Where does the doctor place the computer?

Pauline Chen's "An Unforeseen Complication of Electronic Medical Records"
is a timely focus on the computer's not yet comfortable place in the patient-doctor relationship.

...that afternoon as I settled in to see my first clinic patient, I realized I had no idea where to sit. The new computer was perched atop a desk in one corner of the room; the patient sat on the exam table on the other side of the room. In order to use the computer, I had to turn my back to the patient as I spoke to him. I tried to compensate by sitting on a rolling stool but soon found myself spending more time spinning and wheeling back and forth between patient and computer than I did sitting still and listening. And when my patient did talk, his story came only in spurts because every time I turned my back to him to type, the room fell silent.

My vision of an interaction marked by the seamless flow of conversation and capture of information vanished. Instead, I was spinning my wheels. Literally.

Yes, it gets better. Read the full article here.

Chen's article is based on the release of "Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less?", a study based on how EMR's effect clinician's interpersonal communication in 26 practises. The study is a very worthwhile read, here is a summary graphic that you can click on to enlarge.

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