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EMRs and Physician/Patient Communication

By April 20, 2010Commentary

In an era when physicians typically feel very rushed getting through their patient appointment schedule every day, maximizing the face-to-face interaction is important.  How physicians interact with other doctors and clinical staff regarding a patient’s care also has a significant bearing on the quality of care.  Electronic medical records could make patient and staff interactions more productive and efficient but they could also cause loss of some hard to categorize patient information.  The emotional content of any communication are sometimes its most important aspect.  An Issue Brief for the Center for Studying Health System Change looks at the impact of EMRs on communication.  (CSHSC Issue Brief)

The authors interviewed a small number of physicians and some EMR experts about the technology’s potential effect on patient/physician and physician/physician or staff communication.  On the positive side, physicians believed that the rapid access to stored information allowed them to better prepare for a patient interaction.  They also felt that an EMR’s email and instant messaging tools could create more efficient staff communication.  On the negative side, using the EMR could distract from paying attention to the patient and could lead to only collecting the information the EMR prompted.  It also might prevent valuable personal interaction with colleagues and staff.  There also is a dangerous assumption that EMR information is always accurate.

Some suggestions were to view the EMR in a shared manner with the patient and go over the information to verify its accuracy and completeness.  Physicians are also encouraged to define appropriate EMR-based communication with and among staff and what should be done in person or by phone.  Doctors need to be trained and sensitive to the non-verbal aspects of communication with patients.  Most physician interactions provoke some degree of anxiety in a patient and empathy for that anxiety and other patient emotions can play a role in better outcomes and patient satisfaction.  Close observation of a patient can lead to important information regarding their condition.  EMRs could be the classic example of more communication but less “hearing” if not used properly.

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