Patient-Physician Interactions and Electronic Health Records

Abstract

To the Editor In their recent Viewpoint, Drs White and Danis 1 discussed using the electronic health record (EHR) to enhance patient-physician interactions. Whereas others have argued that the EHR can hinder patient-physician communication, 2 the authors hold a more optimistic view that expanded uses (such as inviting patients to participate in EHR viewing during the clinical encounter) are untapped tools for patient activation. We share the optimism of White and Danis for health care information technology. During an era of technology innovation and adoption in all aspects of daily life, patients as well as medical professionals are, in general, becoming increasingly familiar with computer use during the clinical encounter. Current EHR systems, however, can be awkward to use, and there is a lack of standardized data structure for true integration of patient data across different EHR platforms. 3 These issues are technical and will likely be overcome through innovations in EHR technology, allowing expanded EHR use to further enhance patient care. Additionally, there is a growing repertoire of technologybased tools for patient activation that can complement the EHR. The relatively nascent web-based patient portals allow patients to securely log in and access their personal health information. The portal pulls data from the patient’s EHR and can support items such as screening reminders and patient-physician messaging. One study showed that patient portals in conjunction with an EHR may improve patient engagement. 4 Health care–focused social networks also offer a platform for patient activation. Patients can post questions online about their health condition. Physicians registered with the network can then post answers, which can be peer reviewed by other registered physicians. As medical students, we believe proper EHR usage instruction during medical education is important. Patientphysician communication is a part of the standard curriculum at most medical schools. For example, during our preclinical years, we learned a patient-centered model of patient interviewing. These interviews can serve as opportunities for students to practice using the EHR in a way to enhance the interaction. Appropriate use of the EHR to enhance patient activation can thus be taught concurrently with patient communication. 2,5 Ultimately, EHR education