There's an interesting article in a recent issue of the Connecticut Mirror about the impact of EMRs on the patient-doctor relationship. It starts out with one patient telling a solo-practicing general surgeon that she's glad the surgeon doesn't have an EMR because the physicians spend more time on the computer than with the patient.
This type of distraction - the third person in the examining room phenomenon - is not a new complaint. I can attest to experiencing such a visit with my nurse practitioner a few years ago when my physician practice implemented the EMR system that its parent health system uses. It's important to note that I have always had a good relationship with the one practitioner who had a steep learning curve with the EMR when I first visited following the initial implementation. It was clear that she would be spending a good deal of time inputting data long after the patients had left the visit, which means she was going to be working extra, what with the disruption to the normal workflow. This was to be expected, and even she had made mentionof that.
Was it a distraction? Absolutely. Did it impact our patient-clinician conversation? Yes. By the same token, it didn't change our usual rapport. She was still attentive to my needs and even more so because she asked more questions than usual, which was prompted by the fields in the EMR system.
Patients are going to have varying experiences with their physicians when the physicians implement EMRs. One of the interviewees in the article commented that the industry needs physician training on how to use EMRs and still communicate with their patients. There's a definite need for this kind of training.
One thing patients and physician are going to have to take into account is the physician's personality. Some physicians may have a go-with-the-flow personality or are very personable, which may help them maintain a close relationship with their patients. It's going to be different with every physician and has everything to do with their confidence level and tolerance with change, their comfort level with technology and many other factors.
To say that all physicians will be hunched over their laptops tapping away and ignoring their patients just doesn't hold water. It will take a while for physicians to get used to EMRs, and it wouldn't hurt to get some training in this area. Some may never make the adjustment. Perhaps patients would do well to query physicians on their comfort level with EMRs and choose according to the responses. Perhaps that is what should be done, especially given that the industry is heading in that direction anyway, regardless of whether you're on board or not.
Photo by Seattle Municipal Archives courtesy of Creative Commons license.
