Protecting healing relationships in the age of electronic health records: report from an international conference

Abstract

We present findings of an international conference of diverse participants exploring the influence of electronic health records (EHRs) on the patient-practitioner relationship. Attendees united around a belief in the primacy of this relationship and the importance of undistracted attention. They explored administrative, regulatory, and financial requirements that have guided United States (US) EHR design and challenged patient-care documentation, usability, user satisfaction, interconnectivity, and data sharing. The United States experience was contrasted with those of other nations, many of which have prioritized patient-care documentation rather than billing requirements and experienced high user satisfaction. Conference participants examined educational methods to teach diverse learners effective patient-centered EHR use, including alternative models of care delivery and documentation, and explored novel ways to involve patients as healthcare partners like health-data uploading, chart co-creation, shared practitioner notes, applications, and telehealth. Future best practices must preserve human relationships, while building an effective patient-practitioner (or team)-EHR triad.

Keywords: burnout; design; international experience with electronic health records; patient–practitioner relationship; patient–practitioner–computer triad; solutions to electronic health record challenges.

Figure 1.

HUMAN LEVEL mnemonic for patient-centered electronic medical record use. Abbreviation: EHR: electronic health record. From Mann and Slaboch and Lee et al.