Humanizing the EHR
In a recent CLOSLER feature, Jeffery Millstein of Penn Medicine reinforces a sentiment frequently shared by Stanford Medicine 25, writing that “the clinically excellent clinician makes an effort to know each patient’s unique story, moving beyond the confines of the content within the [electronic health record] EHR.”
In his essay, Millstein emphasizes that the current EHR template, characterized by “tedious data entry, finding the right diagnosis codes, and a blur of pop-up reminders,” hinders physicians from capturing someone’s personal history, therefore dehumanizing the patient. His proposed solution is technology capable of recognizing and underscoring a patient story to allow for a complete picture of the person. Millstein suggests an EHR format that puts human and social descriptions in the “heading, even before chief complaint or history of the present illness.” Additionally, he calls on physicians to reexamine the way they were “taught to present and document patient histories from the very beginning,” a practice he says perpetuates the impersonal nature of medical recordkeeping.
Millstein concludes that humanizing medical documentation may ultimately improve health outcomes by better positioning physicians to partner with their patients and “create a care plan that consists of thoughtful, shared decisions.” We are advocates for thoughtful implementation of technology in medicine and agree that Millstein’s strategy could be effective for allowing physicians more time to focus on connections with their patients.
Humility is an underappreciated skill in a time of global budgets, evidenced based approaches, and cost-containment. The bright, well-read, talented medical students who may lack humility are not uncommon.
Patient-centered care is an important aspect of the National Strategy for Quality Improvement on Health Care. As such, healthcare institutions are strongly focusing on the patient-physician relationship and the patient experience.
The editor-in-chief of Medscape, Dr. Eric Topol, visited Stanford to sit down and do an interview with our Dr. Vergese for the Medscape One-on-One online video series.
Peter Conrad, a sociologist at Brandeis University, spoke of the rise and fall of the medical authority in the doctor patient office encounter in his many scholarly articles. With the internet becoming the “elephant in the doctor’s office,” the dynamic of medical authority has certainly changed…