Health Informatics Discussion Forum

This is the discussion thread for Component 2, Unit 10, Lecture C of the MOOC:

 

Discuss the advantages and disadvantages of having the computer in the same room as the doctor and the patient.

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  • Depends on how you want to use the computer for..:) If stressed, watch some videos, FB..!!

    On a more serious note:

    Will start with the Patient:

    Adv: 

    1) Does not have to carry all the physical records

    2) Does not have to bother about explaining the problem over and over again

    3) Need not explain what medications the Patient is on..

    4) Need to realise that the Doc using a computer for Clinical care will be beneficial to him

    Disadv:

    1)Some might think that Doc is not looking at the Patient

    2)Typing continuously on a keyboard might irritate and create a sense of suspicion

    Adv to the Doc:

    1) All records in one place

    2) No need to search through multiple papers

    3) All Medical history a click away

    4) All allergies, prior medication will be considered before deciding on a course of treatment

    5)  Perform research on the ways he is treating Patients (to bring in a Evidence Based approach)

    Disadv:

    1) Need time to get used to the system

    2) To have a belief that the application will really help him deliver more efficient Healthcare

    • (And of course for accessing the Health Informatics Forum...!)

      Do you think there could be an advantage in having the computer in a separate room from the patient encounter? Or perhaps asking the patient to wait in the waiting area while the doctor uses the computer?

      • Well..iam not sure how will it help..

        And even if we have a computer in a different room than the consultation one, the Doc again has to write down (presumably on a paper) all that he has seen and done on all the Patients. And go back and enter all the notes..

        And this way, negates the entire purpose of going paperless.. :)

  • Maybe the question should be:  How can we best use the computer in the room with the doctor and the patient?

    Yes......The obvious disadvantages to workstation/tablet in the clinical care space when dealing with the patient is the loss of person-to-person interaction while documenting.  The obvious advantage is extensive (hopefully) knowledge of the patient diagnosis/treatment and possibly elements while apparently unrelated that may have some impact on future treatment and prognosis.

    FIRST: there has over time been an evolution of rules about technology which need to apply in the healthcare space as well as others.  We know for instance that USING ALL CAPS in the equal of yelling is message management(email), and it is generally thought to be extremely rude to continuing to answer emails and message traffic having invited someone into your office.  There is nothing that prevents doctors form taking notes on a pre-printed summary page and then documenting the visit after the patient has left right in the exam room or the doctor has returned to the nursing station/hallway workstation.

    BUT SECOND: What they are finding in hospitals and some doctor offices is that we can take advantage of the technology in the room to share with the patient or to instruct the patient on their situation.  They already have the rights to the the information....so why not use it to show the visual issues/progress (x-ray, sonogram, etc.) or even just review the relevant findings of the lab results.  This involves the patient, shares the information, and uses the technology that is available in the room.

    • Thanks for you thoughts Jonathan. I once read a history of medicine book that went through the standard doctor-patient encounter a hundred or so years ago. The doctor would first call in the patient and take their history, perform an examination and then take any samples. He would then go to his own laboratory where he would look up information in textbooks, look at samples down his microscope and perform any chemical tests that were possible. Then he would call the patient back in and explain his findings and issue a prescription.

      Maybe it's time for doctors to have some space and time to think and investigate (using the internet and electronic notes) for every patient until they have decided on the best course of action and then call them back in. Yes, all this could be done with the patient but it may be more efficient to do this in private. Explaining the diagnosis and plan could be done using a tablet with the patient but this is a separate step from the investigation phase.

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