Electronic Communication Doctors - Patients - Computers - Learners
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1 Electronic Communication Doctors - Patients - Computers - Learners Janet Hamstra, Ed.D.. Nova Southeastern University College of Osteopathic Medicine Center for Excellence in Medical Education
2 Objectives The learner will be able to: Describe the impact of the EMR on physician patient communication in the exam room Identify skills for including the computer during the clinical encounter Describe how electronic communication can hinder and enhance communication in osteopathic medical education
3 Are you experienced with Audience Response Systems? 1. No, not at all 2. Yes, only as audience member 3. Yes, only as presenter 4. Yes, both as audience member and presenter 5. Yes, I invented ARS! No, not at all 0% 0% 0% 0% 0% Yes, only as a... Yes, only as p... Yes, both as a... Yes, I invente...
4 Where have you used ARS most? 1. Hospital 2. Clinic/Ambulatory Setting 3. COM 4. Conference like an OME Leadership Conference perhaps 5. More than one of the above 6. Some other place, I d rather not say Hospital 0% 0% 0% 0% 0% 0% Clinic/Ambulat... COM Conference li... More than one... Some other pla...
5 Who is in the audience? (select your top title) 1. AOA Senior Leader/Staff 2. AACOM Senior Leader/Staff 3. COM Dean/Administrator 4. COM Faculty/Staff 5. OPTI Leader/Staff 6. Hospital DME 7. Residency Program Director AOA Senior Lea... AACOM Senio ior L... COM Dean/Adm dmin... COM Faculty ty/st... OPTI Leader/ er/st... Hospital DME Residency Prog... Residency Prog... Resident/Stu Stude... None of the ab Residency Program Faculty/Staff 9. Resident/Student d t 10. None of the above 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
6 OME Leadership Conference Attendance? 1. 1 st time attendee 2. 2 nd, 3 rd, or 4 th time 3. 5 th 10 th time 4. More than 10 times 5. All 22 of them! 0% 0% 0% 0% 0% 1st time att tten... 2nd, 3rd, or th 10th t tim... More than 10 t... All 22 of the hem...
7 Objective #1 Describe the impact of the EMR on physician patient communication in the exam room
8 EMR Impact on Communication i Computers impact visual, verbal, postural connections with ihpatients. Baseline skills are carried forward and amplified positively or negatively Frankel R., et. al. Effects of exam-room computing on clinician-patient communication: A longitudinal qualitative study. J Gen Int Med. 2005;20(8):
9 EMR Impact on Communication i Facilitates or inhibits Visit organization Verbal, nonverbal behavior Computer navigation, mastery Exam room spatial organization Frankel R., et. al. Effects of exam-room computing on clinician-patient communication: A longitudinal qualitative study. J Gen Int Med. 2005;20(8):
10 EMR Impact on Patient Satisfaction i overall patient satisfaction with visits ii physicians familiarity with patients communication about medical issues comprehension of decisions made No change in perception of visit time Patients felt computer helped visit efficiency Hsu J et.al. Health information technology and physician-patient interactions: Impact of computers on communication during outpatient primary care visits. J Am Med Inform Assoc. 2005;12(4):
11 EMR Impact on Patient Satisfaction 74.6% felt computer had overall positive impact on quality of care Positive association between patient satisfaction and their rating of physician computer skills Garrison GM, et al. 21st-century health care: The effect of computer use by physician on patient satisfaction at a family medicine clinic. Fam Med. 2002;34(5):362-8.
12 EMR and Clinician i i Practice Styles 3 Clinician Practice Styles Related to EMR Use: Informational Interpersonal Managerial Ventres W, et al. Clinician style and examination room computers: a video ethnography. Fam Med. 37(4):
13 Do you have EMR where you practice medicine? i 1. Yes, every place I practice 2. Some places but not all of them 3. Not at all 4. NA Not a clinician 0% 0% 0% 0% Yes, every y pla... Some places bu... Not t at all NA Not a a cli...
14 Do you use EMR in the exam rooms with ihthe patient present? 1. Yes, all the time 2. Yes, some of the time 3. No, prefer to use it when patient isn t present 4. I don t use EMR and/or am not a clinician i i 0% 0% 0% 0% Yes, all the t... Yes, some of t... No, prefer t to... I don t use E EM...
15 Objective #2 Identify skills for including the computer during the clinical encounter
16 EMR and Patient Communication From Dyad to Triad
17 Maintain eye contact with the patient
18 Let the patient see the screen
19 Explain what you re doing
20 How do you really feel about EMR? 1. Love it best thing to happen to medicine 2. It s OK I can take it or leave it 3. Hate it worst thing to happen to medicine i 4. NA don t have it or not a clinician Love it b best... 0% 0% 0% 0% It s OK I ca... Hate it wors... NA don t hav...
21 Value the computer as a tool
22 Tell the patient you are logging off
23 Do your LEVEL Best Let t the patient t look on Eye contact with the patient Value the computer as a tool Explain p what you are doing Log off and say you are doing so Mann, WR. & Slaboch, J. Computers in the exam room: Friend or foe. Permanente Journal, 2004;8(4):49-51.
24 Switching Gears
25 Objective #3 Describe how electronic communication can hinder and enhance communication in osteopathic medical education
26 To what generation do you best relate? 1. Traditionalists ( ) 2. Baby Boomers ( ) 3. Generation X ( ) 1976) 4. Generation Y ( ) 1995) Traditionalist... 0% 0% 0% 0% Baby Boomers (... Generation X (... Generation Y (...
27 To whom do you best relate?
28 To whom do you best relate? 1. Andrew Taylor Still 2. Marcus Welby 3. Doogie Howser 4. Gray s Anatomy 5. House 6. None of the above 0% 0% 0% 0% 0% 0% A.T. Still Marcus Welby Doogie Howser Gray s Anatomy House None of the above
29 To what technology do you best relate?
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36 Keeping up with Change For medical education to flourish from one generation to the next, it has to reconfigure itself in response to changing scientific, social, and economic circumstances. The Flexner Report, 1910
37 Medical Education Paradigm for Millenniums Learn About One See One Do One Teach One Simulate One Do Enough hunder Direct Supervision to Demonstrate Competence and Confidence Do Enough Under Indirect Supervision i Be Taught to Teach One Teach One The Millennial s in Medicine: The Learning Gap, B. Joyner, MD, UW School of Medicine
38 Electronic Communication in OME
39 Words of Advice Formal instruction and assessment on communication Teach/Model Triad communication Social Media training
40 Words of Advice Communicate about electronic communication Social media policy Electronic communication policy Generational idiosyncrasies Personal idiosyncrasies
41 Do your LEVEL best Thank You! Janet Hamstra, Ed.D.
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