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Your Patient's Words Bypass Your Brain on Their Way to the EMR

When physicians spend the entire office visit typing data into the EMR, they may be hearing what the patient is saying, but they sure aren't listening.

Last month, I blogged about the reasons why I felt electronic medical records would not improve the actual medical care of patients. The prime reason to me is that doctors who use some form of EMRs just won’t be able to give their complete attention to, and listen to, their patients without being distracted by the act of entering data into the EMR (heck, even without EMRs, it seems like many of us are already being accused of not listening to our patients). To illustrate my point, I recounted my experiences during a recent visit to my family physician, who spent the entire visit staring at his computer monitor while he tapped away on the keyboard.

Well, last week I visited my urologist…

“Expanding quite a bit with your hardware, eh, Frank?” I said when I noticed that he had a laptop computer in each of his four exam rooms.

“Yah, I got tired of wheeling one around," he said.

I started telling him what had transpired with me urologically over the past few months. I was impressed that he was touch-typing on his laptop. I figure maybe 10-15% of physicians can touch-type, if that many.

“What do doctors do who hunt and peck?” I asked.

“They have to do it later, maybe dictating using voice recognition, which isn’t the greatest either," he replied.

But, as I spoke, I was sure there was no way he was keeping up with my history; concentrating on spelling and making corrections while he was typing had to be at least somewhat distracting him from actually paying attention to what I was saying.

So I finished with my history and he finished his exam, and we discussed the case further to my satisfaction. But I am still convinced that while he was taking my history, my words were bypassing his brain and headed to his fingertips, confirming why I think EMRs will never make it in patient care.