Three ways health IT can improve the doctor-patient relationship
Years ago—on the heels of the HITECH Act of 2009 – I told a physician friend that electronic health records (EHR) were coming and he’d better get ready. They would be, I said, an irresistible force. He pish-poshed me. If EHRs were to happen, my friend said, he would be an immovable object.
It hasn’t worked out that way, at least not for him. Not only did he fail to repel the forces of the EHR, he – and probably many others in his profession – have made the least of the situation. And, unless they are prompted otherwise, they will continue to do so.
Here’s where health IT can do. And it involves the EHR or, more precisely, the computer and display screen on its periphery.
First, the problem. The EHR has met the basic goals set for it, allowing patient information to be electronically updated, stored, and shared with practitioners and, in some cases, patients. The EHR has done so, however, in a ham-handed way, wedging itself between the physician and patient.
In a commentary published in the November issue of JAMA Internal Medicine, a professor of medicine at the Indiana University School of Medicine, Richard Frankel, Ph.D., describes where physicians have gone wrong. During patient visits, physicians’ attention, he says, is on the screen, not the patient. This has gotten in the way of the physician-patient bond at precisely the time when the transition to value medicine has made forging this bond of inestimable worth.
Frankel proposes a model for improving the physician-patient relationship. One part involves physically turning the computer screen so patients can see what is being typed.
If doctors can’t look patients in the eye while they’re inputting information, patients should at least see what is being typed about them. But…why turn the physician’s screen when there is so much more to be gained by giving patients screens of their own.
First, providing screens dedicated to patients engages them in the care process. It builds trust. It might even instill a sense of awe at how fast the doctor can navigate the on-screen field of boxes. (Don’t underestimate the importance of this for either the doctor, who can take pride in the countless hours of “practice” that have gone into getting good at inputting data, or the patient who wants to believe in the superhuman powers of the person in the white smock.)
Second, a patient screen can be used to help explain the problem. If a CT, MRI or radiograph is available, it can be displayed. Patients will be amazed at what their insides look like, as they are either relieved that the problem can be seen or that there is no problem to be seen. Regardless, they will feel a little more certain that their doctors know what they are talking about.
The doc might show other data as well, for example, recent blood work that indicates a high cholesterol level. Data from values contained in past blood work might be graphed to those of the present to show a trend that needs to be altered, further driving home the point
Third, the screen can be used to show YouTube videos. Not just any videos. Ones that teach patients how to manage their conditions. IT staff might help by assembling links to different videos, priming the pump for physicians to find more of their own.
If your doc works in a sports clinic, you might consider a YouTube on how patients can wrap a sprained ankle. Or, if your doc has a sense of humor, maybe you want to throw in a link to a video illustrating the importance of handling a bruised ego. (Seriously, humor can be the best medicine). If your doc specializes in geriatric patients many of whom have breathing problems, a YouTube on how to operate an inhaler might be appreciated. (Don’t laugh – the finer aspects of operating one of these are seldom practiced.)
What better way to make physicians appreciate IT than to turn what was (and may still be) a bitter foe into an ally?