Do Your EHR Manners Turn Patients Off?

Paul Cerrato, MA

Disclosures

September 17, 2013

In This Article

Location, Location, Location

Like several other experts on EHR usability, Lopez emphasized the importance of putting the computer in a strategic location. Placing it in a way that allows you to see both the screen and the patient at the same time eliminates the need to turn your back to document care. Some practices even put the monitor or tablet on a swivel arm so that it can be easily seen by the patient and used as a teaching tool. Several clinicians like to show patients EHR-generated graphs of their blood pressure or blood glucose readings over time to show them their progress, for example.

Despite these practical suggestions, some clinicians find e-documentation during an office visit to be a poor fit for their practice. In cases like this, Martich suggested scribes as a possible solution to help ease the disruption that comes from working with computers. An assistant in the room can document physical findings as the doctor does her assessment, freeing her from typing completely. In specialties in which there's a high volume of patients and the need to document lots of precise numerical data -- ophthalmology, for instance -- that approach seems to work well.

What About Patient Satisfaction?

You can't expect all your patients to automatically embrace your EHR system or see its benefits. That may take some extra patient education. The Office of the National Coordinator for Health Information Technology (ONC) suggests mentioning these benefits:[3]

Less waiting time for office appointments and better appointment scheduling;

Faster turnaround time responding to billing and clinical questions;

Access to clinical guidelines for physicians, which help keep them up to date on new research;

Access to their own patient data; and

Better management of prescriptions through e-prescribing software.

Of course, whether you talk up any of these advantages will depend on whether your practice has been able to deliver them.

ONC also offers a patient satisfaction tool to help you find out how patients as a group feel about your digital records system.

In a recent interview with Medscape, Manas Kaushik, MD, ScD, from Boston Medical Center, emphasized the importance of patient satisfaction, with one caveat. "There is a lack of high-quality randomized controlled trials to assess the impact of electronic medical records (EMRs) on patient satisfaction, which should not be surprising, given that the promise of EMRs is to improve efficiency and information interexchange and not necessarily patient satisfaction."

Despite this lack of data, clinicians with experience in training physicians on how to use EHRs emphasize the need to bolster patient satisfaction. Robert Budman, MD, CMIO, at Yuma Regional Medical Center in Yuma, Arizona, says one way to build such patient satisfaction is to incorporate AIDET into your daily practice.[4]

This communication-building protocol -- which stands for Acknowledge, Introduce, Duration, Explanation, and Thank you -- is being adapted by many customer-oriented industries and a few forward-thinking healthcare organizations.

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