Peter Abaci, M.D., chronic pain specialist, author and radio host points out that it’s commonplace to see people in gathering places like coffee shops looking down at their digital devices, tapping away. He likens that to what he sees in medical offices across the country.

While technology makes a lot of things happen quicker, easier, and more efficiently, it is amazing how much it now seems to slog down the practice of medicine into a less fulfilling and user-unfriendly version of itself. Most doctors nowadays are using electronic health records (EHR), which is a huge shift from several years ago when old school paper charts still dominated most offices. Along with the inclusion of the EHR into our lives have come tighter regulations for how medical records are recorded, the hunger for big data, and the insertion of what I call “The Device” meaning computers, laptops, and tablets that now populate exam rooms.

When you take this new paradigm and add the fact that doctors are under increased pressure to condense appointment times and see more patients, then you start to see a picture of the practice of medicine becoming more about punching the right keys on the tablet to move on to the next appointment and less about providing empathy, meaningful dialogue, and quality time with the patient. The dynamics of how doctors and patients interact has become unwittingly unglued by virtue of the addition of EHR along with its partner, “The Device.”

When “The Device” becomes the third wheel in the doctor/patient relationship, this diverts the doctor’s eye contact and mental concentration away from the patient and toward “The Device” that keeps gobbling up more and more data and begging for more of the doctor’s engagement to click more boxes. This loss of eye contact diminishes the chance for bonding between the patient and doctor, leaving the patient feeling less understood, overlooked, and discounted in the whole process. At the same time, the doctor runs the risk of missing important visual cues (and verbal if they are distracted) from the patient that could help with assessment and better treatment.

If we just treat data – lab values, blood pressure readings, MRI results – and not the story behind the data, then we are missing the real opportunities to impact the health of our patients, and here is why: Chronic diseases like diabetes, heart disease, and strokes account for 7 out of every 10 deaths in the U.S., and chronic diseases account for 86% of all health care costs. Both prevention and effective chronic disease management is about engaging with the story. It requires behavior modifications, lifestyle changes, education, and a whole lot of hand holding. This type of work can’t get done without having a strong emotional connection between the healer and the patient.

What seems to be missing is that people of all ages, for the most part, seem to be comfortable telling about their lives in prose and pictures on their smartphones at the drop of a hat on sites like Facebook, Twitter, Instagram, and Snapchat. Why not have at least some of the record keeping and data entry done by patients on their own gadgets of choice? Shifting more of the medical record stewardship back to the patient would seem to be more empowering and engaging anyway. The next iteration of EHR should not just exist on “The Devices” in exam rooms and hospitals, but also on patient smart phones or tablets with easy to use features for simple clicking and swiping.

Technology needs to find ways to enhance the doctor patient relationship, not tear it down. Let’s start by bringing eye contact back to the practice of medicine.

huffposthealth.com

January 11, 2015