The electronic medical record and Patient-centered care.

Area of Science:

• Health Informatics
• Clinical Systems Design
• Patient-Centered Care

Background:

• Electronic Medical Record (EMR) development has historically prioritized objective data capture.
• Less emphasis has been placed on incorporating patient concerns and preferences into EMR systems.
• Facilitating a patient-centered clinical encounter is a key goal for EMR development.

Purpose of the Study:

• To identify opportunities and obstacles in promoting patient-centered care within integrated settings reliant on EMRs.
• To offer suggestions for how EMRs can be individualized to support patient-centered approaches.
• To analyze the role of EMRs in enhancing the patient experience.

Main Methods:

• Literature search supplemented by author's extensive experience with a national EMR system.
• Qualitative analysis of EMR use from physician, educator, and administrative perspectives.
• Exploration of strategies to integrate patient-reported data and preferences into clinical workflows.

Main Results:

• Three promising areas for patient-centered EMR development: chief complaint elicitation, health screening, and health literacy evaluation.
• Identification of strategies, including potential IT developments, to enable patient direct data entry.
• Demonstrated need for EMR features that capture subjective patient information.

Conclusions:

• EMR design is pivotal in facilitating patient-centered clinical encounters.
• Patient-centric EMR modifications can enhance quality improvement and research in patient-centered care.
• Focus on patient-centricity is crucial for Accountable Care Organizations utilizing EMRs to avoid system-centric approaches.