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Physician Focused on Computer Screen, Not Patient

Posted on April 5, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


Definitely sends a message to the patient. I’m still just surprised that it’s still happening, but it is:

What’s annoying to me is that there are simple solutions to this problem. Not the least of which is positioning the screen in a way that you can look at your patient while you’re working on the computer. An even better way is Dr. James Legan’s approach that he calls #ProjectedEHR. In Dr. Legan’s case he plugs in an HDMI cable so that patients can see him work in the EHR. Plus, he can show patients their results and other health info.

Plenty of other doctors just choose not to document in the exam room so they can focus on the patient. As mobile EHR interfaces develop, I could see a partial documentation done on a mobile phone or tablet and then the rest of the documentation done after the fact as well. I’m a little surprised we haven’t seen more of this already.

Of course, I’ve written for many years about the coming video EHR. That would be a game changer. Although, would certainly take a dramatic change in perspective. Scribes are also popular with many people I know. I’ve even heard of people working on remote scribes which is quite interesting.

What other solutions have you employed to combat the challenges of interacting with patients and the EHR?

Solution for “Too Many Clicks” Problem in EHR?

Posted on January 27, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve long been intrigued by the complaint I hear from doctors about “too many clicks” in the EHR. Long time readers may even remember my piano analogy which looks at the issue of too many mouseclicks and keystrokes in EHR software. I still think that largely applies today.

With that said, I’ve been fascinated to watch the evolution of click free solutions like what Note Swift is offering. Many are familiar with Dragon Naturally speaking an in particular the Dragon Medical product. It does amazing voice recognition. What I love about NoteSwift is that it takes Dragon’s voice recognition and integrates it naturally into the EHR interface.

Here’s a demo video that was all done by voice using NoteSwift to illustrate how it works:

I think it’s fascinating to see the evolution of these products. Plus, with things like Siri. “Ok Google”, and even Amazon Echo,we’re creating a culture of people who are use to using their voice to do things. So, that will help efforts like the one above.

No doubt doctors are blown away by the concept of documenting a patient visit with 1, 3, or 5 clicks. Now let me leave what’s available today and think into the future. Imagine a video EHR which was voice enabled. The doctor could literally go into the room and using video, voice recognition, NLP, technologies like NoteSwift, connected devices, etc they could easily chart a note with no clicks. While that’s not happening tomorrow, it’s not as far fetched as you might imagine.

The Impact of Patients Recording Their Doctors Visits

Posted on September 14, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Martine Ehrenclou has a great article titled Patients Secretly Record Visits with Their Doctors that is worthy of further discussion. Here’s an excerpt from the article to get the discussion started:

Since I suspected this office visit might contain some complicated and possibly stressful information, I considered recording what the surgeon said by using an app on my iPhone. I envisioned asking the doctor’s permission to record the conversation and decided against it because he might not have responded well to that idea. Some physicians and other providers react with suspicion and a defensive medicine posture when asked by patients to record what they’ve said.

My husband’s surgeon had a reputation for highly successful surgeries but not the greatest bedside manner. He’d always been pleasant with us, but since my husband’s recovery had been compromised with episodes of pain, I decided that an audio device could have instigated alarm. That would have interfered with the doctor’s focus on Jamie. With only 7-10 minutes, we had to make the most of this office visit. I wanted my husband out of pain.

In place of an audio recording, I took notes instead.

I’m sure that many patients have gone through the same situation. They want to have the valuable information that the doctor has shared, but they’re afraid of the impression they’ll give the doctor if they tell them they’re going to record the visit. Unfortunately, that’s the culture of fear that we’ve created in our healthcare system. Doctors are rightly afraid of the medical malpractice implications of anything they do.

The article goes on to talk about some patients who secretly record their visit with their doctor. A commenter and the author both described this trend of patients secretly recording doctors visits as alarming. However, that feels like a bit of a contradiction to me. The article talks about how asking your doctor to record the visit could compromise the patient-doctor relationship. In order to avoid compromising it, recording the conversation privately seems like the natural alternative.

What’s worth noting is that these private recordings might not be admissible in court depending on your state. I’m not a lawyer, so I’m not sure of the exact laws, but I know that in many states both patients have to be aware that a recording is being made. This should actually provide much comfort to doctors. If a secret recording isn’t admissible in a medical malpractice case, then the doctor should be glad that the patient is secretly recording the visit. It would illustrate that the patient really just wants to review what the doctor said as opposed to trying to ensnare the doctor in some legal lawsuit. Sounds like deep patient engagement to me.

Since pretty much all of us now have an audio recording device in our pocket (better known as a cell phone), this topic is going to become more and more popular. More and more patients are going to want to record their office visit. No doubt some will do this in full disclosure to the doctor and others will do it privately.

I wonder when we’ll see the first doctors flip the script on the patient and suggest that the patient record the office visit. We probably won’t see this happen for the full visit anytime soon, but you could easily see the doctor recording the plan and instructions part of the visit and sending it to the patient or the doctor encouraging the patient to record it themselves. In fact, I recall Kareo doing something like this for doctors using Google Glass. It’s a happy medium where the doctor is likely more comfortable having what they say recorded. A great part of a patient portal would be a list of all the things a doctor’s instructed the patient as part of a visit.

Of course, all of this leads to my concept of a video EHR that captures the audio and video of every visit. I’ve been talking about it more and more lately. I’ll have to do a full post on my vision for a video EHR in a future post. If the idea of a video EHR makes you uncomfortable, that’s no surprise. However, it’s not as far fetched as you might think.