Guest posting by Charles Ho
When we go see a doctor, we expect a one-on-one conversation. However, increased digitization of medical records and clinical tools has made physicians more and more attached to the computer, even during a patient visit. While it can be easier to access and share patient information electronically, we also need to think about how physician computer usage affects the patient’s experience.
A common complaint expressed by patients recently is that physicians are not paying attention to them as they are sifting through information on the computer during a visit.1 As a student, I can get a sense of this frustration if I were to visit a professor during office hours and the professor would be reading notes off the computer when trying to explain a concept to me. I would not find this to be the most effective way to communicate when the professor is positioned behind a computer screen.
These situations have been studied objective and quantitatively. A recent study measured duration of eye contact during office visits between a patient and a physician.2 Their findings, as one may expect, indicate that the amount of eye contact a physician makes with the patient is significantly less when the physician is using the computer during the meeting.
However, an interesting observation in that study revealed that this decrease in eye contact duration was when the physician was sharing information from the computer to the patient in a passive fashion. If the physician were conveying the information and using the computer as an aid in an active manner, the eye contact duration was not significantly affected.
So this brings about the following question: How can we make computers more conducive to an active two-way conversation between patients and physicians? Because physicians struggle to utilize their electronic medical record systems in their daily routine3, it is an even bigger obstacle for such computerized tools to be effective for both physicians and patients simultaneously.
Thus, it is important to figure out how to incorporate computers as an aid, rather than an obstacle, to the one-on-one discussions between patients and doctors. Perhaps have the computer connected to a large screen that could be easily seen by the patient would be a start, as opposed to having the back of the computer facing the patient. In the long run, the user interface of computer software used in the clinical setting need to be revamped. We should make the interface less text-cluttered and have more visually appealing icons and diagrams, making it easier for patients to understand their health record. It is hardly useful to share information with patients from the computer if the content is incomprehensible to the patients.
These are just a few ideas that I propose, and ultimately, I believe that developments in technology will be a great asset for clinicians. However, these benefits can only be realized when we also think about the implementation process and how technology affects medicine from the perspective of the most important stakeholders, the patients.
REFERENCES
[1] Marte, J. “Why your doctor should put down the ipad.” MarketWatch. (2014)
http://www.marketwatch.com/story/why-your-doctor-should-put-down-the-ipad-2014-01-28
[2] Asan, O. et.al. “How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care”. Patient Education and Counseling 98 (2015). 310-316
[3] Verdon, D.R.. “Physician outcry HER functionality, cost will shake the health information technology sector”. Medical Economics (2014).
http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/ehr/physician-outcry-ehr-functionality-cost-will-shake-health-informa?page=full
Image credit: http://images.wisegeek.com/doctor-with-tablet-and-patient.jpg