Maintaining healthy communication

Dietitians at the Royal Prince Alfred Hospital in Sydney investigate the effects of eMR2 on inter-professional communications.

We live in a time where technology advancements are inevitable. So it was no surprise when the old-fashioned hand-written medical records were slowly shifting to an electronic form. Traditionally, hospital professionals such as doctors, nurses and allied health would have to search for the paper medical records of patients under their care. Sometimes the medical record would be vacant and other times it would be unavailable, making documentation time longer. Therefore, making medical records available online has improved time-efficiency and allows health professionals to write medical records simultaneously.

An innate quality of technology is reduced face-to-face contact. We know that constant and effective communication among health professionals is paramount in patient-centred care. This is especially important for hospital dietitians who usually need to liaise with the medical team in order to make drastic nutritional changes for their patients. This sparked an interest in a group of dietitians at Royal Prince Alfred Hospital in Sydney, NSW, to investigate more into the effects of electronic medical records (eMR2) on inter-professional communications (IPC).

Eligible dietitians were asked to track two full days of clinical work pre and post the introduction of eMR2. This included all types of IPC, amount of time spent as well as mode of communication. Three months post the introduction of eMR2, semi-structured interviews were conducted with available dietitians to gain insight into possible perceived impacts of such changes.

Study findings

For a larger view of the graph, click here.

The graph above gives an insight into how dietitians distribute their time to patient-related tasks pre and post eMR2. It is evident that IPC plays an integral role in dietetic practice and this was further reinforced in the interviews. Dietitians interviewed stated that since eMR2 has reduced the time it would take to gather patient data and document, they have more time to spend with patients. Study participants raised that the ability to edit existing medical entries on eMR2 may also lead to miscommunication among health professionals and need to be looked into to allow for the continuum of optimal patient care delivery.

Dietitians conveyed that they still communicate all necessary information with the rest of the care team; however, face-to-face communication was reduced while over-the-phone contact was increased. They attributed this change to the availability of patient information remote from their designated wards. This meant that all health professionals could access patient information from their own office or computer without having to be physically present in a ward.

During the interview process, there was an interesting discovery. Most dietitians identified that because health professionals no longer needed to crowd around the nursing station to gather information or document, there was a reduction in incidental conversations had with the rest of the care team. For most dietitians, this had perceived negative impacts on IPC and effective teamwork. This was not a concern for dietitians who had established a firm professional relationship with the rest of the care team prior to the introduction of eMR2.

Bottom line

• Perceived advantages of eMR2 were better flexibility, efficiency and availability of patient information.
• Face-to-face interaction remains the main mode of communication; however, it has reduced since the introduction of eMR2.
• Study participants indicated a reduction in incidental conversations had with the rest of the care team. These conversations facilitate the sharing of professional knowledge formally and informally but also incidentally help build constructive professional relationships that allow for more meaningful collaborative decision-making. This is an important consideration to be aware of for service development.

*Niki Mohtat is an Accredited Practising Dietitian who conducted this research as part of her Master’s degree at the University of Sydney. Niki currently sees patients in her private practice, facilitates corporate workshops and writes evidence-based articles. Niki enjoys working with individuals with various health conditions, in particular, hormonal imbalance, diabetes, obesity and gut-related conditions.

Image credit: ©stock.adobe.com/au/Monkey Business