The digitization of healthcare has led to a gaping hole in one key element of providing care for patients: the patient's narrative. In a contributed article in The New York Times, Dhruv Khullar, MD, a resident physician at Massachusetts General Hospital and Harvard Medical School in Boston, writes patients are too often left out of their own medical record, and that can lead to inaccuracies and a depersonalization of the practice of medicine.
Dr. Khullar writes patients' medical records often contain incorrect or outdated information. "Sometimes these discrepancies are minor and inconsequential; sometimes they can be devastating," he writes. Dr. Khullar cites a study that found 43 percent of medications listed in an EHR were inaccurate.
These mistakes may come from the automation of EHRs themselves, as copy-and-paste functions and automatic data uploads put information in EHRs without requiring clinicians to ensure the information is accurate.
Dr. Khullar writes the automation of EHRs creates a barrier between understanding the whole person.
"Eliciting, distilling and communicating an account of what's happened in a person's life are skills that are vital for doctors, but especially for doctors in training still learning to care for patients," he writes. "Gathering and sharing a patient's story offers the fullest sense of who a patient is as a human being, why he might have received this treatment, for example, and not that one, and what the best course of action might be going forward."
Instead of spending time reporting quality measures, Dr. Khullar says physicians should be required to learn to gather information and tell the patient's story. He suggests offering patients access to their medical records may be one way to achieve this. Physicians, he writes, may be inclined to write more accurate and detailed notes if they know patients will read them. And, if more patients have access to their records, Dr. Khullar suggests they may be more motivated to be involved in their healthcare.
"The push to digitize healthcare has its upsides. But what's too easily forgotten is the patient's story, a coherent narrative of who a person is and what he or she has been through," Dr. Khullar writes. "As medicine continues to modernize, we can't afford to lose this ancient art."
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