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    Tips on how to put patients before electronic paperwork


    Each physician needs to learn their own best way for managing the EHR during encounters. Ende, for example, says he never types on a computer during patient examinations, instead jotting a few notes while focusing on the patient.

    “I will take a history for a new patient the old-fashioned way: with a pad of paper on my lap, making good eye contact and being able to appreciate the patient’s body language,” he says.


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    He enters lab orders, billing information and similar data into the computer, but typically dictates the narrative portion of the patient note to a staff member. Ende, who is also professor and assistant dean at the Perelman School of Medicine at The University of Pennsylvania, admits that’s a rare method for today’s physicians but says it’s the way he feels he can best connect with patients.

    Melissa Lucarelli, MD, a solo primary care physician in Randolph, Wisconsin, says that before she walks into the exam room she studies the patient’s data and history to make sure she has the basic knowledge she needs to avoid relying on the computer. Also, she will copy and paste the patient’s  history in her EHR to get a head start on the note before the upcoming encounter.

    “Ideally, your EHR would become invisible, but what I’ve set for myself as the sort-of gold standard for the computer in the room, is to make it as unobtrusive as a paper chart,” says Lucarelli, a Medical Economics Editorial Advisory Board member.

    Lucarelli uses laptops on carts in her practice, which lets her position herself to look the patient in the eye regardless of the layout of the exam room. 


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    Dias works in a similar way, doing as much prep work as possible before walking into the room so that he can focus on connecting with the patient. He studies the patient’s history, including what preventive care screenings the patient needs and what lab orders or tests are likely, based on the patient’s conditions.

    “You are essentially walking into the appointment with some good background knowledge and really already knowing what you want to do,” he says. 

    Building bridges with technology

    The EHR need not be a barrier: It’s also a tool to potentially increase patient engagement.

    Next: Growing patient satisfaction and involvement


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