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    Don't implode EHR use, improve it

     

    The EHR as an obstacle to patient-doctor interaction in the exam room is another common physician complaint. Interestingly, it rarely comes up as a negative comment in our patient satisfaction surveys. The EHR only need be an impediment to connecting with patients if we allow it to be, and the way we deploy it during a visit can make all the difference.

    First, we can introduce it and briefly explain to patients that we will periodically need to enter some information into the record. When reviewing test results, it can be helpful to share the screen with the patient to help clarify details and engage them in the discussion. We can document during a visit without appearing glued to the console—it requires “reading the room,” and knowing when the patient most needs our full attention, such as during a detailed description or sensitive emotional expression. Making good use of shortcuts such as smart phrases (commonly used sentences that populate the record with only a few keystrokes) can free us from excessive typing. Scribes are also an option, and gaining popularity.

    Thomas Edison said, “Just because something doesn’t do what you planned it to do doesn’t mean it’s useless.”

    I prefer to look at the EHR as a work in progress that requires the wisdom and creativity of physician leaders to gradually craft it into something that is an ideal tool to support our craft and improve patient care.

     

     

    2 Comments

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    • [email protected]
      "The EHR as an obstacle to patient-doctor interaction in the exam room is another common physician complaint. Interestingly, it rarely comes up as a negative comment in our patient satisfaction survey." I find that very hard to believe. Every day I hear patients complaining that the "last doctor put their head in the computer and never even looked up at me when I was speaking". It is not our job nor expertise to make the lousy EMRs work. I agree that they work very well for data mining. However they are next to useless in the exam room. Have you not read the data stating that "for every hour a doctor spend with patients that we spend 2 hours documenting" I don't know what EMR you use, but it must be better that what the rest of us are using. Perhaps you could teach us how to "improve" our EMR.
    • [email protected]
      But something that doesn't work IS useless. EHR impedes PATIENT care. It takes the focus off the patient and onto the computer. As a repository for information (what the chart historically is meant to be) a computer can be extremely helpful. As a mandated collector of useless information and clicking it is amongst the top reasons for physician disenchantment with the practice of medicine. As a billing modality, it is useful. My disgusting gripe with EHR is I am forced to use it in a manner which helps neither my patients nor myself. Let me use the computer as I see it being useful; you, Dr. Millstein, use the computer as you find it useful. We are not the same, but the powers that be are trying to make us that way. As far as "value as a tool for tracking our adherence to clinical best practice..." seriously? I would rather my being able to take care of my patient, follow clinical best practice and not have attorneys/insurance/government looking into my computer for reasons to deny care, not pay for care, or find a technicality for suing me. Wouldn't you? Can you not do your best for your patient without such a monstronsity of useless information that is inserted into your every note?

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