Computers and Clinical Environments – How to Engage Your Patients

More and more physicians are using computers in examining rooms.  There are desktops, laptops and tablets making the rounds with you.  Computers are great tools for improving patient health, from ensuring best practices are followed to having a full patient history available at each visit.  Unfortunately, depending on how you use a computer in the exam room, you may be alienating your patients.

Consider these points:

  1. Do you make eye contact with your patient during the exam?  When the patient is in the room, where are you looking?  Are you focused on the computer screen, or in looking at the patient
  2. Body language – both yours and your patients.  What message are you sending as you concentrate on the computer screen?  Are you picking up on body language that your patient is sending you? 
  3. Barriers to engagement.  Where is the computer in the exam room?  Does the screen block your view of the patient?  Is your back turned to the patient while you enter information into the computer?

Here are ways to help improve the clinical environment.

  1. Location of the computer.  Can you put the computer on an adjustable stand so that it doesn’t interfere with you looking at your patient? If not, consider a tablet or other smaller mobile application.
  2. Eye level.  Make sure that your at the same level as your patient as you talk to them and enter their history.
  3. Physical environment.  Most patients are not accustomed to having difficult and potentially life-changing conversations.  As physicians, you have these conversations on a far too regular basis.  As you speak to them, are your patients and their family in an uncomfortable environment, perched on exam tables, in bright lighting with little privacy as you have difficult conversations with them?  Are you looking directly at them while talking to them, or focusing on the computer as your give them information and enter clinical data?  Consider having one room in your office suite with a more comfortable environment, one with a comfortable, even reclining, chair and adjustable lighting.  Perhaps even with no computer in the room at all.  Create an environment where your patient feels total engaged in the conversation with you. 
  4. Consider making short notes while engaged with the patient in the examining room, and make your computer entries in another, perhaps centralized, room. 
  5. Check with the patient that you’re sure that you’ve heard them correctly.  Don’t assume you both heard the patient correctly or that you can capture all the important information from an anxious patient who is speaking quickly.  If you’re entering a significant piece of information in the patient’s medical records, reflect it back to them to ensure accuracy.  They’ll also feel that you’re actively listening to them.
  6. Making EMR and EHR programs support importing dictation.  You can speak far faster than you can enter information into a computer.  Consider dictating your notes, even in front of the patient, and then having them transcribed and entered in your EMR.
  7. Reflect on your body language.  Ask a staff member or colleague to give you feedback based on the way you would interact with a patient.  Just angling your body slightly towards your patient and leaning forward will make your patients feel that you are more engaged with them.  And make sure you’re picking up on your patient’s body language.  Are they telling you the whole story about their medical history?  Are they leaving out some embarrassing information that might be significant?  While the tone of our voice, and not just the words, conveys a significant amount of information, so do our bodies. 

And keep things clean.  You may also want to check out these articles on keeping commonly used items clean.  You may be surprised where the germs are in your office.


Ties and lab coats:

Mobile phones:   waiting for another article dirty mobile phones to go up to enter link!!!

Considering your clinical environment is another aspect of good patient care.

2Ascribe Inc. is a medical transcription services agency located in Toronto, Ontario Canada, providing medical transcription services to physicians, clinics and other healthcare providers across Canada.  With WEBscribe, a client interface portal for document management, 2Ascribe continues to implement and develop technology to assist and improve the transcription process for physicians and other healthcare providers.  As a service to our clients and the healthcare industry, 2Ascribe offers articles of interest to physicians and other healthcare professionals, medical transcriptionists and office staff, as well as of general interest.  Additional articles may be found at and

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