Computers are everywhere. Naturally, they’re used widely by doctors and hospitals. Without doubt, these technologies are improving care and communication among doctors and patients. But there are new challenges too. Do digital tools interfere with a doctor’s ability to treat patients effectively? There are pros and cons, but one thing is certain: they are here to stay.
What can you do to optimize your relationship with your doctor and his/her computer? Before I present my four tips for being a patient in the digital world, it is important to understand some of the pros and cons of computers in medicine.
Electronic Health Records (EHR) systems can improve data accuracy and sharing, but currently, most EHRs don’t communicate with each other, making it difficult for doctors to easily access comprehensive patient information.
How doctors use EHRs can significantly impact appointment quality. Doctors must listen to patients, respond appropriately, and engage with patients. A doctor typing or dictating may not be able to listen intently to the patient and may have diminished face-to-face connections.
Additionally, doctors can make mistakes when entering information, including mistakes regarding diagnosis, tests, and medications. This misinformation will travel with you if corrections aren’t made.
So What Can You Do?
- Make Sure Your Doctor Is Paying Attention to You
It is crucial that your doctor listens to your complete story, as this is a major part of getting a correct diagnosis and treatment plan. If your doctor is distracted by the computer, speak up. If needed pause while your doctor types. Realize that doctors are people too and it’s a challenge for anyone to do two important things simultaneously.
- Take Charge of Your Medical Information
Make sure your EHR is accurate by asking your doctor to print a copy of each appointment’s notes. Notify your doctor if you see inaccuracies.
Don’t rely on your EHR – keep your important medical records together and organized, including test results, medications prescribed and clinical trial information, and bring them with you to all medical appointments, including visits to the ER.
Don’t assume your doctors are communicating with each other, or reading each other’s reports. Doctors are not communicating with each other as much as 70% of the time.
- Take Detailed Notes at all Appointments
Your doctor’s notes may be inaccurate or incomplete, and are often not shared between doctors. It is critical that you take detailed notes, while still with the doctor, at every medical appointment – don’t even wait until you get in the car! A landmark study found that 40-80% of medical information provided by healthcare professionals is forgotten immediately; the more information presented, the lower the proportion remembered. Of the information that was remembered, almost 50% was remembered incorrectly.
Take notes by hand, not on your phone, tablet or laptop. Importantly, writing (versus typing) helps you remember and understand information. A recent study on note taking by college students found those who took handwritten notes remembered the material better, and were able to synthesize the information better, than students who used a laptop. It’s hard to say if this translates into note-taking in a doctor’s office, but these findings could apply.
Writing helps you maintain eye contact with the doctor which can improve the quality of the appointment. Lastly, if you use a tablet or phone, auto-correct may dramatically change important words, leaving you guessing. If you want to keep digital notes, type your handwritten notes at home.
- Be Vigilant About Medications
To minimize your risk of dangerous medication errors caused by ordering systems:
- Don’t assume ordering systems will eliminate the risk of being given medications that dangerously interact. If you are taking multiple medications, discuss the potential for adverse drug interactions with your doctor and/or pharmacist. Fill all your prescriptions at one pharmacy; their computer may detect potential adverse drug interactions.
- When given a new prescription, write down the name, dosage and instructions. Before you pay, double check to make sure you are given the right medication.
- If a medication doesn’t look familiar, ask your pharmacist (outpatients) or your nurse (inpatients) before taking it!
Technology in healthcare is here to stay. Ideally, we’ll each have a master digital file that fully captures our health history which can be accessed, shared and updated by all of our doctors, offering a more comprehensive view of our overall health and improved care coordination between specialists. However, even when EHRs reach their full potential, it will remain critical for patients to be fully involved in their care by actively advocating for themselves. It will always be important for patients and providers to ensure that EHRs and other technologies don’t get in the way of basic care and critical patient-physician communication. By being engaged in the process and speaking up if something doesn’t feel right, you can help ensure that your doctor’s computer is a help, not a hindrance.