Small Practice

Go Beyond Using Your EHR; Practice Heads Up Medicine

Tom GuillaniWhen providers and their staff don’t have the time or tools to effectively communicate with patients, a slew of issues can result: from physicians missing important cues and misdiagnosing patients to preventable hospital readmissions and poor outcomes because patients didn’t understand or follow care guidelines.

The problem has become endemic. According to one study, 80% of what doctors tell patients is forgotten as soon as they leave the office. Beyond that, 50% of what the patient did recall is incorrect. In addition to impact communication and follow up have on care and outcomes, patients are expecting a different experience than they once had. Nearly two thirds of patients now say they would consider switching to a physician who offers access to medical information through a secure Internet connection.Just having the technology isn’t really enough. It is just as much about how you use it. Using an EHR, providing access to a secure patient portal, and other features are great but if you don’t take advantage of all they have to offer, you aren’t likely to change the physician patient dynamic.

That is where heads up medicine comes in because it is a process that engages patients with and in spite-of technology. It enables a variety of actions to be accomplished by a simple gesture, finger swipe, or tap rather than diverting your attention with complex navigation, keystrokes, spelling, or editing. As a result, you can focus your attention on your patient, instead of your technology.

The use of a truly mobile EHR can allow providers to practice heads up medicine by:

  • Enabling physicians to maintain eye contact with patients.
  • Allowing providers to have meaningful conversations with patients, share images, and educational materials, drug interactions, and more on the device.
  • Offering care recommendations to improve both preventive care and chronic disease management.
  • Assist the provider in capturing accurate information efficiently, yet without distraction.
  • Providing visit summaries and educational materials for review with patients before they leave the office.
  • Extending patient care beyond the boundaries of the office/office hours.

What all this requires from providers, aside from having the technology, is the commitment to using it completely. Many physicians want a truly mobile EHR but only a handful use one. My impression is that fear of learning and using new technology stands in the way. So here are my suggestions for getting comfortable with your mobile device so you can better engage with patients, improve outcomes, and increase satisfaction.

  1. Don’t skip the how-to: When you get new device, sit down for an afternoon and go through any and all tutorials on how to use your hardware and software. No one can do this part for you.
  2. Use your device every day. Use it for everything from the beginning, not just documenting visits. Read books, do email, play games. The more you use it, the more familiar you’ll get with how to use it.
  3. Tweak your templates. You’ll have preloaded templates in your EHR but you can customize them to fit better with your patterns. The more familiar the sequencing, the faster and easier you’ll be able to run through the template and document while talking to the patient.
  4. Practice makes perfect. Do several test runs with staff or family before real patients to get your flow down. You want to get to the place where you can mostly tap and swipe without having to look at the device too much.

When it comes to choosing an EHR, take your time to get it right because the software and device are important. But if you want to practice a heads-up medicine approach, a big part of your success will also depend on getting comfortable with the device so you can focus more on the patient and less on the technology.

To discover more strategies to fully engage patients, download 10 Powerful Ways to Engage Patients.

Tom Giannulli, MD, MS, is the chief medical information officer at Kareo. He is a respected innovator in the medical technology arena with more than 15 years of experience in mobile technology and medical software development. Previously, Giannulli was the founder and chief executive officer of Caretools, which developed the first iPhone-based EHR.

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