Freedom to Be a Doctor

By Dr. James Winnickwinnick, Stockton, CA

There’s no denying that the movement from paper charting toward electronic health records is well underway. While many factors have contributed to EHR adoption, I noticed two distinct attitudes toward this movement from my colleagues:

  • They were active adopters of an EHR because they prided themselves on having the latest technology, and they realized the increased efficiencies that EHRs provide over paper; or
  • They adopted an EHR reluctantly—kicking and screaming—because government regulations threatened to pinch their bottom lines if they didn’t.

Whatever your attitude toward EHRs, the outcome is the same: you’re now charting with a computer.

I admit, early EHRs rubbed me the wrong way. They seemed to disrupt the doctor-patient relationship. I was bothered more by my own experiences as a patient rather than as a doctor. More times than I would like, I had the pleasure of talking to my doctor’s back as he asked me questions over his shoulder, locked to his keyboard and typing my responses. It seemed to me that experiences like that are impersonal, and I swore I would never replicate that experience in my practice. Looking a patient in the eye, listening, conversing and showing that I genuinely care about why they’re sitting in my examination chair are important to me. Jotting notes in a paper chart on a clipboard has allowed me to maintain that relationship. So, how does a doctor maintain that close doctor-patient interaction amid increasing pressure to adopt an EHR?

Well, some doctors still take written notes during the patient visit. They then enter their notes into the computer, or delegate this task to a staff member, after the patient visit. Some doctors have employed scribes. Both of these techniques allow the doctor to maintain the personal patient interaction. But, both methods cost the practice additional time and money.

Another solution is using a tablet, such as an iPad. They’re light and mobile like a paper chart on a clipboard, and yet they’re also powerful and intuitive. EHR companies have recognized these advantages as well, and are now offering native tablet apps for their latest generation products. For a doctor, tablets break the chains that tied us to the keyboard and pulled us away from our patients.

My practice adopted Eyefinity EHR on the iPad. Because of its light and mobile nature, I can use my iPad for charting exactly how I used to with paper charts. I’m able to face the patient, converse with them, and simply swipe my finger to enter findings as I go. The app can record normal findings for numerous procedures at once, so I don’t spend time documenting “clear” for each individual structure I examine. New adaptive learning technology within Eyefinity EHR actually changes and builds my drop-down menus to match my most commonly used plans and treatments. When I’m done with my examination, my output notes are clear and complete, and my staff can actually read them! If I haven’t completed and documented enough elements of the examination to justify the billing code that I want for the visit, the program tells me what I’ve forgotten. My material orders, medical prescriptions, and billing codes are all sent to the next user with the touch of a button. And, the following year, all of this information is brought forward to the next visit—without looking for a chart!

Before tablet-based EHRs were available, I always said that nothing could beat the speed and efficiency of a doctor documenting with paper. Eyefinity EHR on the iPad has changed my opinion. Being able to maintain the freedom to move around my exam room and office like I would with a paper chart and being present with my patients, all while gaining all of the advantages of an EHR system, has revolutionized the way I practice. I believe it’s the very best way to deliver superior service to my patients and grow my practice.


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