“I just hate it,” the elderly patient complained to us about her GP. “He comes in the [exam] room and goes straight to that computer without even looking at me.” (This is a true story, by the way.) “The doctor is friendly enough, I suppose, but it’s like I’m playing second fiddle to the computer thing. I don’t think he knows he’s doing it, but I just hate it.”
As Electronic Medical Record (EMR) systems become increasingly common, they deliver significant benefits to patients, doctors’ offices, hospitals and health systems. But when patients feel that the computer is getting more “face time” than they are, patient experience and satisfaction are likely to suffer.
Unfortunately, this downside to technology is common. The Journal of the American Medical Association (JAMA) recently published a child’s drawing of a family in an examination room. The physician is pictured facing his computer and his back to everyone else. The clear implication—apparent even to the child—is that the doctor isn’t relating with his patients in a meaningful way.
For study purposes, trained observers followed interns during a “call” day on general internal medicine wards at a VA hospital. Their findings, published in the Journal of General Internal Medicine, revealed that 40 percent of intern time (the largest proportion) was given to clinical computer work. Only 12 percent of their time was spent at the bedside.
Surprisingly, with these doctor-patient relationship challenges, the majority of patients are supportive of the EMR technology. Some 78 percent of patients believe that EMR helps the doctor provide better care, according to a GfK Roper survey. What’s more, patients are eager to get e-mailed appointment reminders, have their prescriptions sent electronically and view appointments online.
The picture that emerges is that everyone likes the benefits and advantages of the technology, but patient satisfaction suffers from user “bad manners.” Of course every clinical situation and office arrangement is different, but it’s important to be sensitive to a possible problem from the patient’s perspective.
Organize solutions that contribute to, not detract from, the patient experience. Here are some general idea starters to being the process:
- Be aware that the computer in the room—where it’s located and how it’s used—might be a problem.
- Organize exam rooms so that the computer doesn’t create a barrier between provider and patient.
- Consider an agenda for each encounter to concentrate on the patient and the conversation first.
- Ask the patient’s permission to use the computer (or gently apologize).
- Explain how EMR and/or note taking is beneficial to the patient and the care team.
- Verbalize what you’re doing on the computer and invite patients to confirm or comment on what’s being said or entered.
- Share the computer screen with patients to remove the mystery and allow them to see their own information, lab report, list of meds, etc.
Better, smarter use of technology can have strong benefits for everyone.
Technology is making a strong contribution to positive patient experience and medical outcomes. When used in better, smarter ways, it can only serve to enhance the doctor-patient bond and improve patient satisfaction.
“While the realities of running an efficient practice can’t be ignored, people certainly can’t [feel minimized],” said Howard J. Luks, MD. “Technology has broken down barriers to allow doctors to see patients as people and to celebrate them as such.
“When all is said and done, what really matters to any human—physician, patient or otherwise—is that they mean something, and that they are treated with respect and dignity.”