Do Your EHR Manners Turn Patients Off?

Paul Cerrato, MA


September 17, 2013

In This Article

Some Doctors Will Still Alienate Patients

To some extent, physicians who are less socially skilled to begin with will continue to alienate patients when this third party comes into the room, says Martich. Physicians who have honed their communication skills and have developed an easygoing style of interacting with patients before EHRs entered the picture have had a relatively easy time incorporating electronic data entry into their practice. Conversely, those less skilled at collecting data while interviewing patients in the paper world "also had additional difficulties using the computer as an interpersonal communication tool," according to a study reported in the Journal of General Internal Medicine.[1]

Apparently, enough patients have complained that the distraction is interfering with the doctor-patient relationship that the American Medical Association (AMA) has deemed it necessary to issue a policy statement addressing the issue.

The policy, based on recommendations in a AMA Board of Trustees report,[2] states that the association will "make physicians aware of tips and resources for effectively using computers and electronic health records (EHRs) in patient-physician interactions through AMA publication vehicles." It also encourages physicians to put questions about EHRs into patient satisfaction surveys to "provide feedback on how their own patients experience the use of computers in the examination room."

The original AMA Board of Trustees report that led to adoption of its policy on computers in the examination room also pointed out that removing barriers, installing mobile monitors, and setting up the examination room so that one can make eye contact with patients while working on the computer can help maintain the interpersonal relationship that many patients crave.

Some Techniques That Help

Incorporating the laptop into the conversation can sometimes be as simple as "Here are the labs I got from your last admission -- let's go over them together; or, Here's what the x-ray of your ankle looks like," says Martich. A tablet computer in particular can be quite useful for sharing images, but Martich believes that its small screen isn't ideal for sharing text information on medications, for instance.

Unfortunately, not all clinicians find it easy to bring the EHR into the conversation. If a doctor doesn't really like working on a computer and starts off the visit saying, "I have to do this and I hate it," the patient-doctor relationship will suffer, says Norma Lopez, DO, a family physician at the Lynn Community Health Center in Lynn, Massachusetts.

Lopez, who also heads up Physician-to-Physician EHR Strategies for the Healthcare Information and Management Systems Society (HIMSS), has spent a good deal of time training colleagues on using an EHR in a multispecialty practice. That experience has taught her that physicians who did well handling paper documentation and completing it on time tend to do better when they switch over to e-records.


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