American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs

Humanizing the Electronic Medical Record with the Personal Fact

doctor talking on cell phone stting at his desk, looking at computer

The current model of patient care promotes a system wherein patients are viewed as diseases with treatment plans rather than individuals with a lifetime of experiences. This is further exaggerated by the electronic medical record, wherein streams of impersonal data are presented above the patient narrative. Quantitative data are crucial for medical management, but it should not obscure the view of patients as people. Physicians contribute to this depersonalization by thinking of “the chronic patient” rather than “a mother of 5.” Instead of “a retired kindergarten teacher,” doctors often refer detachedly to “the patient in room 502.” Physicians need a tool to allow them to acknowledge a patient’s identity and humanity.

In 2005, Kirkpatrick et al wrote about applying the principles of humanism in medicine to ward rounds.1 The authors pose that rounds, as events that define medical teams, can intentionally be made into classrooms for professionalism and humanism. For example, they recommended asking patients what they are famous for, encouraging physicians to express their feelings about patients especially after bad outcomes, and describing one positive thing about each patient (including the “difficult” ones).1 Ten years later, there is still a gap between the emphasis on objective data points and patients’ humanity.

We seek to build on the framework described by Kirkpatrick et al1 by offering a straightforward, yet practical, initiative. We propose that a Personal Fact be elicited from every patient on hospital admission. We believe that this formal expectation to elicit information about hobbies, professions, or life experiences, in the same way that everyone is asked about smoking history and code status, will restore personhood to dehumanized patients. The Personal Fact is placed above the chief complaint in the admission note. By purposefully placing the Personal Fact above the chief complaint, we are emphasizing that the patient is first and foremost an individual.

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-Irina A. Skylar-Scott, MD, Barry J. Wu, MD

This article originally appeared in the July 2017 issue of The American Journal of Medicine.

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