Over the years, medical practice and healthcare facility have gradually shifted to using EHRs (electronic health records) or EMRs (electronic medical records). This shift to digital records was mandated by the Health Information Technology for Economic and Clinical Health Act or HITECH (2009) and strengthened by the Affordable Care Act or ACA (2010). There are always challenges when selecting a new EHR system, with every system offering positive and negative benefits. But once your medical office has learned how to use the new EHR interface, absorbed the implementation cost and even worked through any interoperability issues — the hardest part is now behind you. Right? Your office can now enjoy the efficiency benefits that a good EHR system provides. However, there is a new problem. Some of your patients do not like your EHR. At first glance, you may like that these patients are only concerned about security and privacy issues. After all, the electronic medical records for major health systems have been breached by hackers in recent years. For example, in 2015 over 4.5 million health records were hacked at UCLA Medical Center.
But this is not the main reason. A surprisingly common criticism from patients about EHRs is that the healthcare provider spends too much time on the EHR device. Physicians are accused of spending less time engaging with patients and more time looking at a computer screen and inputting information. Computer interfaces, databases and data entry are an everyday occurrence in modern healthcare. Yet, healthcare providers and their patients should not have to feel like the EHR device is an enemy. New medical technologies should aid and not hinder your workflow.
Here are 5 quick tips that health professionals can use to improve the doctor/patient relationship when using an EHR or EMR device.
Tip #1 – Mobile and Flexible:
In the quickly-changing world of the internet technology, non-mobile desktops are falling out of the favor. Smartphones, laptops and tablets are increasingly more popular, with a similar trend occurring in EHR systems. Mobile technology is excepted in a modern medical office or healthcare facility. This could mean placing a heavy laptop on wheels, using newer (lighter) tablets or simply placing an extendable arm on a desktop’s monitor. The primary goal is to place the computer screen where you, and if needed, your patients can see it. The ability to swivel or flip a computer screen around so that the patient can see x-rays, diagrams or charts is invaluable. Migrating your hardware to a more mobile-friendly option may seem expensive and even unnecessary. After all, if it is not broke, why fix it (spend money on it)? However, having office equipment that makes you look like a technological dinosaur will not cast you in the best light with your patients. In the long-run, investing in transportable devices will also give your office a more up-to-date, technology feel.
Tip #2 – Make the patient the center of attention:
In any face-to-face social interaction, it is never pleasant to talk to someone’s back. The same social graces apply to physicians and patients. The patient is the center of attention, not the EHR device. A good piece of advice is to ignore the computer monitor when you first enter the room. Healthcare professionals should initiate and develop a conversation with the patient. Once there is some level of understanding as to why the patient is seeking treatment, then you can shift the focus to the EHR system. Ideally, this means that any computer screen or monitor is positioned between the healthcare provider and the patient. Placing a monitor against the wall may save office space, but this can encourage poor patient engagement. Some possible solutions are to make sure that computer screens and keyboard are positioned in a way that lets you face the patient. This will discourage any tendency to turn your back on the patient and not maintain good eye contact. Patients can even be invited to view their own medical data with you so that they are more engaged in their own healthcare. This is as simple as sitting next to your patient and sharing the computer monitor with them.
Tip #3 – Leverage your staff and new technology:
When a patient is in the room, the focus is on them and not computer screen and keyboard. One way to demonstrate this focus to your patients is to spend as little time as possible entering data when they are present. In order to accomplish this, healthcare providers should have nurses or physician assistants pre-enter as much as possible of the patient’s history of present illness (HPI). By delegating this task, it will allow you to quickly review the HPI before you enter the room. So before seeing the patient, you should have some level of knowledge about the patient’s medical history as well as possible diagnoses and treatment plans. Time is also saved by using a good dictation software. These software applications have improved greatly over the last few years. Dictating your notes is usually always faster than typing and can accelerate a physician’s workflow.
Tip #4 – Include the patient as you finish the chart:
In the modern healthcare environment, patients are often concerned that they did not receive enough time and attention from their healthcare provider. One possible solution to this problem is to finish the EHR chart with the patient in the room. This allows your patients the opportunity to add details, ask questions as well as make sure they understand the diagnosis or treatment. If the healthcare provider has already previewed the HPI before entering the room, this task is much easier. A provider can ask about their patient’s history of prior injuries or chronic conditions and if any of these issues still persist. In some EHR systems, past encounters are left “open” in the system. During this step, you can hopefully close these encounters and reinforce the doctor-patient relationship by showing your patients that you are actively engaged in their healthcare. Using a good dictation software will speed this process up while allowing the patient to hear your voice as you enter information. Closing the chart with the patient present also discourages “copying and pasting” patient data from one patient note to other notes, which raises potential legal liabilities.
EHRs and EMRs can greatly improve productivity, but they need to become a logical part of your workflow. These systems should benefit and not hinder your patient interactions. Although there is a learning curve when using EHRs, once you familiar with the system and know how to use them, they should make every patient interaction easier.
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EHRs, Patient Engagement, Electronic medical records, EMR