The Computer Will See You Now

I received this email from a fellow
MD-IT employee, a medical transcriptionist with 18 years of experience transcribing narrative notes for a wide variety of specialists.  I thought her email perfectly captured the EMR experience from the patient’s perspective.  With her permission, I am reprinting it here:

I recently accompanied my 21 year old daughter to a gastroenterology appointment at a leading multi-specialty clinic in the northwest.  My daughter had been having terrible abdominal and back pain for over two weeks, and we weren’t sure what was going on.  She was in acute pain, on pain killers, with elevated liver enzymes, and we arrived at our visit very upset and worried. 

Almost the entire time during the exam and discussion, my daughter’s doctor was typing on the computer about her symptoms and treatment, making mistakes in his typing, and repeatedly going back to edit what he had just typed.  I felt like the entire visit he was distracted because he was concentrating so hard on composing and typing the chart note.

Additionally, I also felt that if my daughter or I asked him a question, it was interrupting his train of thought.  As a result, I felt very restricted about asking questions.  We lost the free flow of information between patient and doctor.  Instead, we would speak, and then wait 30 seconds while he typed.  Several times, I forgot what question was on my mind while I waited for him and his EMR.  It didn’t seem like good communication between us. 

I was taken aback by the amount of time he spent on the computer.  Our visit was about 15 minutes long, of which he spent about 30% of the time paying attention to my daughter, and 70% paying attention to the computer.  I didn't feel we had his whole attention during any part of our visit.

I was also thinking that I could have typed what he just did in less than half the time he spent doing the same task and produced a more comprehensive note.   I think that he could have dictated the note in less than half the time as well, since he probably only typed about five sentences. 

The other thing that surprised me was the time it took him to go through all the diagnostic codes and choose the right one. It amazes me to think that a doctor that has gone to college and medical school for 8 to 12 years is now having to do this clerical work.

I have been a medical transcriptionist for 18 years, and I really take my job seriously about getting the medical record correct for doctors and patients.  It makes no sense to me that doctors are using EMRs that take away from patient interactions, require more time to complete, and produce poor quality notes with very generalized information.