Jane McCredie: Texting hazards

WE humans are quite good at convincing ourselves that rules are for other people.

The less nimble or less skilled might need to comply for their own safety but we can safely cross against the red light or send a quick text while driving to meet friends.

I don’t know how scientifically based it is, but this New York Times interactive game designed to highlight the effect of texting on driving certainly makes you question your ability to multitask at that level.

A paper published in the Annals of Internal Medicine last week argues the use of electronic health records may pose a similar challenge for doctors.

“As when driving, physicians… need to be alert to environmental cues and unexpected turns. Multitasking can undermine the core activities of observation, communication, problem solving, and developing trusting relationships”, US general internist Dr Christine Sinsky and family physician Dr John Beasley write in an opinion piece provocatively titled ‘Texting while doctoring: a patient safety hazard’.

Medical encounters are particularly unsuited to multitasking, they argue, because they already exhibit the characteristics of “information chaos” — “various combinations of information overload, information underload, information scatter, information conflict, and erroneous information”.

“Although there is a relative lack of observational data, in clinics across the country, we have observed patients send signals of depression, disagreement, and lack of understanding and have witnessed kind, compassionate, and well-intended physicians missing these signals while they multitask”, they write.

But does computer use have to undermine communication during a medical consultation?

As a patient, I’ve certainly come across doctors who seemed more focused on the computer screen than the consult, but I’ve probably seen more who integrate their computer use seamlessly into the encounter, in some cases using it as a tool to improve communication.

In fact, an Australian study of GPs suggested inclusion of the computer as a third party in the encounter could actually empower patients, by helping them to ask questions of the doctor, for example.

An American Medical Association report earlier this year also suggested computers could help rather than hinder the consultation — as long as they were used well.

The position of the screen — allowing the patient to see it and the doctor to maintain eye contact while using it — was considered crucial as was individual doctors’ level of skill and comfort with the technology.

“The accumulating evidence suggests that whether exam room computing has a positive or negative effect depends in significant measure on the perspective and skills physicians bring to using computers in encounters with patients”, the report said.

So texting while doctoring might not be such a hazard after all.

Like many of our interactions with technology, the really important question may not be whether, but how.
 

Jane McCredie is a Sydney-based science and medicine writer.