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ADVANCE Perspective: HIM

HIT: Friend or Foe?

Published December 29, 2009 9:58 AM by Cheryl McEvoy

I have to wonder sometimes--are electronic health records (EHRs) really the way to go? Now, before someone launches a spiel about how they save time, cut costs and improve the patient experience, let me tell you about last night's visit to the dentist.

It had been a while since my last exam, and this was a new dentist. As I plopped into the seat, the tech said she needed to take a full set of X-rays "to see what's going on" (Like I said, it had been a while). To my delight, up popped an imaging program on a wall-mounted computer, directly in my line of sight. The tech slowly and meticulously placed a small scanner at various points and angles in my mouth, capturing a complete view of my pearly whites.

The device was a step up from my last X-ray experience, with countless not-so-flexible dental films being shoved in and out of my mouth. This tool had the some of the same invasive qualities, but the individual films were gone and the scanned image took only seconds to load. The tech was quite pleasant throughout the process, telling me what a great job I did while I sat there watching tooth after tooth emerge on screen.

I was already formulating a blog about my HIT experience when the dentist came in. She entered behind my chair, snapped on gloves and gave a quick "Hi, I'm the doctor" before turning to the computer. She hastily clicked through the X-rays, even tapping her foot, as if to emphasize her hurry. Then she wheeled around, reclined my chair and gave my mouth a once over. "What happened here? An ulcer?" she asked.

"Um, not that I know of. What--"

"Doesn't hurt? It's benign. No cavities. I'll send the hygienist in, if she's still here."

And that was it. Out the door she went. To where, I'm not sure--I was the only patient in the waiting room when I arrived. I kicked myself for not being more aggressive, like asking her what the deal was with this apparent "ulcer." But that's what WebMD is for, right?

Now, I think back to another doctor I went to a couple months ago. Actually, I saw the nurse practitioner, and all she had were paper charts. She had trouble reading some of the doctor's notes from my previous visit, but she was upfront about it and asked me to clarify things she wasn't sure about. I appreciated her honesty, and quite frankly it was comforting to know she cared enough to ask. By the end of the visit, she not only gave me piece of mind, but also two free samples of my prescription and a savings card that would save me $16 per refill. Happy holidays, indeed.

It makes me wonder whether EHRs will really improve health care. Technology-wise, they might be superior, but when it comes down to it, a good doctor's a good doctor, and an impersonal one--well, HIT might just make them further detached from the patient. Like so many have said, HIT may have all the functions, but what makes the difference is how doctors use it.

2 comments

It’s an interesting and common concern amongst caregivers that the addition of the EHR can result in less communication, eye contact and overall banter between doctors and patients. From what I’ve heard from some doctors, however, is how HIT is actually helping to grow upon their relationship with their patients. One doctor, Dr. Baker, CIO at Wellspan, populates the EHR right in front of his patients. He manages to keep this interactive though by adding speech recognition to the process. Rather than typing in a note with his back to his patients, he speaks freely so that the EHR is populated and simultaneously the patient is listening so 1). They can listen for mistakes or add more detail, 2). Once the note is complete, Dr. Baker presses print – so the EHR is complete, his patient has heard the details and take-home directions, and also has a text version to overlook. It’s incumbent upon caregivers and healthcare organizations to make sure HIT adds to care quality and the patient experience, not takes away from it.

Holly December 30, 2009 9:24 AM

If you were charged for a full exam, and the dentist failed to encourage you to express what was on your mind, you were cheated quickly. Had it not been for digital x-rays, it would have taken much longer.

D. Kellus Pruitt DDS

Darrell Pruitt December 29, 2009 12:40 PM
TX

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