EHRs in the Exam Room: Tips on Patient-Centered Care

The AAFP has a shiny new white paper with tips on how to use EHRs in the exam room.

They say “with a thoughtful approach, you can maintain your focus on the patient.” In their introduction they point out that most people talk about how to buy and deploy EHRs but that “minimal attention has been paid to understanding how family physicians use EHRs with patients in the examination room.”

I agree.

Here are the ten tips they mention in the white paper (many items taken verbatim, some with minor edits):

  1. Use mobile monitors. We recommend investing in either flat-screen monitors on mobile arms, tablet computers or laptop computers.
  2. Learn how to type and use a mouse and use Google and MS Word.
  3. Integrate typing around your patients’ needs — which means it is important to know when to push the computer screen away.
  4. Use templates for documentation, not for patient interviews, which require room for an open-ended narrative.
  5. Separate some routine data entry and health-care maintenance issues from your patient encounters. Until patients are able to complete forms online in your waiting room or at home, consider having office nurses or medical assistants enter basic information before you walk into the exam room.
  6. Rather than walking straight to the monitor following only a brief greeting, consider listening to the patient’s concerns before opening the screen to review the last visit’s notes.
  7. Tell your patient what you’re doing as you’re doing it. Try to keep talking as you go about the work of both searching for and entering data into the EHR.
  8. Use a finger, pen or cursor to guide the patient’s gaze when discussing data viewed on the monitor.
  9. Encourage patients’ participation in building their charts.
  10. Look at your patient. Patients deserve our primary attention.

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