Wei Wei Lee
NEW ORLEANS — Maintaining as much eye contact with patients as possible improves doctors’ relationships with their patients, reduces the time spent on EHRs outside patient settings and improves one’s ‘computer-side manner,’ according to a presenter at the American College of Physicians Internal Medicine Meeting.
“Eye contact is a very big predictor of a good patient-doctor relationship. The computer can be seen as a distraction, a new sort of third-party in the room,” Wei Wei Lee MD, assistant professor of medicine at the University of Chicago told Healio Family Medicine. “Make sure your back isn’t to the patient the whole office visit and make sure there’s eye contact and that your eyes aren’t locked on the screen the entire office visit. These important nonverbal cues really help to set the stage for your relationship.”
“We know that oftentimes electronic health records can get a bad rap,” she said. “But there are many things we can do on the computer in the exam room that are potential ways to engage the patient in their care, to provide that education, at the same time to build the relationship with the patient.”
Lee said utilizing the mnemonic HUMAN LEVEL can help this process.
The ‘H’ stands for honoring the golden minute. “The first minute of the visit with the patient should be completely technology free. Greet the patient, start with what’s on their mind, what their agenda is and then transition into using the computer,” she said.
Other parts of the mnemonic, according to Lee:
‘U’ - Use the triangle of trust by placing the computer so that you and the patient can see the screen at the same time.
‘M’ - Maximize patient interaction by engaging the patients as much as possible, as you work on the computer.
“Act as a resource center for your patients,” Lee told attendees. This means having videos on how to use EpiPens medical devices, diabetes education videos, and other similar tools readily available so you can help the appropriate patients.”
‘A’ - Acquaint yourself with the patient’s chart before entering the examination room.
‘N’ – Not focusing exclusively on the screen during the visit, especially when the patient is talking about sensitive subjects.
The first “L’ stands for Let the patient look on. The first ‘E’ stands for Eye contact, while ‘V’ stands for Value the computer, the second ‘E’ stands for Explain what you’re doing to the patient as you do it.
“It’s important to keep up with your notes as you talk to the patient, because at the end of the day you don’t want to have to bring them home to finish,” Lee said in the interview. “Document with your patient in the exam room as you go and talk out loud as you’re typing. Plan care out loud with your patients, let them know exactly what you’re thinking about and next steps for their problems.”
The second ‘L’ stands for making it clear to the patient you have logged off the computer at the end of the visit. “Some patients are concerned that their health information is out there for everyone to see. I make a point of telling the patient that I’ve logged off their record and I even walk out of the examination room with them,” she said.
“Following all of these steps can help patients better adhere to their medications, decrease resource use and the risk for litigation,” she added. – by Janel Miller
Lee, WW. Computer and Patient: Competition or Collaboration. Presented at: American College of Physicians Internal Medicine Meeting; April 17-21, 2018; New Orleans.
Disclosure: Lee reports no relevant financial disclosures.