A Counterintuitive Tool for Connected Care
Authors: Zuzanna Czernik, Robert Chang, Vineet Chopra
Journal: Annals of Internal Medicine (2019)

Ideas and Opinions20 August 2019A Counterintuitive Tool for Connected CareZuzanna Czernik, MD, Robert Chang, MD, and Vineet Chopra, MD, MScZuzanna Czernik, MDUniversity of Michigan Health System, Ann Arbor, Michigan (Z.C., R.C., V.C.)Search for more papers by this author, Robert Chang, MDUniversity of Michigan Health System, Ann Arbor, Michigan (Z.C., R.C., V.C.)Search for more papers by this author, and Vineet Chopra, MD, MScUniversity of Michigan Health System, Ann Arbor, Michigan (Z.C., R.C., V.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0589 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A young man with recently diagnosed HIV was admitted yesterday with pleuritic chest pain. He declined antibiotics, was rude to the nursing staff, and frustrated the night team with all of the attention he required. As a result, he was labeled a “difficult patient.” This morning on rounds, I found him simmering with distrust and reluctant to speak. Shortly after I got a strained conversation started, I asked him, “Can I show you something?” I pulled the computer monitor toward the bed and brought up the computed tomography scan of his chest. “This is your healthy lung,” I said. “And ...References1. Rosenthal DI, Verghese A. Meaning and the nature of physicians' work. N Engl J Med. 2016;375:1813-5. [PMID: 27959650] CrossrefMedlineGoogle Scholar2. Arndt BG, Beasley JW, Watkinson MD, et al. Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations. Ann Fam Med. 2017;15:419-26. [PMID: 28893811] doi:10.1370/afm.2121 CrossrefMedlineGoogle Scholar3. Block L, Habicht R, Wu AW, et al. In the wake of the 2003 and 2011 duty hours regulations, how do internal medicine interns spend their time? J Gen Intern Med. 2013;28:1042-7. [PMID: 23595927] doi:10.1007/s11606-013-2376-6 CrossrefMedlineGoogle Scholar4. Czernik Z, Lin CT. Time at the bedside (computing). JAMA. 2016;315:2399-400. [PMID: 27299616] doi:10.1001/jama.2016.1722 CrossrefMedlineGoogle Scholar5. Payson HE, Gaenslen EC, Stargardter FL. Time study of an internship on a university medical service. N Engl J Med. 1961;264:439-43. [PMID: 13733711] CrossrefMedlineGoogle Scholar6. Parenti C, Lurie N. Are things different in the light of day? A time study of internal medicine house staff days. Am J Med. 1993;94:654-8. [PMID: 8506894] CrossrefMedlineGoogle Scholar7. Duke P, Frankel RM, Reis S. How to integrate the electronic health record and patient-centered communication into the medical visit: a skills-based approach. Teach Learn Med. 2013;25:358-65. [PMID: 24112206] doi:10.1080/10401334.2013.827981 CrossrefMedlineGoogle Scholar8. Walker J, Leveille S, Bell S, et al. OpenNotes after 7 years: patient experiences with ongoing access to their clinicians' outpatient visit notes. J Med Internet Res. 2019;21:e13876. [PMID: 31066717] doi:10.2196/13876 CrossrefMedlineGoogle Scholar9. Lanier C, Dominicé Dao M, Hudelson P, et al. Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents. BMC Fam Pract. 2017;18:69. [PMID: 28549460] doi:10.1186/s12875-017-0640-2 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Michigan Health System, Ann Arbor, Michigan (Z.C., R.C., V.C.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0589.Corresponding Author: Zuzanna Czernik, MD, Division of Hospital Medicine, Department of Internal Medicine, UH South, Unit 4, SPC 5220, 1500 East Medical Center Drive, Ann Arbor, MI 48109-2800; e-mail, [email protected]umich.edu.Current Author Addresses: Drs. Czernik, Chang, and Chopra: Division of Hospital Medicine, Department of Internal Medicine, UH South, Unit 4, SPC 5220, 1500 East Medical Center Drive, Ann Arbor, MI 48109-2800.Author Contributions: Conception and design: R. Chang, V. Chopra.Drafting of the article: Z. Czernik, R. Chang, V. Chopra.Critical revision of the article for important intellectual content: R. Chang, V. Chopra.Final approval of the article: Z. Czernik, R. Chang, V. Chopra.Administrative, technical, or logistic support: V. Chopra.This article was published at Annals.org on 16 July 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 August 2019Volume 171, Issue 4Page: 283-284KeywordsChartsComputersDisclosureElectronic medical recordsForecastingHospital medicineLungsPatientsResearch laboratoriesThorax ePublished: 16 July 2019 Issue Published: 20 August 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...