like having another person in the room, and that does not enhance the patient-physician interaction." says Dan Martich, MD, Chief Medical Informatics Officer (CMIO) at the University of Pittsburgh Medical Center (UPMC). That conclusion was based in part on his participation in an experiment in which physicians, patients, and computers were put in the same room and videotaped.
One nontechnical solution is to "make the computer part of the conversation" says Martich. As he goes through the process of entering a medication history or documenting allergies, for instance, he explains to the patient, "UPMC has spent a lot of money on electronic health records. Let me show you how the tool can help me care for you in a more engaged way." On the other hand, telling patients, "Pardon me as I type in all this information and turn my back on you" is not the best approach, says Martich.
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Cite this: Do Your EHR Manners Turn Patients Off? - Medscape - Sep 17, 2013.