Risk Tip: Don't Make Patients Compete for Attention with EHR

Electronic Health Records (EHR) are here to stay. Physician offices implementing these tools will realize their promise of efficiency, shared data, and potential for avoiding mistakes.

However, just as texting while driving raises safety concerns, physicians should be mindful of paying too much attention in the exam room to the computer screen and not enough to their patient. When a doctor fills in a computer template, it may divert attention from the patient, limit interactive conversation, and restrict creative thinking. This may depersonalize and weaken the doctor-patient relationship.

Tips to enhance your interactions:

• Avoid turning your back to the patient.

• Position the monitor so the patient can see the screen, and tell them what you’re doing.

• Focus on one task at a time. If you are trying to talk while typing or type while listening, your patients may get the impression that you aren’t listening.

• Know when to push the computer away, and give your full attention to the patient.

Watch your documentation; exert care when entering data in the record:

• Beware “alert fatigue”- avoid the temptation to ignore, override, or disable alerts, warnings, reminders, and embedded practice guidelines. A physician could be found liable for failing to follow an alert or a guideline that would have prevented an adverse patient event.

• Be wary of clones: copying information from previous notes and visits (known as “cloning”), or documenting by exception may result in irrelevant over-documentation. By substituting a word processor for the doctor’s thoughtful review and analysis, the narrative documentation of daily events and the patient’s progress may be lost.

• Auto-population: EHRs auto-populate fields in the history and physical sections and in procedure notes. While this feature may make some aspects of practice easier, erroneous or outdated information may increase liability.

Contributed by The Doctors Company. For more risk management tips, articles, and information, please visit www.thedoctors.com/knowledgecenter.The Doctors Company is a contributor to the eRisk Working Group’s eRisk Guidelines. Find them at www.thedoctors.com/erisk.

For more information on the OSMA program with The Doctors Company, click here or for more on the OSMA’s EHR Standards of Excellence Program (EHR SOE), click here.