In a recent JAMA issue (2012;307(23):2497-2498), author Elizabeth Toll, MD, shares a poignant patient example of the “Cost of Technology.” Illustrated by a pediatric patient’s colorful drawing for her doctor, the patient is on the exam table with her parent seated nearby, and the physician is pictured behind her, back toward her, and head buried in a computer.
Revealed is the fear most providers have about adopting an electronic health record (EHR)–the loss of patient interaction. Dr. Toll makes some very valid arguments in her essay: first, that the connection between and physician and his or her patient is established best by face-to-face interaction; second, “picking and clicking” has replaced internalized learning; and third, written notes are easily corrected after the patient leaves, but documenting in a computer seems more unforgiving. Thus, physicians tend to focus more on the computer than the patient in order to prevent a wrong click from becoming an irreversible mistake.
As an electronic health record analyst, I would like to disagree with Dr. Toll’s points, but I can’t. There are certainly some drawbacks to having an EHR; specifically, the loss of connection between patient and physician. However, there are numerous advantages, and as Toll goes on to write in her essay, there is no use fighting the system. In fact, she challenges her fellow physicians to “embrace technology to help us consolidate and organize data and communicate with colleagues for the benefit of patients and ourselves” (2498).
While it may seem defeating, even daunting, resistance is futile. Fighting a system that could (will?) eventually get better can only cause more anguish for the resistor and further delays in improving EHR design.
Toll concludes with reminders–of how lucky healthcare providers are to care for patients like the young artist and to work with physicians like the young provider she describes within her essay. Of how human we all are and how important the human connection is when facing new challenges, including the electronic health record. She states, “If we take time to connect with one another and draw strength from listening, learning, teaching, and caring we can join together to find ways to take on new challenges” (2498). Meaningful use, in theory, was put into place to help improve patient care, not deter it. Of course, it’s a work in progress, and the way I see providers taking on Dr. Toll’s challenge is not to refuse to participate (because patients still need care), or to complain or grumble (because complaining and grumbling makes everyone miserable), but to start voicing thoughts, ideas, and opinions on how to improve system.
From an analyst’s perspective, we appreciate ideas and feedback. When something isn’t working, tell us. When you have an idea that could make the system more user-friendly, tell us. If a meaningful use requirement doesn’t really make sense for your scope of practice, get involved in government policy.
Obviously, a challenge is never easy, but if providers, administrators, analysts, and policymakers can work together, perhaps one day the EHR truly will be meaningful.
Revealed is the fear most providers have about adopting an electronic health record (EHR)–the loss of patient interaction. Dr. Toll makes some very valid arguments in her essay: first, that the connection between and physician and his or her patient is established best by face-to-face interaction; second, “picking and clicking” has replaced internalized learning; and third, written notes are easily corrected after the patient leaves, but documenting in a computer seems more unforgiving. Thus, physicians tend to focus more on the computer than the patient in order to prevent a wrong click from becoming an irreversible mistake.
As an electronic health record analyst, I would like to disagree with Dr. Toll’s points, but I can’t. There are certainly some drawbacks to having an EHR; specifically, the loss of connection between patient and physician. However, there are numerous advantages, and as Toll goes on to write in her essay, there is no use fighting the system. In fact, she challenges her fellow physicians to “embrace technology to help us consolidate and organize data and communicate with colleagues for the benefit of patients and ourselves” (2498).
While it may seem defeating, even daunting, resistance is futile. Fighting a system that could (will?) eventually get better can only cause more anguish for the resistor and further delays in improving EHR design.
Toll concludes with reminders–of how lucky healthcare providers are to care for patients like the young artist and to work with physicians like the young provider she describes within her essay. Of how human we all are and how important the human connection is when facing new challenges, including the electronic health record. She states, “If we take time to connect with one another and draw strength from listening, learning, teaching, and caring we can join together to find ways to take on new challenges” (2498). Meaningful use, in theory, was put into place to help improve patient care, not deter it. Of course, it’s a work in progress, and the way I see providers taking on Dr. Toll’s challenge is not to refuse to participate (because patients still need care), or to complain or grumble (because complaining and grumbling makes everyone miserable), but to start voicing thoughts, ideas, and opinions on how to improve system.
From an analyst’s perspective, we appreciate ideas and feedback. When something isn’t working, tell us. When you have an idea that could make the system more user-friendly, tell us. If a meaningful use requirement doesn’t really make sense for your scope of practice, get involved in government policy.
Obviously, a challenge is never easy, but if providers, administrators, analysts, and policymakers can work together, perhaps one day the EHR truly will be meaningful.
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