2. The time demands of EHR data entry
Health information technology tools such as electronic health records (EHRs) have the potential to significantly improve care delivery and patient outcomes. However, physicians who have adopted EHRs continue to struggle to effectively use these systems because of the difficulty of dividing their time between the patient and the computer.
The average physician spends 30% to 50% of a patient encounter looking directly at the EHR, with the majority of that time spent typing in an office layout that does not allow the patient to remain engaged through screen sharing, according to 2013 research from the Journal of General Practice.
Thus the question has become: How can physicians find a balance between EHRs and satisfactory patient engagement? One solution is to use scribes, as Jerry Hizon, MD, told Medical Economics earlier this year.
“The key to a good EHR is the minimal touching of keys,” says Hizon, the owner of Motion Sports MD, a primary care practice in Murrieta, California.
Hizon says the scribe’s responsibilities are to update the patient’s medical records since his or her last encounter and determine the purpose for the patient’s visit.
After presenting the information to the physician, the scribe transcribes the physician-patient encounter through a combination of free typing and completion of pre-made templates. The scribe also documents all procedures performed in the office, new imaging and/or laboratory results and any notes from outside physicians.
Melissa Lucarelli, MD, a solo primary care physician in Randolph, Wisconsin and Medical Economics Editorial Advisory Board member Medical Economics Editorial Advisory Board member says that before entering the exam room she:
Studies the patient’s data and history to make sure she has the basic knowledge she needs to avoid relying on the computer;
Copies and pastes the patient’s history in her EHR to get a head start on the note before seeing the patient; and
Uses laptops on carts, which lets her position herself to look the patient in the eye regardless of the layout of the exam room.
“Ideally, your EHR would become invisible, but what I’ve set for myself as the sort of gold standard for the computer in the room, is to make it as unobtrusive as a paper chart,” says Lucarelli.
For more on overcoming EHR-related issues, visit bit.ly/18-EHRs