Humanistic Charting: Empowering Person-centered Emergency Care Through Reimagining the Electronic Health Record

The rise in health care standardization has increased the focus on documentation, subsequently leading to the depersonalization of patient care. Humanistic Charting attempts to enhance person-centered care (PCC) by streamlining the integration of a patient's narrative into the electronic health record (EHR), while reducing a clinician's administrative workload. The Humanistic Charting Tool (HCT) transitions the collection and documentation of person-centric data to patients, empowering them to convey their values, preferences, and individuality.

We carried out a pilot study in an academic emergency department (ED) at the University of California, San Francisco, between February and April 2023, involving 6 clinicians and 29 adult patients using the HCT. Clinicians reviewed HCT entries prior to patient encounters. The feasibility and impact of HCT were assessed using surveys and interviews pre- and postuse. The statistical significance of patient and clinician responses was assessed with 2-sided paired t tests.

The HCT was met with high patient satisfaction, with notable improvements in patient-rated care experience metrics post-HCT implementation, such as respect for patient preferences and clinician availability. The HCT received excellent Net Promoter Scores from both patients (52) and clinicians (83). Clinicians observed that the HCT promoted a humanistic care approach and helped alleviate burnout.

In this pilot study, the HCT has demonstrated encouraging feasibility and promise in helping enhance PCC within the challenging ED environment. Clinicians have noted its advantages in providing deeper insights into patient histories and improving the quality of interactions, having the potential to aid in counteracting biases. This pilot study demonstrates the HCT's potential to help foster humanism and PCC in emergency settings and supports the potential for broader applicability in health care systems.