[dotti105]

We are making our permanent move to our home in TV this month and are anticipating getting established with The Villages Health Care System. I have been reading many of the posts here to educate myself regarding our expectations.

One thing I see, again and again, are negative tone references to the "provider"(PA or MD, DO, NP) spending time on the computer during your visit. I am a RN and still working in this fast changing healthcare climate and I feel that I must explain that from now on, we had all better get used to that scenario.

With the advent of electronic medical records which provide instant access for a provider to your medical history when needed, we will be seeing the provider using the computer during our visit and exam. At least, that is the way it should be!!

Electronic records are much more accurate and detailed. Your provider is required to fill in his "chart" as the visit occurs. This is for your benefit. I personally would be very concerned if my provider did not chart during the appointment, in live time.

The newer, younger, more computer literate providers will chart as they are making eye contact with you and it will not be as intrusive. A less computer literate provider will struggle more and those "keyboarding skills" they did not develop early in their career will be a challenge for them. Those are the providers who appear to not be listening, to not be a personable during an appt. Most likely they will also be running late for appts too as they try to "fill in the blanks" between appointments.

Many of the providers that I work with have chose to retire rather than figure out how to "chart", or "write orders" electronically. In most cases, it was time for them to move on anyway.

Change is never easy. Insurance companies have written the rules for health care for so long, and now we are struggling with health care changes. Some of which are long overdue. There will be many changes in the future. But I can guarantee you that the computer, or tablet will be in the exam room with you. As new and strange as that may seem, most of us in the trenches of healthcare do feel that it is time, in fact past due, for many of these changes.

Try to see past the computer to communicate with your provider and realize that for many this is new and strange for them as well.

We all are required to demonstrate some patience and do our part to make time with our provider productive, as we each deal with healthcare changes as they occur.

But please do not think that your provider is "on the computer" rather than listening to you. The computer is helping them to address your needs today and to provide the documentation that may need to be reviewed in the future to meet your ongoing needs.

Hope this helps some to understand the role of the computer in the exam room.

[CFrance]

My doctor, if he has to turn his back to me to type on the computer, will stop, turn around in the middle of it all, and apologize for "having his back to me." In different rooms, he is facing me while on the computer, and we are talking. It's not that big a deal for me because he makes sure that every question I have is answered. He also walks me out to the front desk. I never feel like I'm a number. It's very pleasant.

[dotti105]

CFrances, sounds like you have a good provider and good communication. As it should be!!
(I may be contacting you for references)

[dodaneodwyer]

Thank you for your posting/clarification!

[skyguy79]

Dotti, excellent post and one I agree with 100%.

This issue reminds me of a commercial that used to air several years ago for Fram Oil Filters. The key phrase was "You can pay me now, or you can pay me later!"

In the contemporary medical world, that means that today you can accept the new trend of "during appointment data entry", or you can chose a doctor who's not documenting this way and risk a less than ideal situation down the road if and when a doctor needs quick access to you're history in an emergency!

Personally, I'm more than happy with my providers at the VHC Center documenting things during my appointments!

[Bizdoc]

Well put. I sit next to the "desk area" at Colony clinic so that the doc (or PA-C or ARNP) can talk while they type. When it is hands on time, I'm usually on the exam table.

I have no problem with the provider typing info into the computer. I go in with my list of questions and I don't stand up to leave until they are answered. If you have trouble remembering your questions, write them down. If you're naturally shy, take someone along. I haven't encountered anyone in the Villages Health system who minds answering questions or actually discussing alternatives.

[Cedwards38]

Computers make every facet of life easier and more efficient. That includes medicine. I haven't noticed a problem at all with The Villages Health Care providers. We talk, they record the information. I'm happy.

[NotGolfer]

My provider is very relational therefore we seem to have a good professional relationship. She'll make a comment re: needing to get "this" down so she won't forget, or some such thing. I, for one, have been used to this format as my clinic up north was electronic. I missed it when we first moved here but now we're with TV health system...I think it's a good thing. Years ago I worked in a clinic environment...first in the chartroom as a file clerk. THAT was an eye-opener as I had to correctly file the various pieces of paper in the chart so the doctor (and/or nurse) could refer to it at the next visit.

