The use of electronic medical records: communication patterns in outpatient encounters
The is a review of the article, “The Use of Electronic Medical Records: Communication Patterns in Outpatient Encounters. The article was written by Makoul, Curry and Tang.
The article summarizes the use of electronic medical records. The purpose of the study was to determine if communication patterns change when physicians use EMR as supposed to using paper records of patients. They also wanted to determine do determine if the ordering of particular labs and length of stay increase compared to physicians who use paper records.
The study was conducted at the general medical faculty practice of an urban medical center in Chicago. The physicians use the EMR system were using EpicCare for about 18 months. The participants of the study were three physicians who were using EMR system already implemented in their facility. The other three physicians use paper charting. The study also included a wide range of patients to participate in. All the subjects use in the study were male, due to the fact that the women that use the EMR only use the system outside of the examination room. The physicians that participated in the study were told to focus on physician and patient communication.
The results of the study shows that the physicians that use the EMR were able to checked and clarify information better than the physicians that use the paper charting. When it came to time and how the test were ordered, there was no difference between the physicians that use paper charting and the physicians that use the EMR. The physicians that used the paper charting spent less time with their patients then the physicians that used the EMR system. The study also showed that there was a lack of personal interaction with the physicians that use the EMR. The physicians were often looking at their computer screens to type in data, which let to long periods of silence. The physicians using the paper chart had more personal interaction with their patient.
During the study many different findings were discovered. The Physicians that used the EMRs were more active in clarifying information more efficiently. The EMRs that were being used gave them the proper tools needed to be more effective in their work. It also allow them to complete their tasks. The EMR physicians spend more time looking between the patient and screen, which made them look less sincere. The interaction that the physician has with their patient are very important. The EMRs were effectively when it came to workflow, but the small distractions with computer screen and recording information divides the attention of the physician. The information gathered in this study can be used to learn how to minimize these distractions.
Having access to patient medical records at the face to face encounter is needed to make sure that patient concerns can be answered in real time. This access to medical records is also need to reduce the reliance from memory during the encounter. Paper and electronic medical records both have their benefits, in paper world it was easy to start a note and record important parts of history and physical exam findings during the interview, whereas depending upon the EMR it may not be that easy in the EMR, but all relevant information is at fingertips. Each facility may have to design their exam/encounter rooms in a way that minimizes these distractions.
Related Article Reviews
Makoul, G., Curry, R., & Tang, P. (2001). The Use of Electronic Medical Records: Communication Patterns in Outpatient Encounters. Journal of the American Medical Informatics Association, 8(6), 610-615. http://www.ncbi.nlm.nih.gov/pubmed/11687567