The EHR and Patient Engagement
Connect with us
Follow us on LinkedInFollow us on FacebookFollow us on TwitterFollow us on YouTube
Language of
Caring Blog

The EHR and Patient Engagement

I was recently speaking to a roomful of physicians about communication skills that promote patient engagement.  Not five minutes after I began, one physician exclaimed, “I hope you’re going to talk about how impossible it is to engage patients when you have to use the EHR!” A groundswell of his colleagues responded, “Yes, yes, yes!”

There is no question that dealing with a tech device like the Electronic Health Records while talking with a patient is challenging.  But the EHR doesn’t have to interfere with patient-physician conversations, nor does it need to impede patient engagement or negatively affect the patient experience.  Communicating in a caring way, while using the EHR, requires adopting a mindset that you and the patient are partners, actively involving the patient, and carefully navigating the dual demands on your attention (patient and computer).

Drawing on research done at Kaiser and best practices presented in the web-based program Language of Caring for Physicians®, here’s what you can do to promote patient engagement while consulting and entering information into the EHR.

  1. Explain the EHR in a positive tone. Tell the patient what you’re doing and why. “Let’s open up your chart so we have your history and results in front of us. This excellent record-keeping system helps me access info from your history and enter information from our conversation, so I won’t forget it.” Use inclusive words like “we” and “together” that set the tone for engagement and partnership.
  2. Engage the patient with the device. Log in and out in front of the patient. This helps prevent anxiety about confidentiality. Turn the screen toward the patient and invite him/her to look on with you, showing there’s no secret. Tell the patient what you’re entering.  Share information, like lab results. When entering information, explain: “Please give me a moment to jot this down while it’s fresh in our minds.”
  3. Don’t multi-task. Don’t try to enter information and listen to the patient at the same time. Instead, rotate between mindfulness toward the patient and full attention to computer tasks. When talking with and listening to the patient– especially when discussing an emotional or critical issue–focus completely on the patient. This way, the patient won’t perceive you as rude, inattentive or distracted. When you turn to the device, excuse yourself, saying, “I hope you don’t mind if I consult the computer for a moment… I don’t want it to get in the way of our conversation.” Then, when entering or looking up information, fully focus on that task. This is more efficient and prevents errors.
  4. Practice mindfulness. Even when using an EHR, you can apply mindfulness techniques, as in any conversation with a patient. Take a deep breath. Bring your full attention to the present moment. Sit. Lean in. Adopt an open, receptive posture.  While the patient is speaking, maintain eye contact. Don’t interrupt.  Resist interruptions by others. Tune in fully.

You CAN be patient-centered while using the EHR!
It takes care to prevent the EHR from impeding your communication with patients and your efforts to engage them in information sharing and collaborative decisions about their care.  Still, it is doable.  In fact, you can make patient engagement more likely and more effective by adopting practices that show patients that the information on the EHR is theirs, and using that information together to make patient-centered decisions.  Also, by making sure you attend fully to the patient in conversation, you will ensure that the patient will feel important… and not secondary to the power of tech.

I welcome your comments below.

Categories: Caring and Empathy, Patient Experience Strategies, Patient-Family Engagement, Physicians


Leave a Reply

Your email address will not be published. Required fields are marked *