Why Patients, Not EHRs, Deserve our Undivided Attention

Prayus Tailor, MD, FASN

We cannot earn patients’ trust and respect if we are tethered to a computer in the exam room, navigating the EHR concurrent to a visit or otherwise in a hurry to finish so we can return to our office where data entry to the EHR awaits us.

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I am a physician married to a physician, and for years, our evenings consisted of putting the kids to bed, then sitting next to each other, laptops open, finishing our charting. If you are a physician, you likely know the drill. There is even a name for it: “pajama time” in the EHR, and it usually consumes two or more hours.

This scenario, which plays out in physicians’ homes all across the country, is not just robbing us of work-life balance, it is robbing our patients of the undivided attention they deserve. We cannot earn patients’ trust and respect if we are tethered to a computer in the exam room, navigating the EHR concurrent to a visit or otherwise in a hurry to finish so we can return to our office where data entry to the EHR awaits us.

We have become slaves to computer data entry for the sake of insurance billing and regulatory requirements

These administrative burdens have driven some of my colleagues to retire early and others to simply quit practice and take a different direction with their careers. This is not why we went to medical school and certainly not an effective use of our license. It is a national crisis, an assault on our profession.

Artificial intelligence can do much of this for us

Not long ago, during one of those long evenings of charting, I thought to myself, if I can use Alexa to place an order for my favorite shaving cream and have it delivered the next day, surely there has to be a better, easier way of doing this. I searched Google for “artificial intelligence (AI)” and “physician charting” and came across a product that claimed to be a voice assistant designed expressly to automate the creation of clinical notes.

I signed up for a free trial. I figured I had nothing to lose and everything to gain. Client testimonials made reference to numerous benefits, not only eliminating after-hours charting and restoring work-life balance but improving the patient experience. The company instilled confidence they would be able to tailor the product to my specific style and preferences, and the artificial intelligence would learn and become more adept with continued use.

A voice assistant that listens to physician-patient conversations via an iPhone app

This voice assistant doesn’t require a separate device like an Amazon Echo. I am able to access it from an app on my iPhone, which I take into the exam room with me. I don’t have to use instructional commands, I just talk naturally. It listens to my conversations with patients, constructs clinical notes, then populates both narrative and structured data directly to the EHR.

A win-win for physicians and patients alike

I find that patients really like this, especially when I summarize what I’ve heard them say and what I intend to include in their record, which gives them an opportunity to either confirm that I have it right or correct me if I’ve misstated something. It also helps reinforce what they need to do before their next visit.

After using this voice assistant for the duration of the free trial, I ended up purchasing a subscription. Now, several other physicians in my group are adopting it as well. It has been life-changing, and I say that in the literal sense, not with hyperbole. I spend more time listening to my patients, I no longer spend my evenings charting, and the accuracy of my notes is amazing. 

This is how practicing medicine is meant to be 

We need technology that helps physicians rather than hinders them, and I believe technology like this is going to make a huge difference in the lives of physicians and their patients.


About Dr. Prayus Tailor
Dr. Prayus Tailor is a board-certified nephrologist and internist who specializes in the care of patients with kidney disease and hypertension. He is an attending physician with Nephrology Associates, P.A. (Newark, Delaware) as well as the medical director of Fresenius Medical Care Brandywine Home Therapies. He does not have any affiliation with nor a financial interest in the company that develops and markets the voice assistant mentioned. You may reach him on Twitter at @PrayusTailor or on LinkedIn.