Focus on the Patient, Not the EHR

There are aspects of the EHR that patients love. That’s why putting yourself in the patient’s shoes can help keep the focus on the patient during their visit, said Mitch Morris, a physician as well as vice chair and global healthcare sector leader at consulting firm Deloitte and former chief technology officer at MD Anderson.

For example, patients love ePrescribing and they love that their doctor has all of their lab results and tests right in front of them in the EHR. Another benefit to having the EHR in the exam room is it allows the doctor to review with the patient in real time what happened during their previous visit, putting the doctor and the patient on the same page, said Morris.

Still, having the EHR in the exam room can introduce disruptions to the patient-physician interaction, said Morris. One very practical way of handling this is for the physician to document a few notes from the patient visit, while the patient is with them in the exam room, and then document the visit more fully after the visit. “There’s a lot of time pressure that’s really pushing physicians to try to [document care and treat the patient] at the same time,” he said.

If the physician chooses to document care in the EHR during the patient visit, it’s important to remember to pause, to make sure that the patient is listening. That human interaction is just as important to the physician as it is to the patient, said Morris.

One of the challenges is many physicians don’t have much control over the EHR they use, he said. And even when they do get to choose their EHR, physicians often don’t realize how important it is to configure the software and change their work flow to optimize their time with patients, added Morris.

Keeping the patient as the central focus of the visit will always be the best route to take, he said, and he provides a personal example: Morris’ doctor starts off his visit with some open-ended questions, during which time his doctor is just listening to him and not typing at the computer. After that conversation, Morris’ doctor starts to run through some more routine questions - such as how much alcohol he drinks, how often he exercises and his weight - and then his doctor enters that information into the EHR in real time. His doctor will typically end the visit by confirming prescription refills, which are already at Morris’ local pharmacy before he leaves his doctor’s office.