Original Publication
Open Access

Breaking Away from the iPatient to Care for the Real Patient: Implementing a Patient-Centered EMR Use Curriculum

Published: November 20, 2014 | 10.15766/mep_2374-8265.9953

Included in this publication:

  • iPaCT Curriculum Overview & Description.docx
  • iPaCT Toolkit.docx
  • Lecture.ppt
  • TedVideo.mov
  • Video1.wmv
  • Video2.wmv
  • OSCE Door Chart.docx
  • OSCE SP Guide.docx
  • OSCE Facilitator Packet.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

Introduction: Trainees from the millennial generation are adopting technology at a faster rate than their senior counterparts. Technology adoption in health care is also being fueled by national policies such as the sharp rise in electronic medical record (EMR) use after President Obama’s 2009 health care stimulus package. Nonetheless, there is very little curricular focus addressing patient-centered use of technology. Abraham Verghese has drawn attention to the unfortunate practice of focusing on the “iPatient,” who exists only on the computer screen as a set of data points, while ignoring the real patient. Methods: Our resource provides a framework for educators to teach learners of various levels (students, residents, fellows, and attendings) how technology use (e.g., EMRs and tablet computers) can affect patient-doctor communication in both the inpatient and outpatient settings. The resource includes a PowerPoint lecture on patient-centered EMR use and best practices; two teaching videos of a less-than-ideal and a more-ideal patient-provider interaction, along with an accompanying worksheet; pocket cards to summarize best practices for patient-centered technology use in both outpatient and inpatient settings; resource files for implementing the patient-centered EMR-use objective structured clinical exam (OSCE), including iPaCT Curriculum; overview and description, standardized patient (SP) guide, and door chart for active experimentation; and an e-CEX evaluation tool for use during the OSCE as well as for direct observation. The lecture, OSCE, and feedback take about 90 minutes. Results: We implemented this patient-centered EMR-use curriculum with second-year students at the University of Chicago Pritzker School of Medicine. To date, we have results only for our second-year students, with our third-years (who did not receive the lecture but did participate in the same OSCE and evaluation) as a comparison controls. For these two groups, we demonstrated statistically significant improvement in SP evaluation OSCE performance scores of second-years who received this curriculum as compared to third-years who did not. We also demonstrated statistically significant improvement on second-year scores on a post-OSCE survey assessing self-perceived knowledge, attitude, and skills. Discussion: We first started our curriculum in 2013 with second-year students, but we have since expanded it to internal medicine residents and will be also including faculty (of various disciplines). The curriculum can help train learners of all levels to promote and maintain patient-centered care in the context of EMR use. Furthermore, the e-CEX evaluation tool can help programs monitor the quality of patient-centered technology use and identify areas for improvement.


Educational Objectives

By the end of this resource, learners will be able to:

  1. Understand the impact of modern technology use in health care on the patient-doctor relationship.
  2. Identify best practices to utilize technology in a patient-centered manner to enhance patient-doctor communication.
  3. Adapt best practices and key lessons learned in order to promote respectful and engaging technology use.


Author Information

  • Maria Alkureishi, MD: University of Chicago Division of the Biological Sciences The Pritzker School of Medicine
  • Wei Wei Lee, MD: University of Chicago Division of the Biological Sciences The Pritzker School of Medicine
  • Jeanne Farnan, MD, MHPE: University of Chicago Division of the Biological Sciences The Pritzker School of Medicine
  • Vineet Arora: University of Chicago Division of the Biological Sciences The Pritzker School of Medicine

Acknowledgments
Drs. Alkureishi and Lee are co-primary authors on this publication.

Disclosures
None to report.

Funding/Support
This research was supported by the following grants: (1) Clerkship Directors of Internal Medicine (CDIM) iInTime Small Grants Program, PI: Wei Wei Lee, Co-Investigators: Maria Alkureishi, Jeanne Farnan Vineet Arora, Title: “Evaluating a Patient-Centered Electronic Medical Record (EMR) Use Curriculum”, Total Funding: $5,000, Project Period (4/2014-4/2015); (2) Picker/Gold GME Challenge Grant, PI: Wei Wei Lee, Co-Investigators: Maria Alkureishi, Vineet Arora, Title: Improving Patient Centered Technology Use (iPaCT), Total funding: $50,000 (Grant Funding $25,000, Matching Grant $25,000), Project Period (8/2013-8/2014); (3) The University of Chicago Academy of Distinguished Medical Educators Grant, PI: Maria Alkureishi, Title: Patient Centered EMR Use, Total funding: $25,000 per year, Project Period (7/2013-7/2015); (4) Gold Foundation Research Institute: Review of Humanism Literature, PI: Wei Wei Lee, Co-Investigators: Maria Alkureishi, Title: Impact of Technology Use on the Patient-Doctor Relationship and Communication, Total funding: $5,000, Project Period (8/2013-2/2015); (5) Bucksbaum Institute For Clinical Excellence 2013 Pilot Grant, PI: Wei Wei Lee, Title: Improving Patient Centered Technology Use (iPaCT), Total funding: $9,000, Project Period (7/2013-7/2014).

Prior Presentations
Workshop presented at: AAMC Integrating Quality Meeting; 2014.

Poster and workshop presented at: Association of Program Directors in Internal Medicine (APDIM); 2014. 

Poster presented at: Section of General Internal Medicine (SGIM); 2014.

Workshop presented at: AAMC Central Group on Educational Affairs; 2014.

Poster and workshop presented at: Council on Medical Student Education in Pediatrics (COMSEP); 2014.

Invited workshop presented at: Gold Humanism Honor Society (GHHS) Conference; 2014.

Poster and workshop presented at: Midwest Section of General Internal Medicine (SGIM); 2013.

Oral presentation at: UIC Clinical Skills Conference; 2013.

Oral presentation at: Research & Innovation in Medical Education (RIME); 2013; Chicago, IL.

Poster and platform presentation at: Association of Pediatric Program Directors (APPDM) & Council on Medical Student Education in Pediatrics (COMSEP); 2013. 

Workshop and oral presentation at: Clerkship Directors in Internal Medicine (CDIM); 2013.



Citation

Alkureishi M, Lee W, Farnan J, Arora V. Breaking away from the iPatient to care for the real patient: implementing a patient-centered EMR use curriculum. MedEdPORTAL. 2014;10:9953. https://doi.org/10.15766/mep_2374-8265.9953