There have been various conversations over the years about the use of tablet computers for data entry into EHRs by MDs (see, for example: Why Tablets Are The Future Of Electronic Medical Records; Tablet-Based Patient Registration Deployed at Longone Medical Center). This would seem to be a logical EHR capability given that one of the criticisms of these systems is that physicians spend too much time at the keyboard and not making eye-contact with patients (Doctors Need to Maintain Patient Eye Contact While Using EHRs). With a tablet, the physician can face the patient while entering data. The use of tablet data entry seems to be commonplace for some EHR vendors. For example, here is a list of physician functions that can be accomplished with a tablet using the cloud-based Practice Fusion (see: Practice Fusion Blog):
- View your daily schedule and see every provider’s schedule.
- Chart patient visits with touch-based templating, new vital sign options, and clinical decision support notifications in the new encounter.
- Access all your patients and add new patients.
- Manage your EHR users and connect with labs, imaging centers, and ePrescribing from your new EHR dashboard.
Although some tablet computers have keyboards, or can be equipped with them, most are used with the touch screen for data entry. Here are some salient points for consideration about this topic:
- The use of EHR scribes who accompany physicians when a interacting with patients is now common (see: Four Considerations When Hiring an EHR Scribe). They perform all keyboard entries into the EHR so the physician can interact directly with the patient. This increases personnel expenses but also increases physician efficiency.
- During some ambulatory patient visits, patients are often first seen by a nurse practitioner or some other type of physician extender (e.g., ophthalmic assistant or technician). In these cases, these other personnel perform the major share of the keyboard data entry.
- It's possible to simplify tablet data entry for physicians with automatic data entry (i.e., using macros). Keyboard macros allow short sequences of keystrokes and mouse actions to be transformed into other, usually more time-consuming, sequences of keystrokes and mouse actions. In this way, frequently used or repetitive sequences of keystrokes and mouse movements can be automated.
The problem with automatic data entry as opposed to, say, the use of drop-down lists or drop-down menus, is that the macros themselves need to be memorized. Hence, they will probably need to be reserved to call a relatively small number of, say, documents that the physician uses frequently. I would be interested in hearing any reader comments about this topic.