My old concept of the patient’s chart, multiple pages of paper faxed, typed up, hand written notes bulging the manila casing to a max, stacked in multiple layered shelves stare at me constantly as I sit at my office desk. Eighteen years of practice easily encased and stored as a constant reminder that at this ripe old age of soon becoming a half centenarian, I can still learn.
This is my work, I paid for the paper, chart covers, invested in the staff to help create and maintain all these files, reminders of all the sleepless nights spent at the hospital, multiple office visits over the years. But this way of thinking has not only been shattered but destroyed and I intentionally keep the old paper charts handy in my office for two reasons. One to access old reports or notes, the other confirmation of where I have been.
Where am I going? The Samsung 1080p 24 inch screen TV’s in both exam rooms remind me of this everyday. As I stand in front of the TV, with my ruler in hand and go through line by line twenty years of past medical history, the old and new converge. The hospital stay for the pneumonia, the initiation of anti hypertensive treatment, the appendectomy, the old stroke, we reminisce together.
I cannot hold all of this information and carry this contained in a chart as I whisk into the exam room, but I can share the chart, together with the patient on a large screen. I still pay for the software and hardware, and staff to help maintain, but have the opportunity to share the chart as I have never been able to.
Which brings me to the next thought. Who’s chart is it? And if the patient wants to review with you at the time of visit, should you, would you?
I am continually learning as I explore this new territory, but am reminded on a daily basis, this is the patient’s chart, and incredible things happen when you go over things together at the visit.