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There Is No Such Thing as Too Much TV in This Doctor’s Office: A Different Approach to Patient Engagement

There Is No Such Thing as Too Much TV in This Doctor’s Office: A Different Approach to Patient Engagement

A recent Accenture report found that patients in the United States are increasingly accessing their electronic health records (EHRs), with rates rising from 27% in 2014 to 45% in 2016. Most patients (92%) reported that they should have full access to their medical records, whereas only 18% of physicians shared this belief.   TVs to the Rescue? What if, instead of providing patients with access to their medical records before or after their appointment, physicians were able to share it with them in real-time during their encounter with the patient? Leveraging modern technology, physicians can change their point-of-care delivery model by sharing their screen with patients. It doesn’t require a major investment. With an HDMI cable and remote access, physicians can connect their laptop computer to a TV in order to project their patients’ records, thereby boosting engagement with patients. Doing this can also help physicians and patients identify potential inaccuracies in medical records, which in turn could improve overall patient care. Displaying a patient’s EHR on the big screen can help break down walls between physicians and patients by enabling them to interact face-to-face. A side effect of this could be increased patient trust in their physicians. In addition, when showing patients their BMI, blood pressure levels, and lab results graphed out over time, trending is instantaneously realized by both physician and patient. Furthermore, sharing other health characteristics on a large-screen TV may help patients feel empowered and involved in their care.   Implementing the Approach One key element for physicians and practices implementing this type of approach is a user-friendly, intuitive EHR system. A difficult-to-navigate EHR system...
EMR notes: Copy and paste, done in haste, what a waste

EMR notes: Copy and paste, done in haste, what a waste

An epidemic is sweeping the country, and no one is doing anything about it. No it’s not Zika virus. The epidemic I’m talking about is the widespread use of “copy and paste” in medical progress notes. How widespread is it? A 2009 study from Cornell surveyed faculty residents from two academic medical centers and found that 90% of the physicians who wrote inpatient notes electronically used copy and paste in their progress notes. Most of them acknowledged “that inconsistencies and outdated information were more common in notes containing copy and pasted text,” but fewer than 25% thought that using copy and paste was detrimental to documentation or caused errors in patient care. My anecdotal experience is that 90% is an underestimate. Using copy and paste can be detrimental. I have said before that it doesn’t matter what is written in a chart unless something goes wrong. “…90% of the physicians who wrote inpatient notes electronically used copy and paste in their progress notes”   Progress notes in electronic records are cluttered enough without adding material that was in previous notes word for word. An even bigger problem is the extensive use of copy and paste raises issues of credibility. In a progress note, a patient was described as “alert and oriented X 3” because that’s what that the notes from the three previous days said. A few lines further down in the same note the physical examination said the patient was “intubated, sedated, and on mechanical ventilation.” Another note said, “The patient appears well nourished” because that appeared every day for the last week. Later on in the note,...
ED Information Systems and Patient Safety

ED Information Systems and Patient Safety

Throughout the United States, emergency department information systems (EDISs) have been developed in an effort to reduce medical errors. These systems are becoming a significant focus of both federal legislation and healthcare reform. “EDISs are an important component of the movement toward improving quality and outcomes with electronic health records,” explains Kevin M. Baumlin, MD, FACEP. Many types of electronic systems perform various functions for EDs throughout the country, but variations in EDISs can impact physician decision making, clinician workflow, communication, and the overall quality of care and patient safety. The common perception is that EDISs may ultimately improve the quality of medical care delivered in hospitals. Unfortunately, as they are currently configured, these systems also present important threats to healthcare quality and patient safety. The Pros & Cons The purpose of EDISs is to decrease practice variability and improve system reliability. “These systems are designed to enhance communication among healthcare providers, facilitate the retrieval of past information, and assist in clinical decision-making,” Dr. Baumlin says. They can help make medical references easily accessible, assist with important calculations, and monitor for potential adverse events. Some have the potential to share medical information across health systems and may help identify epidemics early. The perceived advantages of EDISs are so significant that Congress allocated nearly $30 billion to build incentives for EDs to universally adopt them through the American Recovery and Reinvestment Act. The rush to capitalize on the government’s investment for EDISs, however, led to some unfortunate and unintended consequences. Vendors for EDISs are making efforts to meet new demands by clinicians, healthcare administrators, and government, but the uniqueness of...
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