1) My physician spends the first minute or 2 rifling through my “paper record” trying to find recent lab results, visit notes from last visit and doesn’t look at me. I understand that my doctor has to familiarize himself with my record. I don’t expect him to “look at me” following the face-to-face greeting, handshake as he gets up to speed. EHRs are simply another way of communicating information.

2) Research suggests that many patients are quite receptive to IT if they understand how the doctor uses it with respect to managing the patient’s care. This requires the physician to help set the patient’s expectations relative to the EHR, just as they would a new electronic BP monitoring system. Physicians with good patient communications skills already shouldn’t find this hard to do.

3) EHRs are typically designed for clinicians not patients. As such, most EHRs do not collect/report much non-clinical information about the patient, i.e., patient health beliefs, preferences, previous experiences. My dentist for example knows that I prefer using a “bite block” so I don’t have to strain my jaw holding my mouth open during procedures. It would help a great deal if patients could see a practical application of an EHR like this that they can relate to.

I joked today that if someone asked me where I “exist” (ie, do they need anything more than my email address to reach me) I’d say I was “half and half” – half online, half offline. I don’t get eye contact online, but I don’t mind. I wonder how far in the future we’ll all be comfortable with online-only interactions.

I know online conversation is completely different (at this time) from the clinical setting you describe, but thanks for inspiring new thoughts & ideas.