EMR: A Wedge between You & your Doctor

  The electronic medical record (EMR) or the electronic health record (EHR) is quickly becoming an integral tool in the primary care and other office settings.  While many support its use for efficiencies of information storage and information sharing, reduction in errors from illegible handwriting, and ease of third party payment, I believe the single greatest flaw that has resulted it use is the complete loss of eye contact with your health care provider.
   

My experience on the patient’s side of the desk has been doctors keeping their heads bent down to the screen in a busy effort to complete the necessary keystrokes and electronic checkmarks for the encounter.  I can’t remember the last time a doc looked at me since these tablets and other devices have infiltrated the medical office setting.

What is being missed here is the grave importance of listening to the patient’s history in order to reach an accurate diagnosis.   More than eighty percent of the information necessary to reach a diagnosis for treatment comes from the medical history.  About another ten percent from the physical exam and the smallest percent come from diagnostic tests such as labwork and imaging.   Sir William Osler said, “Listen to your patients.  They’re trying to tell you what’s wrong.”   How can a doctor listen adequately to a patient if they have their eyes glued to the screen of an EMR?

It seems to me, if a doctor cannot listen with eye contact, there cannot be accurate history taking. Without this vital information, there is a greater likelihood of hit-and-miss scenarios with repeat visits, redirecting treatment plans, or worse -- missed diagnoses leading to a more serious medical scenario.  Where is the efficiency here?