In the early 2000s, a book came along that spouted a lot of what I found to be unsubstantiated bunk about Hush Puppies and other things. It rewarded its author with fame and fortune beyond any I’ll ever sniff, and it popularized a term that has resurfaced this week with a government news report about EHR.
It seems, says a Centers for Disease Control and Prevention study, we have reached the “tipping point” in physician adoption of electronic health records. In 2011, 55 percent of physicians reported having adopted an EHR, and of those, 85 percent said they were either somewhat or very satisfied with the technology. Roughly three-quarters of physicians using EHRs said the software enhanced overall patient care. And an almost equal percentage would buy their EHR program again. Even among the laggards, nearly half have begun or will soon begin the transition from paper records.
Out in the real world, many practices are still struggling with implementation, if not mastery, of their EHR systems. We’re fortunate to have a real-world report this month from Dr. Michael Boland, who’s director of IT at Wilmer Eye Institute, and his colleague, Ravi R. Pandit. They were wise enough to record the experience of turning the EHR transition at their glaucoma clinic into a formal study, and generous enough to share some of the lessons they learned with us. You can find that enlightening report on p. 62.
Another worthwhile resource, though in the patient-care end rather than the technical end of EHR implementation, appeared this month in the American Medical Association’s news publication. An article there describes the Kaiser Permanente-designed LEVEL system of doctor-patient interaction in the EHR setting. (See the link below for the full report). To paraphrase LEVEL:
L: Let the patient look on; share things on the computer screen with the patient.
E: Eye contact. Maintain a normal level and avoid a total focus on the screen.
V: Value the computer. Take advantage of opportunities to point out a benefit of the system to the patient. And the reverse—avoid the temptation to vent frustration when things aren’t going smoothly.
E: Explain what you’re doing. Talk through each step.
L: Log off. Logging off while the patient is still in the exam room enhances confidence about security.
For much of the past decade, the only EHR-related tipping that most physicians wanted to do involved tipping the computer over and getting back to the business of treating patients. There’s still a ways to go, but let’s hope the CDC is right.