With more medical practices recording patient data electronically rather than on paper, health care officials here say they are now focused on training staff in how best to use technology in patient interactions. 

Dr. Kirk Rowbotham, chief medical officer for Providence Medical Group here, says that using technology in exam rooms is well accepted and plays a role in almost all health care exchanges. 

 “All our exam rooms have a desktop or laptop available for use. It’s essential to the encounter,” says Rowbotham.

He says having patient data available at the click of a mouse saves time and allows for new interactions between providers and patients as they share information.  

“Now all data is in one place where it is easily referenced. It’s not necessarily better or worse, just different than how we used to do things,” says Rowbotham.

A recent article in the Wall Street Journal titled, “Is your doctor getting too much screen time?” questioned whether using laptops in exam rooms has hurt communication between doctors and patients. The article cites a Journal of the American Medical Association Internal Medicine study that found patients were unhappy when doctors spent a lot of time looking at a computer screen during exams. 

Despite the study’s findings, Sasha Wellington, senior clinical informatics specialist for Providence Health Care here, says the perception that technology limits a doctor’s interaction with patients is changing.  

“When electronic medical records first came out, there was some resistance,” says Wellington. “We’re really not seeing much now, as people understand technology is part of modern life and necessary to health care.” 

“Providers themselves have done a lot to bridge gaps in patient interactions,” she says. “As informatics specialists, we train them in how to input data while still taking time to listen and share information.” 

Wellington says informatics specialists in the clinical setting is a new title within the past five years. She is one of 200 informatics specialists employed by Providence Health & Services, which includes 34 hospitals, 475 physician clinics, senior services, supportive housing, and other health and education services across its five-state service area. 

Wellington took online courses through the University of Phoenix, and although she didn’t earn a degree, she has several years’ experience working in clinical settings.

She says there currently are 34 informatics specialists in both inpatient and outpatient areas at Providence Sacred Heart Medical Center & Children’s Hospital, another team at Providence Holy Family Hospital, and additional specialists serving other Providence hospitals and clinics in Spokane and Stevens counties.

Epic is the electronic medical record software used at all Providence facilities, having been gradually introduced to each in 2012 and 2013. Staff is trained in how to use both Epic and My Chart, the web portal version of Epic. My Chart is a free service that provides patients with online access to their health records, with the ability to manage appointments, pay bills, and email nonemergency questions to their provider.

Wellington says initial training for providers and staff on Epic shows users how the program works, and is often adjusted to accommodate different styles of learning and documenting information. 

“There are many different ways people can use the program to document. We help them find those that come most naturally to them,” she says. 

Wellington says one example is a program called Dragon Speak, a speech recognition software in which the user is able to dictate their notes to the computer, which then types as they speak. 

“We’ve also developed ways for it to better understand various speaking accents, and recognize medical terminology,” she says.  

Wellington says training also reviews privacy standards. 

 “We review the Health Insurance Portability and Accountability, HIPPA, guidelines and reiterate the importance of only accessing files when engaged in a patient’s care,” she says.

While standard training takes about a full day, some roles may need specific or additional training. 

 “Some roles might require learning multiple settings, or two different trainings, one for inpatient settings and one for outpatient,” she says.

After training, informatics specialists work alongside staff for support as they begin to see patients. Most users catch on quickly, especially those who have already had experience using other electronic medical record technology. 

Occasionally, Wellington’s team takes on larger projects, such as introducing practice rehearsals with fake patients, to walk staff through how to apply the software in check-in and exam situations. 

“This gives us an idea of how we’d like things to function before the real patients arrive,” she says. 

Wellington says as providers become more comfortable with the software, they will reach out seeking new ways to use it more effectively.

Iris Bundrock, a registered nurse and practice manager at Providence Internal Medicine, says learning to use the software takes some time, but most staff are quick to see the benefits of using it. 

 “There is some difference in systems and forms, depending on your role,” she says. “But once they catch on, people really come to see all the ways it improves patient care.”

Bundrock says most patients she sees are comfortable with staff using computers in exam settings. 

“It’s so common now that I think they’d be more concerned if we didn’t use some tech,” she says.

According to Bundrock, most providers begin an exam with patient questions, pausing to enter data and explain as they go. Next is the physical portion of the exam, followed by a comprehensive discussion to confirm symptoms, answer questions, and enter additional data. 

If patients are concerned about how to use tools like My Chart, Bundrock says staff are always willing to explain how it works. 

“It’s one of those things people just have to be able to see the value of,” she says. “The whole system has a huge impact, saving time we’d otherwise spend waiting on phone calls, lab results or imaging.” 

Wellington says she sees incorporation of technology like My Chart as a new tool patients can use to play a more active role in their care.

“My Chart includes an after-visit summary so patients can take home a printed reminder of everything discussed, or view it later online,” she says.

 “It’s nice for providers too, as they can print attachments with related treatment information to send home with the patient,” she adds.  

My Chart is available for all patients who care to sign up, enabling them to log in at home or using a phone application. My Chart also has its own help desk, with staff available to answer user questions around the clock. 

“This changing technology is part of keeping up with the times,” says Wellington. “As we’ve changed to include more options patients have changed with us.” 

Wellington says her team is always searching for ways to further improve the technology. 

“We’re continually optimizing the software, as often as every two weeks, just based on requests and clinicians’ feedback. It’s constantly changing and getting better,” she says. 

Previously, The Journal had reported on Rockwood Health System’s addition of an online application called VirtualHealthNow, a free service enabling patients to ask nonemergency health questions via video conference. 

The Spokane area’s only other large health care system, Rockwood Health System, includes Deaconess Hospital, Valley Hospital, and Rockwood Clinic. Rockwood Health System representatives couldn’t be reached for comment on ways the network’s providers use technology in patient interaction.