This past year I was able to visit the University of Indiana (IU) School Of Medicine.
I was there as part of a delegation on business related to our Amarillo campus. Indianapolis
is a very impressive city, and IU School of Medicine is one of the largest medical
schools in the U.S. with a very beautiful campus.
An enjoyable part of the trip was meeting with several chairs of clinical departments
and other people involved in the IU Health, their medical practice. Of course, we
were able to see how they do things and visit their facilities. I also heard about
many of their initiatives, including their Electronic Health Record (EHR). So, when
an article came out in the Wall Street Journal a few days ago related to IU Health
and their use of an EHR to enter data while a physician is seeing patients it was
of interest to me.
The article features the work of Richard Frankel, Ph.D. Dr. Frankel is part of IU
School of Medicine’s Regenstrief Institute, an investigator, and professor of medicine.
He is trained as a medical sociologist. He has developed a mnemonic to help with bedside
manner for physicians to consider when using the computer during a patient encounter.
He calls it POISED and it means:
Preparation: Review the EHR before seeing the patient.
Orientation: Explain how the computer will be used during the appointment.
Information gathering: Enter data to show patients' concerns are being taken seriously.
Share: Show the computer screen so the patient can see the information.
Educate: Display a graphic representation of information such as the patient's weight
or blood pressure.
Debrief: Make sure the patient understands what is being said.
I think there is great value to Dr. Frankel's advice. We all know that this business
of entering data, while concurrently staying connected to the patient, can be difficult
to execute. When I use my primary care doctor at Texas Tech Physicians, I am very
impressed with the way he uses the computer. It does not seem intrusive to me at
all.
While he is examining and talking to me, he is reading my record and looking for items
to address. For example, he might ask if I have had a tetanus booster shot or a vaccination
for shingles. I perceive this as thoroughness and him being interested in my total
care. He has my medications and my problem list. He often stops to ask me questions
and always looks me in the eye while doing so, which makes it a positive experience.
He explains what he is doing with the EHR.
EHRs are here to stay. There is clearly both an art and a science to using them.
Personally, I think they are a great tool. I realize that others see it differently
than I do and that is fine. Difference of opinion is what makes the world go around.
But, to me, when the physician uses the computer and remembers some or all of the
principles contained in the POISED mnemonic, it is really another way of saying, “I
care about you as my patient, we are going to get this right, and we are working together
to improve your health.”
