The computer-assisted patient consultation: Promises and challenges

The implementation of electronic health records (EHRs) holds the promise to improve patient safety and quality of care, as well as opening new ways to educate patients and engage them in their own care. On the other hand, EHR use also changes clinicians' workflow, introduces new types of errors, and can distract the doctor's attention from the patient. The purpose of this chapter is to explore these issues from a micro-level perspective, focusing on the patient consultation. The chapter shows the fine balance between beneficial and unfavorable impacts of using the EHR during consultations on patient safety and patient-centered care. It demonstrates how the same features that contribute to greater efficiency may cause potential risk to the patient, and points to some of the strategies, best practices, and enabling factors that may be used to leverage the benefits of the EHR. In particular, the authors point to the role that medical education should play in preparing practitioners for the challenges of the new, computerized, environment of 21st century medicine.