Maybe the doctor’s employer should apologize for not buying tablet PCs

A physician doing his residency at Cambrige Health Alliance writes in today’s Boston Globe (Eyes shift from patient to keyboard)

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…

When I asked one of the more experienced doctors at my hospital how she deals with having a computer in the room, she said that she acknowledges the problem up front by apologizing to her patients for turning away from them. This helps her patients recognize that she is doing her best to communicate with them on a personal level even though she can’t actually face them for large parts of the visit. She also makes sure to end all visits by turning away from the computer and toward her patient while going over everything that was discussed.

There’s a simple answer to this problem: use a tablet PC instead of a traditional desktop or laptop. When used properly it feels more like a clipboard than a computer to the patient and physician. Some offices have gone further. For example when I visited the West Clinic in Singapore (an oncology clinic) they showed me the Motion Computing tablets they hand out to patients in the waiting room. That way the patient can fill in detailed information about their health status and concerns, which their doctor can review with them and integrate into the medical record.

September 10, 2007

One thought on “Maybe the doctor’s employer should apologize for not buying tablet PCs”

  1. I agree that the mobile interface used has much to do with the interaction between provider and patient.

    I have provided care and supervised teams that have had to use bulky EMR carts when face to face with patients lying in hospital beds, and have had the fortune to coach some providers in the use of handwriting-enabled tablet PC’s. As technology advances, I’m excited at the potential to improve the patient-provider interaction, as it still leaves much to be desired (no matter what the device, there were some providers that simply could not and would not use a device when working directly with a patient).

    My second thought has to do with understanding the benefits of EMR. For those who have used both EMR and paper, I don’t think there are many that would say that EMR actually speeds up the process of working with, caring for, and documenting on patients. Sure, there are some shortcuts here and there, but the overall process of getting the data “in” is not as fast as an open-ended scribble on a notepad. The benefits and the time savings comes on the reporting, management, and error-reduction side of the equation, and for good adoption of EMR by healthcare providers I think this expectation must be framed at the beginning of the discussion, not after implementation.

    Tannus Quatre PT, MBA
    Practice Consultant
    Vantage Clinical Solutions, Inc.

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