EHRs in the exam room: tips on patient-centered care.

(EHRs) are clearly part of family medicine’s future. However, the information available on EHRs to date has focused on the practicalities of buying and implementing a system. Minimal attention has been paid to understanding how family physicians use EHRs with patients in the examination room. In our work both as clinicians practicing with EHR systems and as researchers studying the communication patterns of physicians using EHRs with patients, we have observed how EHR use in examination rooms can inhibit physicians from focusing on their patients. Even skilled physicians commonly use troubling behaviors such as looking predominantly at the computer monitor during office visits, typing while patients are talking about intimate concerns, reading silently from the monitor while patients sit idly, using templates to lead interviewing rather than listening to patient narratives, and turning their backs to patients in spite of the availability of mobile computer monitors. These behaviors need not be the norm. In fact, EHRs have the potential to enhance in-office communication with patients. To accomplish this, however, physicians will need to bring the best of both EHRs and patient-centered interviewing to the examination room. With a thoughtful approach, you can maintain your focus on the patient.