Health IT: A Patient’s Perspective

As a patient, I sat in the exam room awaiting the results of my labs and tests. From my perspective, there was a great deal on the line – my personal health and possibly my longevity.

I sat alone — waiting for the nurse to come in to begin the initial check-in phase — taking in the sterile room, its beach-themed art and the blank flat-screen monitor near me on the counter.

After several minutes alone, pondering my fate and driving myself further into a place of stress, the nurse finally entered the room.

We exchanged pleasantries. Hellos and how are yous.

With that, she turned from her back to me, keyed in a few strokes and began to enter data into the practice’s EHR.

Same weight?, she asked. No change, I replied.

Same insurance? Yes, again, I said.

Same address? Of course.

Finally, after several more clicks, a few mumbled words that seemed like complaints and the occasional over the shoulder smile and the obligatory, “Excuse me,” she tried to make me feel better about our lack of direct interaction by making a bit of useless small talk (about the weather and such).

After several more minutes of intermittent and sparse conversation, I finally decided to ask about the electronic health record she was using.

Which one?, I asked.

The answer was the name of a vendor I did not recognize.

How long had the practice used it? A bit more than a year, she said.

Was the physician or his practice making a play for meaningful use? Not likely, she shrugged. Too cumbersome; the practice would try to make a go of it even though there would be penalties.

Did she like using the EHR system? The answer was an unequivocal “No.”

My response: a befuddled “Why?”

“Notice my back,” she said? I nodded, which she probably did not see (given her back was toward me).

“I haven’t spent any time with you, or any of my patients. I spend all of my time looking at the screen,” she confessed.

Couldn’t other steps or tools – laptops or tablets – be taken or used?

Certainly, but there’s still a disconnect between the patient and the care, she replied. By “disconnect” she meant the computer screen.

What’s the solution?

Perhaps less outside intrusion or data collection efforts by those not involved in the care process and a return to the priorities: patients and their well being, she explained, not computers and their screens.

We reasoned a marriage of the two approaches is likely required and that even with the clumsiness of the exchange, it is the current situation of things and likely the only position for the time being.

However, given my position – on the table as a patient rather than as a writer discussing HIT — I couldn’t help but see her point.

With that, she excused herself and made way for my doctor who entered the room, exchanged pleasantries and turned his back on me to face the monitor …

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