Small Cars, Big Lens
No fuel and complex mechanisms needed. These soap box racecars rolled down the street, gravity assisted. During the 4th of July Holiday, I had a chance to watch my nephew race in Frostburg, a small town in Western Maryland. I used my trusty f/2.8, 70-200 mm. zoom lens to capture this one. I used the focal length near the 200 mm. telephoto end, to compress the view. That way, I can see the start and the end of the strip. To get the focus right smack at the racecars I practiced focusing on the cars that drove by before this round started. By the time they took off, I knew which part of the image would be sharp. I wanted to blur the foreground, which were the young ladies who waved the flag at the finish line. It helped focus the eye on the racecars, which was quite a challenge in a busy photo. This was easier to do with a larger aperture and a telephoto lens. Another trick I used here was to frame the cars in the photo by using the crowd and the hail bails, and again, the foreground. That way, the small subject did not get lost in the big crowd.
My penmanship sucks and I scribble on paper like it was a third grade art project! I welcome the world of EMR. Yes, but how does one maintain patient interaction in the age of the Electronic Medical Record?
Are you a doctor, nurse, physical therapist or healthcare provider reaping the benefits of writing your documents directly on the tablet, laptop, or PC? It seems like the progress with lightning fast computers and wireless networking technology are relieving the constraints of the good ol’ pen and paper documentation techniques.
My penmanship sucks and I scribble on paper like it was a third grade art project! So I welcome the world of EMR (electronic medical record). I am so excited about the software companies, coming up and featuring their best solutions for people like me. I’m a physical therapist who needs to write things down to satisfy the documentation needs of the healthcare profession, the insurance, the patient, and my fellow PTs and assistants.
But somewhere between me and the patient is this cold machine that collects their very personal record about their history, their pain, illnesses, medications, smoking and drinking habits, and social life. Yes, the computer. The sound goes tik, tik, tik, tik, tak, tak, tak tak on the keyboard, while I’m trying to get a fruitful conversation with the patient. Yet, I am not a typist, I have to look at what I’m pecking, thus, losing the ever so valuable eye-contact that convey the respect that I am listening to what they are saying.
A couple of months ago, I posted a Survey on Patient/Physician Interaction hosted by SoftwareAdvice.com. Software Advice is an online consultancy for medical software. The survey was to discover just how EMR systems have impacted physician/patient interactions. A common criticism of EMR (electronic medical records) use in medical practices is that it causes doctors to become less engaged and impersonal. This causes frustration for all parties - patients and physicians - because doctors didn’t sign up for computer duty and patients expect a doctor’s full attention during visits. Although the survey was for doctors, I believe that this applies to therapists using EMR as well.
The survey went and the results came in.
As a result of the survey, Software Advice, was able to gather information on how to improve doctor-patient interactions in the EMR era.
They listed the top seven tips received on maintaining quality relationships:
7 Ways to Maintain Patient Interaction in the Age of the EHR (Electronic Health Record)
1. Position your computer between you and the patient: No brainer here. Face the patient during interactions. Take the time to plan where your equipment will go so that this possible.
2. Invest in mobility: Whether it’s a small rolling desk, small tablets or other lightweight tools, choose equipment that helps you move around. A laptop may cost an extra buck but can be worth the investment.
3. Delegate as much as possible: The objective is to interact with the patient as much as possible. Have staff members enter the medical history, medications, prior procedures, etc. prior to the patient’s visit so you don’t have to during the appointment.
4. Dictate as much as possible: Talk with the patient while scribes enter the information or use dictation software. These allow you to focus more on the patient.
5. Ignore the computer when you first enter the room: Chat with your patient for a few minute before you start recording information in the digital record.
6. Ask about previous complaints: If the patient information is pre-loaded, look over it before entering the room. If they have open complaints, ask them about the issues to close them out in the EMR. This reaffirms to the patient that you care.
7. Finish the chart in the room: This can help to answer any other questions that might come up so patients feel like they have been listened to.
EMRs take some getting used to. Once a physician, nurse, or a therapist develops a rhythm with the software, every patient interaction becomes easier. Practice makes perfect.
Glenn Divinagracia, PT
Glenn is a physical therapist in Maryland, USA. He is the founder of the PTEGG web store. Connect with him at PTEGG.com where you can find links and demos on Physical Therapy software. Click here http://www.ptegg.com