7 Tips to Help Improve EHR Etiquette

It’s been a while since I’ve written, but only because my practice has been booming lately and I’ve barely had a moment to breathe here in DC.  But I’m back now, and for who knows how long given the waves tossing on the sea of digital medical practice!

Patient engagement continues to be one of the most common complaints about EMR software.  There was even a mention of the frustrations in a previous post on Happy EMR Doctor.  Many physicians say that it interferes with patient interactions and that now most of their time is spent looking at a computer monitor and updating charts.  This causes frustration for all parties – patients and physicians – because doctors did not sign up for computer duty when they went to medical school and patients expect a doctor’s full attention during visits.

Software Advice, a website that reviews medical software, launched a survey on how to improve doctor-patient interactions in the EMR era and the results are finally in.  See below for the top seven tips received on maintaining quality relationships:

1. Position your computer between you and the patient:  No brainer here.  Face the patient during interactions.  Take the time to plan where your equipment will go so that this possible.

2. Invest in mobility:  Whether it’s a small rolling desk, small tablets or other lightweight tools, choose equipment that helps you move around.  A laptop may cost an extra buck but can be worth the investment.

3. Delegate as much as possible:  The objective is to interact with the patient as much as possible.  Have staff members enter the medical history, medications, prior procedures, etc. prior to the patient’s visit so you don’t have to during the appointment.

4. Dictate as much as possible:  Talk with the patient while scribes enter the information or use dictation software.  These allow you to focus more on the patient.

5. Ignore the computer when you first enter the room:  Chat with your patient for a few minute before you start recording information in the digital record.

6. Ask about previous complaints:  If the patient information is pre-loaded, look over it before entering the room. If they have open complaints, ask them about the issues to close them out in the emr. This reaffirms to the patient that you care.

7. Finish the chart in the room:  This can help to answer any other questions that might come up so patients feel like they have been listened to.

All in all, EMRs take some getting used to.  Once a physician develops a rhythm with the software, every patient interaction becomes easier.  Focus on the tasks as they come, and remember, practice makes perfect.

About the author

Dr. Michael West

Dr. Michael West

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

2 Comments

  • With regard to #1: It often works to sit next to a patient and both look at the screen, like people working together on a project. This is particularly true for some aspects of chronic disease care where the EHR has lots of boxes and drop downs. The patient gets to know the system, you can often fly through the documentation, and have more time for care.

    With regard to #7: There are other reasons to do this, including accuracy and completeness (which fade exponentially with passing time), congruence between what you say and what you type for assessment and plan, and having the patient see all the work that is involved in the visit.

    I’d add #8: finish in the room and give the patient a copy of the note.

    P

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