A variety of approaches to improving communication while using EHRs has been suggested, starting with informing the patient what you are doing, avoiding computer use when sensitive psychosocial issues are at hand, and involving patients in building their charts. Practical steps can also help, such as learning to type and pointing at the screen (Fam Pract Manag. 2006;13:45-47).
Somehow, we must learn how to retain the patient’s narrative, both in the elicitation of the history and its documentation through EHR (Acad Med. 2011;86:11-14). And we need to be available to interact with that narrative, or we risk becoming the equivalent of computers ourselves.
Back to the Patient
After pushing the keyboard aside, you explain what you’re typing on the computer and how electronic health records have the potential to improve care. She seems impressed that your computer can check for drug interactions, a point of particular interest to your patient because her medication list is long. After discussing her [dizziness] and available treatment options, she is reassured that “ending up in a wheelchair” is not likely. Your visit is a minute or two longer than you’d aimed for, but your relationship with this patient is back on track.