With EHR use increasing, physicians are looking more at a computer screen than the patient:
Although the computerized system has proven to be a huge help, I have confronted an unexpected challenge: Despite repositioning the computer in every imaginable way, I often find myself making more eye contact with the screen than I do with my patients. It is simply more difficult to face a patient while typing than while writing.
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So far in the constant battle to serve and listen to patients vs making sure that I do all the required medicolegal and insurance paperwork, the EMR systems have all but given the battle to the paperwork.
Then, when it is all done, I look at the notes in the EMR and see pages after pages before I see what I needed to know. What ever happened to your progress notes being used to help you care for your patients? Now all they are are menus that mean nothing but help document a 99214 and serve as a bases for legal scrutiny.
Try being the hospitalist who has 20 to 30 pages of this stuff faxed to the ER.
Complete family history every time. Problem list that 3 pages long (ingrown toenail, L foot is problem #1 but CAD s/p CABG is problem #17) and unreadable.
Multiple notes (often by different people) that talk about changing appointments, the unpleasant side effects of a med the pt was on a year ago, and stressors at home.
If you’re lucky, a med list is in there and some concept of chronic medical problems is mentioned. More often than not, it requires a phone call to get this information.
EMRs help document but they don’t help anyone else who has to treat the pt.
Sigh – everyone should be admitted every 3 years for a a good physical exam, a current EKG and CXR, a current med list, and an accurate DC summary.
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