Only once, after moving here was I not happy with a provider. He'd be constantly tapping away on his computer, asking me questions or pretending to be chatting with me. He blew his "cover" when he'd repeat himself. I "fired" him!

[laceylady]

When I see my doctor in The Villages Health Center, his medical assistant is usually in the room doing the typing while he talks to me. I don't believe a medical asst. is there when I see a PA or ARNP. The GPS, FPs and specialists in WA state having been typing into computers in exam rooms for many years. They just situate the computer so their back in not facing the patient as they type. For people applying for SSDI, workers comp, VA disability benefits, etc., electronic records are cutting weeks and months off the processing time for their claims. The future is here and we should embrace it.

[ilovetv]

I don't think anybody is against the concept of electronic medical records. This article describes what I keep hearing from dr. and nurse friends/relatives of all ages and experience levels, and from my own doctors:

"Relative to intuitive touch-based smartphones and tablets commonly used today, electronic medical records are generally antiquated programs that are cumbersome to use. Most force providers to spend more time than ever staring at a computer screen and clicking checkboxes with a mouse to satisfy onerous billing and administrative requirements that do little to help patients.

For instance, it takes me over 50 mouse clicks, all while scrolling through dozens of screens, to document a straightforward office visit for a sinus infection. Refilling a single prescription electronically, which I do over a hundred times a day, takes over 10 clicks.

In fact, more time in front of computers means less time for patients. An American Journal of Emergency Medicine study found that emergency physicians spent 43% of their time entering data into a computer, compared to only 28% of their time spent talking to patients. During a typical 10-hour shift, a doctor would click a mouse almost 4000 times.

Doctors in training have it worse. Researchers at Johns Hopkins University School of Medicine found that medical interns spent just 12% of their time talking to patients, or about 8 minutes a day per patient, but more than 40% of their time on a computer filling out electronic paperwork......"

Electronic medical records obstruct patient interaction

As in most situations, administrators making business, regulatory and billing decisions don't have the same frustrations as those on the front lines actually taking care of sick people while wrestling with very sluggish computer programs/systems.

[2BNTV]

Originally Posted by CFrance

My doctor, if he has to turn his back to me to type on the computer, will stop, turn around in the middle of it all, and apologize for "having his back to me." In different rooms, he is facing me while on the computer, and we are talking. It's not that big a deal for me because he makes sure that every question I have is answered. He also walks me out to the front desk. I never feel like I'm a number. It's very pleasant.

My present doctor does the same thing.

However. my old doctor gave me the impression that he was becoming less familiar with my history and was concentrating on his computer. He made several mistakes that verified he wasn't listening to me. if I didn't move to FL, I would have fired him...... wait... I did fire him!!!

Getting info from a patient is more enlightening, than typing into a computer. This particular doctor was more concerned about his time, and what he had to do than caring about the health, of his patients. Doctors want you to respect their time. they should be aware that some patients value their own time and familiarize themselves with the patients records, before entering the examining room. It's a two way street. as it's not all about them!!!! IMHO

Doctors seem to forget their patients are their customers. They are so use to getting monies from insurance companies, that maybe they are confused about whom they need to please.

Just sayin.......

[Chi-Town]

If you have ever visited the Medical Records department at a hospital it is a scary sight. Archaic would be kind. Be thankful for the change to electronic record keeping, and the fact that The Villages has embraced it. Many parts of the country have a long way to go.

[mrfixit]

The FEDERAL Taxpayers (that is You and Me) provided $42,000.00,
or more, to EVERY Doctor who knew about this subsidy and filled out
the simple form.

The payments were to HELP defray the cost of getting their records
into a Digital, Searchable, Computerized database.

All Docs will have Digital Databases for their Patient Data, soon.

The Docs that I go to have now "added" Records person(s)
IN the room while Doc listens intently to your every word.
The Doc tells the Records person what to enter into the database.
Data Records person does all the data entry on the computer.

My "records" are also on a "thumb drive" that can be carried on person while
traveling.

In the case of Prescriptions....all now digitied and sent automatically
to the Pharmacy of Your Choice.
No more paperwork for me to lose, no waiting in lines for scripts.

Of course, these Docs will also answer their "special" cell phones, during
their time with the patient, to handle "emergency" situations. This is fine with me.