Computer-Illiterate Physicians
I’ve now seen two really excellent physicians really stumble when it comes to using an electronic medical record, and it puts them at a severe disadvantage. While they could easily perform a better and faster physical than me, take a better history, and come up with a better list of possible diagnoses, I’ve got them beat hands-down when it comes to entering orders, medications, consults, or clinic notes. They hunt and peck with two fingers, staring at the keyboard, and click everywhere very cautiously. They’ve learned one way to get the system to do what they want it to do, and while it works, it makes a lot of wasted time. One of the physicians even told me he has to come in on weekends to get all his notes written, because it takes him so long.
We’re moving toward a medical record; if you’re not comfortable with computers, and don’t know how to use them effectively, hire the neighborhood whiz to come give you a few lessons. You’ll save immense amounts of time in the future.
Having seen quite a few “computerphobic” physicians, it makes me wonder whether or not this is at the heart of the resistance to move toward the electronic medical record. So many approach the computer as if touching it will cause some sort of catastrophe to occur should the wrong button be pushed — like the earth will swallow them up if they make a mistake. It amazes me that a physician can cut into a human being with so much confidence, and fall to his/her knees in paralysis when it comes to approaching a keyboard.
I agree with medsleuth. When I worked at Northwestern tech support, I answered calls from med school profs all the time, and many of them were deathly afraid of technology, because they were of an older generation and viewed it with general “one day the robots will control us” suspicion. How old are these physicians with whom you’re currently working? Generational differences can make a big difference in willingness to learn new technology.
The problem is certainly real. The pressure to adopt to the new way of practicing will only intensify. The tipping point will be when use of computers becomes patients’ criteria in choosing their doctors.
P.S. There is a problem with “Contact” form. I am trying to submit a GrandRounds entry.
Its an interesting phenomenon. We already use electronic records in our community health teams. Only a few people are au fait enough with computers to cope. We have had this system for two years now (and its still in beta before being rolled out for the entire State..its alpha versions were a nightmare) and there are still people who, like your physicians, have learned ONE way to get a task done, in spite of the increasing number of shortcuts available. Overall, its still not a timesaver, though. I think I am probably faster than anyone at work, in entering required information (a typing speed of 75wpm), and the system still takes at least 90 minutes out of my day. It could be the system itself, but those who have a vested interest in seeing its continuation refuse to accept that its slow and unwieldy.
having said all that, timesaving is only one possible benefit of computerised records? It may conceivably take half a generation for everyone to familiarise themselves with the new system. And once the data is entered it may save time for other professionals since it will lead to the elimination of ambiguous handwriting from patient notes, electronic patient summaries and summaries of current medical probs etc.,no physical notes that can be lost or damaged, collation of all relevant patient info in one file etc? Esp. when combined with electronic x-ray retrieval etc.
Just a thought.
‘Computerphobic’ physicians don’t get absorbed by electronic medical recording during a consultation. Nor would you catch them frantically searching for patient medications and labwork results. They don’t even busy themselves with the printing of scripts or medicare documentation. No! as luck would have it our ‘Computerphobic’ physician sits calmly in front of you,managing to look you in the eye, even smiling occassionally while undertaking a thorough assessment. They are not afraid to show they care,ask the hard questions,show that you matter. Thankfully this does not require computer literacy just sincere, older, health professionals.
for those whose only problem with the computer is typing [i've hunt and pecked for decades and get in some 50/min] there are the voice recognition programs. i will soon be using that as my hands balk at a lot of typing and my silly looking hunt and peck has thus far saved me from some serious carpal tunnel and i don’t want to be pushing my luck any more.
That’s a great point, pilvikki. David Pogue, who writes a New York Times technology column, uses voice recognition software because he can’t type due to a medical condition.