Computer systems--traditionally stationed at the appointment counter or in the billing office--are frequently joining the physician and patient in the exam room. What impact might this "third presence" have on the patient exam?
At a recent workshop, John Zapp, MD, director of the Crozer-Keystone Center for Family Health in Springfield, PA, said studies indicate that patients generally accept computerized medical records.
Two findings he noted relate to the flow of communication during the exam and the patient's image of his or her physician.
"If I've got my head buried in the computer, that's just about as bad as if I've got my head buried in the patient's chart. You've got to make the human contact," he said. "Also, when we use a computer, there's the patient's perception, 'My physician is up on new things.'"
He said another issue patients raised in one small study was confidentiality. Although the subject was mentioned by several patients, most had confidence that mechanisms were in place to protect the confidentiality of their records.
Several patients expressed their belief that computerized record systems could be more secure than paper records, and only one respondent indicated that concern about confidentiality limited his interaction with his physician. /P>
Dr. Zapp made his presentation at a medical informatics workshop during the Society of Teachers of Family Medicine annual meeting, held April 27-May 1 in San Francisco. He and other speakers at the meeting said that, with widespread and proficient use, the computer may enhance physician-patient encounters. It could, for example, allow the physician to easily obtain clinical information, distribute patient education materials, and write treatment orders at the point of service--leaving more time to care for the patient.
In a presentation to the 1993 Symposium on Clinical Applications in Medical Care, Franois Gremy, MD, professor of public health at the University of Montpellier in France, also theorized that a high-tech medical practice could contribute to retaining the human touch in medicine.
"Although informatics can be helpful in the treatment of disease, it is useless in the treatment of the patient," Dr. Gremy said. "But it can alleviate [our] analytic, intellectual work, save part of our time, and make us more available to meet the patient's needs and wishes. So the most inhuman science may be a contributor to the reintroduction of some humanity into our profession."
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