Thursday, February 23, 2012

COMPUTER AS BLESSING AND CURSE

I have a question for you. A computer-genius friend is designing an electronic medical records system for a clinic—not only the hardware and software, but the entire setup. Where do patient and practitioner sit? When should record-keeping take place? How can practitioner view and enter material without it interfering with their personal contact?


I love EMRs. They provide maximum info quickly, ideally are retrievable anywhere, and don’t involve illegible scrawl. But as used, they can have drawbacks. Patients have lamented to me that their doctor no longer faces them, and instead shows them his/her back while typing on the laptop, as though the EMR is more important that their contact together. And I’ve heard from docs that some EMR software requires so much input from them that it steals time from their presence with the patient.


What’s been your experience? What do you recommend as a way to both keep a thorough, accessible record and a close therapeutic relationship? 

5 comments:

  1. Jeff,
    I've been the project manager for the initiation of the EMR at John's office; I'd be glad to talk to you about our experiences.

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  2. At UC Med Center, ophthalmology dept, rolly wheel chair for doc, who sits facing patient at 90 degrees from the screen, which is on a counter, distance is a comfortable 3 to 6 feet away. Data is entered with patient getting profile view of doc as data is entered, doc swings back and forth between facing screen and facing patient. Doc is excellent touch typist. Much of the data is entered by assistants attending the patient prior to arrival of doc. I suppose a surripeticious audio recording might allow doc to make a more complete record later. Doc can use keystroke macros, to speed things up. Hope this helps.

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    Replies
    1. Ooo. I like these suggestions, and will pass them on. Please keep them coming.
      Thanks,
      Jeff

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  3. My doc uses a setup that sounds like the one SkiTheStars describes. The computer is on a wall-mounted desk, monitor on a swiveling wall-mount. I sit in a chair at the end of the desk, back to wall. Doc sits on a rolling desk chair, usually at a 45 degree angle to the desk, so he can see both me & the monitor. NT takes my vitals & checks my med list before doc comes in. They email/fax prescriptions directly to my pharmacy during my appt. Orders for any work (e.g. Xrays, scans) are printed at a central station and wait for me at check-out. It doesn't hurt a bit that all the support staff are terrific!

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