Maximizing chiropractic patient engagement when using EHR

Although EHR use provides a variety of benefits for chiropractors, software can become a distraction from quality patient care if it interferes with physician-patient interaction.

You may find yourself avoiding eye contact with patients, ignoring questions or forgetting to review key information with your patients because you’re focused on your software.

Thankfully, there are strategies you can use to improve your communication with patients. Some of these strategies take practice and deliberate thought, but communication well with your patients while also using EHR properly will become more natural with time.

EHR distraction and the physician-patient relationship

Compared with paper-only records, EHR use appears to cause more distractions. One study tracked eye gaze patterns to evaluate attention changes and understand how physicians interacted with patients and with technology during clinical encounters. EHR use was linked to less interaction with patients and more distracted doctors.

Doctors using EHR spent more time looking at patient charts and less time making eye contact with patients. Patients, in turn, spent more time staring at the doctors’ computer screens, regardless of whether or not they could actually see the charts. Doctors spent less time interacting with patients and more time interacting with the charts when EHR was used.¹

Software appears to reduce interaction between physicians and patients, in other words. Although patient care is ultimately supposed to be the most important part of the clinical encounter, many physicians are focused primarily on the patient’s chart and are not providing the patient with the care they really need.

Refocusing back to patients

Being aware of your patient and their needs is a good starting point for every clinical encounter. EHR use is beneficial for your clinic, your patient, and for your daily work as a DC. In many cases, avoiding EHR is either impossible, impractical, or both. Rather than stop using software, you may need to refocus some of your habits and behaviors and re-train yourself to focus on your patients.

American Medical News suggested several ways physicians can address this problem, including:²

• Triangle setup: By arranging yourself, your computer and your patient in a triangle shape in the exam room, you can easily shift your focus between the patient and the computer without turning away from your patient. From your patient’s perspective, you also appear to face them throughout the appointment.
• E.V.E.L. System: Let the patient look at your screen by keeping Eye contact with patient, Value the computer (share the beneficial features of your EHR with the patient), Explain what you are doing, and Log off at the end of the encounter to show the patient that their data is secure.
• Create a patient-centered workflow: Redesign your workflow to show your patients that they are your top priority. Review the patient’s chart briefly before the appointment, introduce yourself to the patient or greet the patient before logging into the exam room’s computer and explain to the patient what you are doing when you begin using the EHR system.

These strategies may help you overcome EHR distraction and demonstrate your commitment to patient care. Since DCs are often not the only people in the office using EHR, your office staff should also cultivate an awareness of patient needs and the potentially-distracting nature of software. Letting others in your office know about the importance of eye contact, nonverbal communication, and direct interaction with patients can help improve patient care quality at your clinic.

Care quality

Because a significant part of providing quality care is all about listening to your patients, you may also want to involve them in the process of improving care and communication at your clinic. Using surveys, you can readily gauge how your patients feel about communicating with you and other staff members.

Improving communication is a learning process, so it may be challenging at the beginning. Making quality communication with your patients a constant priority will help you connect better with your patients and deliver better health care. It is well-worth the effort.

References 

1. Montague, E and Asan, O. “Dynamic modeling of patient and physician eye gaze to understand the effects of electronic health records on doctor-patient communication and attention.” International Journal of Medical Informatics. http://www.ijmijournal.com/article/S1386-5056%2813%2900244-X/abstract. Published December 2013. Accessed May 2016.

2. Amednews.com. “How to communicate well with a patient while working on an EHR: A practical look at information technology issues and usage.” American Medical News. http://www.amednews.com/article/20120723/business/307239968/5/. Published July 2012. Accessed May 2016.