Electronic Medical Records and Person-Centered Care

If you ask healthcare professionals, including palliative care community specialists, to name the most burdensome and time-consuming part of working in medicine, you will receive overwhelming feedback that documentation required in the electronic medical record impinges on patient-centered time for listening and connecting.

As a reference point, I remember when all medical records were hand-written. No, I did not write my notes on papyrus. Yes, we had enormous three-ring legal size binders where the healthcare team would narrate their assessments and interventions. For patients who were seriously ill or had lengthy hospitalizations, the team would need to scour several volumes to find historic data and then needed to decipher sometimes illegible handwriting. Sometimes it felt like an archeological dig – when you found the note you were searching for, it was akin to finding King Tut’s tomb. We managed, but with the introduction of electronic medical records (EMR), infinite information was at our fingertips.

However, as EMR’s became more sophisticated, so did the documentation and the amount of time we spent away from patients and in front of a screen. In some cases, healthcare professionals are charting while in the room with patients. This is more efficient, but efficiency comes at a cost to the caring relationship many of us find rewarding. Healthcare professionals enter the field to be healers, and rarely do we enter the field to expand our documentation skills. The EMR has depersonalized and truncated the bedside healing that occurs when we connect with people living with serious illnesses.

The beauty of palliative care, and why we are drawn to the specialty, is the spaciousness of our meetings and visits. We truly take the time to hear about what matters most to patients in their words and with their stories. The answer to, “tell me more about your seven cats” and “how did you learn to cook in a tandoori oven?” may not end up in the EMR, but it creates threads of compassion that connects us as humans. Learning about the nuances and what makes each person special is the secret sauce of palliative care. The compassion satisfaction that palliative care community specialists feel, and the healing that patients receive, far outweighs anything we can write in the chart.

Dr. Jackie Redmer, a palliative care student in the MSPC program, has written extensively on the need for humanity to be infused back into the medical system, in particular the electronic medical record. She has authored poems that reflect the narratives of patients, her professional experiences, and her personal journey related to palliative care. I have included links to her materials below.

For further reading and links to Dr. Redmer’s work: