After I greet my patient, plug in the Chromebook and make sure the TV is on I do something very rare. I show my patient his own record. The record is illuminated on a large screen and consists of one page and is quite foreign in appearance, so I have to make the necessary introduction. First, I explain this is his record, I am the custodian, and we are going to work on it together to ensure accuracy. Second, this is unlike any other visit because we are going to work through each portion of the chart as evidenced on the large screen, and learn together.
The visual involvement of the data points graphed out so the weights, blood pressures and Body Mass Indexes are each demonstrated and explained. This process is mostly unidirectional with the patient being receptive.
The rest of the visit is very much bidirectional, the exchange of banter to relive the past, correct any discrepancies, ensure accuracy, and learn together. As we make our way through each section, before going to the next, we both agree the information is indeed acceptable. The learning is intermingled with the co-documentation process, and with health maintenance, laboratory results, and embedded Up To Date the process may become a bit more unidirectional as I take on the role of teacher.
However, the process from my perspective, with the well structured framework of the chart keeps us both on track and a very effective use of our time together.
I feel very grateful to finally have the technology to interact in this way with my patients. I think my patients are indeed surprised to finally see their own chart but even more surprised to work on it together and learn from it. However, the surprise quickly turns to appreciation and gratification, and I think peace of mind being able to see their own chart in action.