The clinical value of e-records and other e-health tools has been argued for years, but one of the lesser discussed issues is what impact they have on the art of general practice.
As GPs everywhere will tell you, making a diagnosis is only part of the job – being able to connect with patients is just as important.
So three US academics decided to find out how e-records affect doctorpatient interactions.
The two researchers from Brown University in Rhode Island, plus a hospital consultant, surveyed 2500 doctors and asked them what they thought — and plenty of their observations will resonate with Australian GPs.
“It is like having someone at the dinner table texting,” one doctor described the act of taking patient notes on a computer during a consult.
“It takes 90% of the time that would otherwise go to the patient,” said another.
Some doctors said they didn’t update computer records at all during a consult.
“I do not use electronic health records when I am with patients. I have tried this in other settings and it degrades the quality of my interactions. It’s rude as well.”
“I can’t stand typing instead of making eye contact with a patient,” one doctor said.
“The art of medicine and treating is lost in this process,” said another, summarising the views of many.
If the use of computers during consults does undermine the doctorpatient relationship, what can GPs do to fix this, aside from chucking their monitor out the window?
The researchers, writing in the Journal of Innovation in Health Informatics, have a few suggestions:
- Asking patients to look over your shoulder so they can see what you’re doing
- Learning to touch-type so eye contact can be maintained
- Honouring the ‘golden minute’ by engaging totally with patients the minute they walk in the room, rather than waiting for them to sit down before looking up to greet them.
E-records weren’t all bad though when it came to the doctor-patient relationship. Some of those surveyed said taking electronic notes gave them the opportunity to show patients images, notes and results.
“I love showing Google images to patients in the office for the purpose of patient education. I save meaningful graphic representatives with which to teach,” one doctor revealed.
And it was this positive attitude that shone through, with the doctors widely acknowledging that e-health records were here to stay and they would need to adapt their work and workflow accordingly.