Transparent EMR data increases patient satisfaction
Dr. Jeffrey Goldberg, MD
ProHealth Physicians, part of OptumCare®, is a physician-led medical group caring for more than 345,000 active patients with 350 primary and specialty care providers at 85 locations in Connecticut.
Most people would agree that the advent of the computer in the exam room, regardless of its many benefits, has created distance between clinicians and their patients. The physical object, whether laptop or workstation, pulls attention to itself like a magnet.
Despite our best efforts, clinicians must spend time facing the screen rather than meeting eyes with the patient. Patients, too, are drawn to the technology. It’s hard not to wonder what information lies on the screen.
In my exam rooms, transparency means turning the screen towards the patient. Installed in each room is a large, flat screen display. Once the patient record is up on my laptop, I plug in the screen.
With the same view as me, patients can see the information that makes up their key medical data. This openness facilitates trust, improves engagement and adds value to the time spent recording our visit in their record.
Opportunities for learning
Medicine has embraced an egalitarian position, encouraging patient ownership of their health information. However, total disclosure can expose some sensitive areas. Substance use and obesity are all listed as pertinent information in the electronic medical record (EMR).
Seeing words such as “morbidly obese” and “alcohol use” in large print on a screen are opportunities to describe why, to the professionals involved in their care, a patient’s weight or substance use is important.
Turning moments of discomfort into opportunities for education allows clinicians to deal with touchy subjects in a way that might help patients understand why we ask the questions we ask, how these labels impact their wellbeing, and what we can do to help them be healthier.
In addition to encouraging discussion of delicate information, the screen is a teaching tool that helps engage patients in their visit through reading as well as listening. Patients see what the provider notes as medically important.
They have the chance to visually review their own symptoms, diagnosis, and follow-up as I record. As they do this, patients can question what they don’t understand or think may be an error.
Another strong educational tool is reviewing trend lines. Looking at a sequence of lab results helps to correlate lifestyle changes with improving or worsening outcomes. For patients with diabetes or those in treatment for high blood pressure, this visual aid can help put the pieces of the diet, exercise, and medication puzzle together.
From reviewing medication, medical, and social history, to viewing new labs and writing orders for medication and follow-up, the shared screen means value-added time for both the provider and the patient.
Whereas watching a provider type has no value for patients, engaging actively as their visit is recorded certainly does. This large-screen system has served best in error prevention and opportunities for education.
Patient satisfaction since implementation has shown a bump of 2 percentage points.
Satisfying the quadruple aim
This minimal investment in patient inclusion has done well to satisfy all areas of the quadruple aim. With greater openness and better communication, delivery of care is improved on the patient and provider ends.
By serving as a second review of all information, the shared screen reduces errors and duplication, cutting expenses. Patients have an opportunity to engage and understand the facts that create their health picture.
With increased understanding, they are empowered to improve habits and reap health rewards.
This publication is informational and for educational purposes only. The views and opinions expressed herein are those of the authors and do not necessarily represent the views of OptumCare®. The views and opinions expressed may change without notice.