Too much of a good thing: Are digital distractions hurting you and your practice?

Integration of digital technologies into daily clinical practice is vital. However, properly using these devices professionally to enhance doctor-patient relationships, rather than distract from them, is imperative for clinicians.

Today, tablets, electronic medical records (EMRs), and computer screens abound in medical practice and offer a non-stop myriad of potential distractions all day, every day for clinicians. Adding to the mix are personal smartphones, which most physicians, residents, and medical students use to keep up with medical news, communicate with their colleagues, and consult clinical reference tools to help deliver better care.

According to a recent survey by Spyglass Consulting Group that included over 100 health-care professionals working in the hospital environment, 9 out of 10 health-care systems plan significant investments in smartphones and secure unified communications in the next year to 18 months.

Consequently, clinicians need to manage these technologies, and find ways to mitigate their potential for distraction, especially during doctor-patient interactions.

“As a primary care physician, I know first-hand that integrating computers, EMRs, tablets, smartphones, and other devices into the clinical environment changes the dynamic of the patient-provider relationship,” wrote Wei Wei Lee, MD, MPH, assistant professor of medicine, University of Chicago, Chicago, IL, and assistant dean of students, Pritzker School of Medicine and Core Faculty for the Internal Medicine Residency Program.

Dr. Lee explained: “‘Distracted doctoring’ refers to providers who are more focused on their devices than their patients. This phenomenon has spurred discussion at medical schools and hospitals across the country. That being said, most providers receive little to no training on how to use the EMR to enhance their communication with patients rather than detract from it.”

At a recent workshop to address this, Dr. Lee and colleagues presented three of their top tips to enhance EMR-related communications skills in physicians:

1. Adhere to the ‘Golden Minute’: Start the patient visit completely free of technology. Greet the patient, listen to their concerns, and set your agenda for the visit before you use any technology.
2. Establish a ‘Triangle of Trust’: Create a triangle configuration physically that puts you, the patient, and the computer at three corners. This will be beneficial for both you as the clinician and your patient, allowing you both to see the screen.
3. Maximize patient interaction: Review and/or share what you see on the screen with your patient, such as labs, previous history, and other information.

AMA Wire also offered advice for clinicians in integrating personal smartphone use successfully and professionally into their daily practices:

• If you are expecting an important call about a family or medical matter, advise patients in advance.
• Flag important contacts so calls/messages can come through even when your phone is in the “do-not-disturb” mode.
• Advise friends and personal contacts that they should expect a lag time in your response rather than an instant reply.

Distracting from the simple things in life

Not surprisingly, digital distractions also affect our personal lives, and may prevent us from enjoying even the simple pleasures in life, according to results from a recent study presented at 2018’s annual meeting of the American Psychological Association (APA), held in San Francisco, CA, August 9-12.

The study was a field experiment conducted in a restaurant with over 300 diners. The design was simple: Researchers randomized participants to either keep their phones on the table (with the ringer on) or place their phones in a container on the table (with the ringer silenced) during a meal. After the meal, they completed a questionnaire about their feelings during the meal, including social connectedness, enjoyment, distraction, and boredom. They also reported their amount of phone use and what that use entailed during the meal.

Those who had easy access to their phone used them more during the meal, reported feeling more distracted, and found the meal less enjoyable compared with those who did not.

“People who were allowed to use their phones during dinner had more trouble staying present in the moment,” said lead author Ryan Dwyer, MA, University of British Columbia, Vancouver, BC, Canada. “Decades of research on happiness tell us that engaging positively with others is critical for our well-being. Modern technology may be wonderful, but it can easily sidetrack us and take away from the special moments we have with friends and family in person.”

Ultimately, mobile devices and digital technologies are becoming an increasingly important part of the clinical workday. Acknowledging and addressing the potential for distraction they provide can help clinicians in both their professional and personal lives.