EHR and the Patient-Physician Relationship

While EHR implementation involves extensive technological investment, implementation and management, it is essential that the focus remains on the human-centered goals. IT provides tools that both support and extend the patient-physician relationship. When introducing EHR initiatives to the Executive staff and/or the facility staff, it might be helpful to clarify this link between technology and patient-physician outcomes.

In 2003, John Hopkins and American Healthways sponsored a summit bringing over 200 physicians and patients together in a conversation focused on “Defining the Patient-Physician Relationship for the 21st Century.” This conversation might be summarized as a focus and clarification on patient-centered care. They write,
“Amid the changes, one of the clearest themes to emerge is the centrality of patients. Increasingly, they are not simply recipients of care or subjects of research but active, informed individuals who wish to know more about their condition and exert greater control over their own care.”[1]

With this active patient participation in mind, they highlight “seven principal elements that both patients and physicians believe are essential to the relationship.” I suggest the following seven elements might be helpful to keep in mind when considering the role of technology in healthcare practice:

1. COMMUNICATION
Technology introduces a variety of tools that can facilitate two-way communication between patient and physician. Improving communication can lead to improved patient care, better patient comprehension of physician instructions, higher patient satisfaction and more referrals, higher physician satisfaction, fuller perception of patients by physicians and vice versa.

2. OFFICE EXPERIENCE
Technology can facilitate common exchanges like prescriptions and refills, completing information forms, delivering communication to patients and asking questions to physicians/nurses by patients. Extending the relationship outside the office can reduce patient dread at visiting office, increase patients likeliness to seek treatment when needed, and reduce complaints.

3. HOSPITAL EXPERIENCE
Technology can provide information that allow physician and nurses to personalize patient care, improve communication among staff and between staff and patient, and provide continued support after discharge.

4. EDUCATION
Technological tools can help facilitate education between physician and patient, provide patients with more information that can help patients make better decisions, coach patients who are trying to change health-related behaviors, and empower patients with tools to take a more active role in personal care.

5. INTEGRATION
Technology can improve information sharing between all members of the healthcare team, so that they can improve treatment and increase consistency between caregivers.

6. DECISION-MAKING
Technology opens two-way communication, giving a patient (and patient advocate’s) a stronger voice in their own care.

7. OUTCOMES
Overall healthcare outcomes can be improved on multiple levels. Measurable data can improve diagnosis and treatment. Patient’s play a more active role in personal care and treatment. Patient have the opportunity to clarify physician instructions and improve adherence in a given area.

This is just a high level overview but it gives us a way of thinking and talking about technology as support for improving the very human goals of improving patient care by improving physician-patient interactions.

[1] Defining the Patient-Physician Relationship for the 21st Century. 3rd Annual Disease Management Outcomes Summit, October 30 – November 2, 2003, Phoenix, Arizona