Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use Curriculum

Abstract Introduction Trainees from the millennial generation are adopting technology at a faster rate than their senior counterparts. Technology adoption in health care is also being fueled by national policies such as the sharp rise in electronic medical record (EMR) use after President Obama'...

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Main Authors: Maria Alkureishi, Wei Wei Lee, Jeanne Farnan, Vineet Arora
Format: Article
Language:English
Published: Association of American Medical Colleges 2014-11-01
Series:MedEdPORTAL
Subjects:
Online Access:http://www.mededportal.org/doi/10.15766/mep_2374-8265.9953
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author Maria Alkureishi
Wei Wei Lee
Jeanne Farnan
Vineet Arora
author_facet Maria Alkureishi
Wei Wei Lee
Jeanne Farnan
Vineet Arora
author_sort Maria Alkureishi
collection DOAJ
description Abstract Introduction Trainees from the millennial generation are adopting technology at a faster rate than their senior counterparts. Technology adoption in health care is also being fueled by national policies such as the sharp rise in electronic medical record (EMR) use after President Obama's 2009 health care stimulus package. Nonetheless, there is very little curricular focus addressing patient-centered use of technology. Abraham Verghese has drawn attention to the unfortunate practice of focusing on the “iPatient,” who exists only on the computer screen as a set of data points, while ignoring the real patient. Methods Our resource provides a framework for educators to teach learners of various levels (students, residents, fellows, and attendings) how technology use (e.g., EMRs and tablet computers) can affect patient-doctor communication in both the inpatient and outpatient settings. The resource includes a PowerPoint lecture on patient-centered EMR use and best practices; two teaching videos of a less-than-ideal and a more-ideal patient-provider interaction, along with an accompanying worksheet; pocket cards to summarize best practices for patient-centered technology use in both outpatient and inpatient settings; resource files for implementing the patient-centered EMR-use objective structured clinical exam (OSCE), including iPaCT Curriculum; overview and description, standardized patient (SP) guide, and door chart for active experimentation; and an e-CEX evaluation tool for use during the OSCE as well as for direct observation. The lecture, OSCE, and feedback take about 90 minutes. Results We implemented this patient-centered EMR-use curriculum with second-year students at the University of Chicago Pritzker School of Medicine. To date, we have results only for our second-year students, with our third-years (who did not receive the lecture but did participate in the same OSCE and evaluation) as a comparison controls. For these two groups, we demonstrated statistically significant improvement in SP evaluation OSCE performance scores of second-years who received this curriculum as compared to third-years who did not. We also demonstrated statistically significant improvement on second-year scores on a post-OSCE survey assessing self-perceived knowledge, attitude, and skills. Discussion We first started our curriculum in 2013 with second-year students, but we have since expanded it to internal medicine residents and will be also including faculty (of various disciplines). The curriculum can help train learners of all levels to promote and maintain patient-centered care in the context of EMR use. Furthermore, the e-CEX evaluation tool can help programs monitor the quality of patient-centered technology use and identify areas for improvement.
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spelling doaj.art-11d0cae48dcd432088d62e551209dd742022-12-21T19:48:53ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652014-11-011010.15766/mep_2374-8265.9953Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use CurriculumMaria Alkureishi0Wei Wei Lee1Jeanne Farnan2Vineet Arora31 University of Chicago Division of the Biological Sciences The Pritzker School of Medicine2 University of Chicago Division of the Biological Sciences The Pritzker School of Medicine3 University of Chicago Division of the Biological Sciences The Pritzker School of Medicine4 University of Chicago Division of the Biological Sciences The Pritzker School of MedicineAbstract Introduction Trainees from the millennial generation are adopting technology at a faster rate than their senior counterparts. Technology adoption in health care is also being fueled by national policies such as the sharp rise in electronic medical record (EMR) use after President Obama's 2009 health care stimulus package. Nonetheless, there is very little curricular focus addressing patient-centered use of technology. Abraham Verghese has drawn attention to the unfortunate practice of focusing on the “iPatient,” who exists only on the computer screen as a set of data points, while ignoring the real patient. Methods Our resource provides a framework for educators to teach learners of various levels (students, residents, fellows, and attendings) how technology use (e.g., EMRs and tablet computers) can affect patient-doctor communication in both the inpatient and outpatient settings. The resource includes a PowerPoint lecture on patient-centered EMR use and best practices; two teaching videos of a less-than-ideal and a more-ideal patient-provider interaction, along with an accompanying worksheet; pocket cards to summarize best practices for patient-centered technology use in both outpatient and inpatient settings; resource files for implementing the patient-centered EMR-use objective structured clinical exam (OSCE), including iPaCT Curriculum; overview and description, standardized patient (SP) guide, and door chart for active experimentation; and an e-CEX evaluation tool for use during the OSCE as well as for direct observation. The lecture, OSCE, and feedback take about 90 minutes. Results We implemented this patient-centered EMR-use curriculum with second-year students at the University of Chicago Pritzker School of Medicine. To date, we have results only for our second-year students, with our third-years (who did not receive the lecture but did participate in the same OSCE and evaluation) as a comparison controls. For these two groups, we demonstrated statistically significant improvement in SP evaluation OSCE performance scores of second-years who received this curriculum as compared to third-years who did not. We also demonstrated statistically significant improvement on second-year scores on a post-OSCE survey assessing self-perceived knowledge, attitude, and skills. Discussion We first started our curriculum in 2013 with second-year students, but we have since expanded it to internal medicine residents and will be also including faculty (of various disciplines). The curriculum can help train learners of all levels to promote and maintain patient-centered care in the context of EMR use. Furthermore, the e-CEX evaluation tool can help programs monitor the quality of patient-centered technology use and identify areas for improvement.http://www.mededportal.org/doi/10.15766/mep_2374-8265.9953CommunicationPatient-Centered CareEHRDoctor-Patient RelationsPatient-CenteredElectronic Health Record
spellingShingle Maria Alkureishi
Wei Wei Lee
Jeanne Farnan
Vineet Arora
Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use Curriculum
MedEdPORTAL
Communication
Patient-Centered Care
EHR
Doctor-Patient Relations
Patient-Centered
Electronic Health Record
title Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use Curriculum
title_full Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use Curriculum
title_fullStr Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use Curriculum
title_full_unstemmed Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use Curriculum
title_short Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use Curriculum
title_sort breaking away from the ipatient to care for the real patient implementing a patient centered emr use curriculum
topic Communication
Patient-Centered Care
EHR
Doctor-Patient Relations
Patient-Centered
Electronic Health Record
url http://www.mededportal.org/doi/10.15766/mep_2374-8265.9953
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