Will increasing technology in the exam room have a dehumanizing effect on the patient physician relationship? Maybe not.
Mike Magee, MD, a former senior fellow in humanities to the World Medical Association and a recognized leader in healthcare politics, believes that if physicians were to fully embrace and use technology to its fullest capabilities, “our healthcare system would transform and re-center around relationship-based care, cementing the people to the people caring for the people.” This is the concept of techmanity—or the mutual advancement of technology and humanistic values.1 (Editor’s Note: “Health Politics with Dr. Mike Magee,” www.healthpolitics.org, is supported by the Pfizer Medical Humanities Initiative.) Techmanity uses technology to produce better care that is uniquely tailored to each patient. A few simple steps can promote techmanity in your own practice and will allow you to embrace both technology and the essential patient–healthcare provider connection.
It is important not to lose sight of your patients’ needs and perceptions of quality care in the excitement surrounding electronic medical record (EMR) adoption and implementation, as patients may initially feel that there is an uninvited third party in the exam room. Put your patients at ease by involving them in the implementation process. Take some time at the start of a visit to explain the purpose of the EMR and its benefits to patients, and to answer any questions they may have. An informed and involved patient will more likely be tolerant and understanding if the “go-live” phase slows visits. Using the EMR to print educational material, care plan documentation, and a visit summary can further reinforce the benefits of the EMR to the patient by giving him or her an immediate, physical representation of EMR capabilities at the point of service.
As patients become accustomed to the presence of the EMR, they will more likely relax during office visits. However, some patients will struggle with this more than others, and many patients will still feel that they are competing with the EMR for the physician’s attention—especially during data entry. Initiating discussion through open-ended questions during data entry will show your patients that you are able to conduct the exam and enter data simultaneously, demonstrating the EMR as an active tool in their care.
A strong patient–healthcare provider bond should be established prior to EMR data entry and reinforced through an environment conducive to open communication. The physical arrangement of the exam room should always focus on patient contact, not your new EMR. Initially, you may be tempted to walk into an exam room and place your tablet PC on a corner desk and then shift focus to your patient. This arrangement will most likely place you in a position where you must choose between maintaining contact with the patient or turning to the tablet to enter data, leaving your back to the patient. Avoid this issue by planning or staging your exam room ahead of time. If you have individual monitors for each exam room, consider mounting the monitor to the wall with an extendable arm that will move with you. If you will be using a laptop or tablet PC, look into purchasing a movable cart that can be positioned for maximum effectiveness.
The most important part of introducing your new EMR to your relationships with patients is timing. You should be fully prepared and comfortable with the EMR applications and data entry before involving it in the relationship. The patient does not expect you to be an expert, but they do want to see confidence with the tools being used. If patients see the physician fumbling with the system or displaying any frustration, they are likely to lose confidence in your abilities and grow to resent the intruding EMR.
If implemented properly and used to its fullest capabilities, the EMR will become a natural part of your patient encounter and will recede into the exam room environment. Successful EMR adoption can help you to access information more quickly and easily may allow you more time to build the patient relationships that will lead to more effective and efficient care.2
For additional information on EMRs and other office technology, contact Itara Barnes, ACR’s practice management specialist, at (404) 633-3777, ext. 819, or [email protected].
References
- Magee M. Humanizing and revolutionizing medicine through technology. Feb. 13, 2008. Available online at http://healthcommentary.org/public/item/197363. Last accessed April 3, 2008.
- Shortliffe EH. Doctors, patients and computers: Will information technology dehumanize health care delivery? Proc Am Philos Soc. 1993;137(3):390-398.
