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EHR (Computer) Etiquette

When a physician focuses attention on a patient, the beginnings of a relationship appear and the first step is taken to make the patient feel better. With the introduction of computers into hospital and exam rooms, the possibility of losing this important connection between doctor and patient arises. CareConnect is a tool to help provide more efficient and effective care, and computers have been positioned so that physicians and other providers may use them without turning their backs to patients.

Even still, computers might lead to development of other habits that cause a breakdown of patient-centered care. Researchers have found that even the most experienced clinicians sometimes look predominantly at the computer monitor during office visits, type while patients are talking about intimate concerns, read silently from the monitor while patients sits idly, and use templates to lead interviewing rather than listening to patients.

UCLA Health Video on 'Interacting With CareConnect'

UCLA Health system has also developed a short educational video to demonstrate how to use computers while maintaining patient-centered care.

See the video: "Interacting With CareConnect"  

AMA Recommendations

In addressing the issue, the American Medical Association has recommended that physicians be reminded of guidelines and tips on computer etiquette.Everyone has their own style of interacting with patients, however, below are some guidelines from Kaiser Permanente and Family Practice Management.

LEVEL Guidelines From Kaiser Permanente

Here are those guidelines from Kaiser Permanente's Interregional Clinician-Patient Communication Leaders

  • Let the patient look on - move the computer screen so the patient can see it, invite the patient to view information, ask the patient to verify information as it is entered.
  • Eye contact -- greet the patient, maintain eye contact.
  • Value the computer as a tool - acknowledge the computer, let the patient know how it improves care.
  • Explain what you are doing - inform the patient about actions and decisions, tell the patient what you are doing, such as ordering lab tests.
  • Log off and say you are doing so - tell the patient you are logging off to safeguard his or her information.

Watch this short video demonstration of Kaiser Permanente's LEVEL approach to using a computer in patient-care settings.

Tips From Family Practice Management

Here are those tips from Family Practice Management:

  • Use a mobile monitor
  • Learn to type
  • Integrate typing around your patient's needs
  • Reserve templates for documentation
  • Separate routine data entry from patient encounters
  • Start with patients' concerns
  • Tell patients what you're doing
  • Point to the screen
  • Encourage patients' participation
  • Look at your patients