Touch versus technology: A physician's take on the successes and frustrations of technology in the exam room

By Dodge Communications on July 10th, 2014

Ask a physician why he or she chose their career path. You might hear things like “I had a loved one with this disease” or “I had a great mentor who encouraged me to go into medicine.” Most certainly, no matter what statement it is wrapped in, the intent remains the same: the majority of physicians go into medicine to help people – to touch lives.

As modern medicine continues to evolve, technology has entered the exam room. For some, this has expanded clinical opportunities. For others, technology is met with some hesitations

Dodge recently spoke with Eric Ruderman, MD, a rheumatologist and professor in medicine at Northwestern University, who sheds some light on the physician’s goal of keeping medicine personal while utilizing technological advances.

Dodge: What is your favorite healthcare technology piece thus far?

Dr. Ruderman: E-prescribing is the very best thing so far – it’s huge. If I need to refill someone’s medicine, I type it in, push a button, and it’s at their pharmacy. I don’t have to write a prescription and a pharmacist doesn’t have to interpret it. This is very helpful.

Dodge: Why do you think e-prescribing has been widely and quickly adopted?

Dr. Ruderman: Because it’s simple, it’s easy, and it does exactly what it’s intended to do. With Meaningful Use, we have to hit specific benchmarks, some of which feel a bit arbitrary. However, one of the most sensible targets is e-prescribing, where a certain number of our prescriptions have to be e-prescribed. Ninety-five percent of my prescriptions are e-prescribed, and here’s why: it makes sense and it adds value. You don’t have to force me to do it.

Dodge: Have you seen a reduction in errors using e-prescribing?

Dr. Ruderman: That’s one of the things in electronic health that has already been proven. While there is always a chance for error, there is no transcription error with e-prescribing because it doesn’t go through multiple people before the prescription is filled. When I e-prescribe – it is done, and that does minimize errors.

Dodge: You’ve been on an EHR for 10 years – how has this technology helped you?

Dr. Ruderman: It is nice to be able to get to notes from other physicians within our system. If, for example, one of my patients is seeing a pulmonologist or oncologist, I can open their notes and see what they are up to instead of trying to interpret what the patient is telling me. It’s also helpful to easily put my finger on any lab, X-rays, tests, biopsies, etc. done within our system. I can go back several years and I don’t have to dig around, flip through a chart or make a call – it’s all there.

Dodge: What is one concern among physicians when adopting EHRs?

Dr. Ruderman: I think the biggest concern people have is it is going to take up time they don’t have – time away from other important things. Ultimately, there are positives to having all this information at your fingertips, it just takes time and effort to get it all in there, which can lead to physician hesitation.

Dodge: When is EHR technology at its best?

Dr. Ruderman: When there is good interoperability, which for some will be a few years down the road. My EHR vendor has started addressing this. Now, whenever one of my patients is seen somewhere that uses the same EHR, I can get their records, labs, X-rays, etc. This is very beneficial.

Dodge: Switching gears a bit, let’s talk about the patient engagement piece – namely patient portals. Do you see this continuing to grow, and do you see physicians becoming more comfortable with these components of mHealth?

Dr. Ruderman: I do. We have a patient portal. It is helpful for me to send labs, X-rays, etc. out. You don’t need to mail them or make a call. For example, when someone’s labs come back, I can easily forward them through the patient portal with a note explaining them to the patient, and the patient can respond to me.

There does need to be some explaining and boundary setting here to ensure the portal is being used the correct way. If it is a follow-up question after a visit or a question about a medication, the portal is an appropriate way of communicating. If it is a new issue, or something that is more detailed, it needs to be handled in an in-person visit. We need to work to ensure patients understand the power of, and best uses for, the portal.

Dodge: As an interesting aside, your wife works on the other side of this conversation – she implements healthcare technology. Does that make for interesting debates and conversations in your house?

Dr. Ruderman: [laughing] Oh yes, she’s constantly telling me, “Oh you physicians. You’re always griping.” Ah, us whining physicians!

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