Does your doctor look at his computer a lot? That’s not all bad.
Electronic medical records are time-consuming, to be sure. But they also can prevent serious errors and improve care quality.
When a new innovation comes on the scene, it is not unusual for it to generate some negative feelings, hence the term “disruptive technology.”
The entry of the computer and electronic health record (EHR) into the exam room has created some new challenges for doctors and patients. Doctors struggle to balance our attention on patient conversation with the need to document and enter data. As a patient, this may feel as if the doctor is distracted, or more interested in the keyboard and screen than in you, the patient in the room. Although we need to acknowledge these frustrations, it is important to point out the many ways in which the EHR may improve the quality of your health care.
The EHR’s greatest asset is storing and organizing vast amounts of information safely in one place. Records are no longer lost, misfiled or destroyed, and poor handwriting is no longer an issue, making for clearer communication and safer prescribing. Your doctor can accurately keep track of your health history and medications, quickly access test results, and correspond much more easily with other clinicians whom you see. The EHR can also be data-mined for trends or gaps in your care, such as suggested vaccinations and screening tests such as mammography and colonoscopy. Patient portals are an opportunity to view parts of your medical chart and test results, and exchange messages with your care team.
Some providers complain about the EHR, but don’t take that to mean that they are pining for the old days of paper charts. Many of us are not skilled typists, and tasks in the record are often cumbersome, requiring awkward navigation and multiple mouse clicks. You may find that some offices employ “scribes” – assistants who trail from room to room doing EHR data entry, freeing the clinician to focus more on the patient. This can work nicely for some, but I prefer not to have a third party in the office setting where I am addressing sensitive issues with patients I have worked hard to develop a trusting relationship with. It takes some extra work, but hands-on input from clinicians is important to help the EHR evolve from disruptive to efficient.
Best practices are being developed to help doctors weave the EHR into our exam room routine without sacrificing rapport with our patients. Personal patient interactions are always paramount, yet we will need to engage the keyboard and screen from time to time. I hope my own patients will tell me if they think this is too much of a distraction, and I’ll do my best to adapt. It is a work in progress.
Jeffrey Millstein, M.D., is a primary-care physician and patient experience champion for Clinical Care Associates of Penn Medicine.