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EMRs can improve or hurt patient interaction

A U.S. study has confirmed what some doctors’ suspect: Using an electronic medical record system (EMR) can hinder patient care.

“EMRs are a double-edged sword when it comes to communication with patients and other clinicians,” said the study’s co-author, Dr. Ann O’Malley, in a press release distributed with the report. She is a senior researcher at the Center for Studying Health System Change, a non-partisan policy research organization based in Washington, D.C.

Distract attention

While helpful because they permit easier access to information during a patient visit, some EMR-using clinicians who participated in the study said aspects of EMRs can distract their attention. “It’s like having a two-year-old in the room,” one unidentified respondent said of EMRs, according to the study.

Some doctors wind up devoting more attention to the EMR than to the patient.

EMR design

“The study findings suggest that continued refinement of EMRs’ design by vendors and their use by clinicians could help reduce the potential for distraction during patient visits,” Dr. O’Malley said in the statement. “In particular, policies promoting EMR adoption should consider incorporating communication skills training for medical trainees and clinicians using EMRs.”

Source: Canadian Healthcare Network

Interested in your thoughts?

Resident Work Hours in the NY Times

I read with interest the article, On Young Doctors and Long Work Days, that appeared in the New York Times yesterday. It examines the issue of resident work hours in an interview with Thomas J. Nasca, MD, chief executive for the Accreditation Council for Graduate Medical Education (ACGME). The ACGME recently issued a letter endorsing a systematic review of resident duty hours with the goal of creating appropriate standards that recognize the challenges presented in the training of residents.

What I found more interesting was browsing through the 113 comments left on the NY Times Blog about the article. Lots of challenges and issues.

Is current orthopaedic residency training better or worse? Is it more safe now that residents have 80 hour work weeks? More importantly are residents competent at the end of their training? How long does it take an orthopaedic resident to acquire the skills, knowledge, attitudes and judgement necessary to practice orthopaedic surgery safely, efficiently, and cost effectively.

We will be starting a trial of a competency based curriculum in orthopaedics within our Division at the University of Toronto. In preparing for a meeting I came across the following file which is an impressive body of work that helps put the challenges and issues into perspective.

Text similarity searches to identify expert reviewers, appropriate journals and similar publications

I recently came across two interesting tools that utilize text similarity searches of Medline to identify:

  • experts on the topic to review an article or grant
  • collaborators with similar interests
  • appropriate journals in which to publish
  • articles for citation

The premise behind using a text similarity search algorithm is that most individuals do not know how to effectively and efficiently use the search tools provided by NCBI's PubMed. A literature search engine that takes natural text as input and then delivers results with high precision and recall based on similarity search algorithms has the potential to be more useful that simple keyword based searches.

Have a peak at these two resources and post your comments on whether you find them useful.

JANE- Journal/Author Name Estimator: http://www.biosemantics.org/jane/index.php

ETBlast: http://invention.swmed.edu/etblast/etblast.shtml

Video Tutorials on Orthopaedia

Several new Video Tutorials have been added to Orthopaedia.

Video Tutorials

New Orthopaedia Features