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EHRs Best Practices for Patient-Centered Care in 2020

By Team Altus | Published Apr 03, 2020 | 5 MIN READ

An EHR is a reliable, complete digital version of a patient’s paper chart that can be updated and accessed in real-time. This valuable data improves diagnostics and patient outcomes by aiding clinical decision-making and streamlining processes that once were time-intensive. Best Practices of EHRs to Enhance Patient Care in 2020 not only make the lives of providers of healthcare easier but they improve patient care.

A HealthIT.gov report found 75% of healthcare providers say their EHR enables them to deliver better patient care. We know EHRs can improve patient care, but what are the best practices when doing so? Below is a guide on best practices when using EHRs to make a positive impact on patient care.

Equipment and Workflow Considerations

Happy clinicians make happy patients. The success of EHRs is largely dependent on the ability of the adopter – whether it be the clinician or IT support team – to fully understand the workflow and have the tools and equipment they need to support it.

Various devices are throughout during the patients stay and charting workflow. Laptops, all-in-one pcs, keyboards, mouse, cameras, monitors and accessories are all necessary pieces of equipment to consider. Choosing a workstation is important. Whether it be a powered cart that can stay charged an entire shirt, a secure cart specialized in medication delivery, or a wall-mounted workstation or non-powered cart that works well in single or isolation units.

The key takeaway here is clinicians and support teams all work best in different ways, and it’s important to find the perfect mix of equipment and workflow solutions to receive the best EHR adoption rate and ultimately to help your clinicians deliver the best patient care.

HUMAN LEVEL

At the 2019-2020 MacLean Center Lecture Series on The Present and Future of the Doctor-Patient Relationship, Wei Wei Lee, MD, MPH delivered the session: "You, Me, and the Computer Makes Three?”.

Wei spoke on the most common complaint surrounding EHRs. Clinicians are spending too much of their working hours entering data and not enough time communicating with the patient. Communication is a crucial component of patient satisfaction. Wei and her team developed a guide of best practices gathered from research and their work studying patient perspective.

This guide is titled "HUMAN LEVEL". It is filled with best practices that are teachable behaviors and skills to challenge clinicians to do better. These actions frame EHR from a burden into a tool that enhances patient and clinician communication and improves patient education.

  • Honor the ‘Golden Minute’
  • Use the ‘Triangle of Trust’
  • Maximize patient interaction
  • Acquaint yourself with the patient’s chart
  • Nix the screen
  • Let the patient look on while entering information into the EHR
  • Eye contact
  • Value the computer
  • Explain what you’re doing
  • Log off

Honor the ‘Golden Minute’

The first minute of the patient encounter is considered the "golden minute". Make sure to Walk into the patient room completely technology-free. You greet the patient and ask questions like what brings them in. The goal at this step is to make a human connection before you log into your computer.

Use the ‘Triangle of Trust’

The triangle of trust portion sets you up for success. The monitor available should be able to rotate and tilt so both you and the patient can see the screen. This allows the patient to feel like they are working with you during the visit.

Maximize patient interaction

Always leave time for the patient to ask questions to make sure they fully understand something.

Acquaint yourself with the patient’s chart

Do your homework. Review notes and know what you want to talk about and know what questions you’d like to ask before going into the appointment. This preparedness will allow you to use the EHR efficiently.

Nix the screen

If a patient has something sensitive to talk about or something that concerns them, you should swivel the monitor away from the conversation if possible. Remove your hands from the keyboard, turn to face the patient, and remain in eye contact with the patient and away from the technology. Your body language will show you are actively listening and with the patient at that moment.

Let the patient look on while entering information into the EHR

Inviting the patient to look at the screen while you enter in EHR information helps build trust and ensures accuracy, leaving less room for errors.

Eye contact

Maintain eye contact as much as possible while with the patient. Fact: Studies have shown male clinicians who are using the computer have more of a tendency to keep their eyes on their keyboard and screen and there is less eye contact vs female clinicians.

Value the computer

EHR is not going away. It’s important to not make the computer seem negative by badmouthing it. Think about the positive attributes of the valuable resource that it is and share those with your patient. This will make it a positive experience.

Explain what you’re doing

Talk out loud while you’re using the computer. Be open with what you’re doing on the EHR. This eliminates the patient wondering what’s going on while your attention is no longer on them.

Log off

Secured patient information is incredibly important. Make sure to log off as soon as your EHR task is complete.


Ongoing Training

For best practices, it’s important to provide ongoing training from medical students, residents to faculty. There are many resources you can utilize such as patient experience videos and online lectures.


Patient Awareness and Advocacy

Engage and empower your patients. Create a tool that makes it possible for patients to give feedback and to speak up when they see room for improvement. Empower your patients by sharing information on how they can make it a better experience for themselves. To accomplish this, Wei and her team came up with the tips “ABC” to share with your patients.

  • Ask to see the screen
  • Become involved
  • Call for attention

Ask to See the Screen

It’s your right as a patient to view the screen as it’s your medical information. Sharing the screen creates the “triangle of trust” between the patient, clinician and technology.

Become involved

Do your homework as the patient. Review your records and ask your clinician questions.

Call for Attention

If you’re not receiving attention during critical moments from the clinician while they are utilizing their computer, it’s okay to ask for the attention you need.


Conclusion: EHR is not going anywhere. Simply, the benefits greatly outweigh the costs. It’s important to come together and continuously look at ways to increase patient care, safety and satisfaction through innovative approaches. Wei’s thought leadership has already improved current and will improve future generation’s approaches to EHR. These are the best practices of EHRs to enhance patient care in 2020.

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