Electronic Health Record Communication Skills

Skills to use the EHR to center the visit around the patient, from the University of Vermont

Using the acronym RESPECTS, the handout below lays out 8 steps to ensure that the EHR is integrated into the patient visit, while ensuring the patient is at the center of the visit. The 8 steps, comprising RESPECTS, are as follows:

• Review the EHR prior to entering the room: Briefly review chief complaint, vital signs, problem list and recent visits if possible, thereby reducing chance of being distracted by looking up past information
• Entrance: Greet patient, introduce self and build rapport before introducing the EHR. This tells patient/family that they are the center of the visit
• Say everything that you are doing: Verbalize all actions performed when using the EHR. This Informs patient of your current task thereby ensuring them that it is an integrated part of the visit and their care, reduces multitasking, and reduces chance of patient talking while you are doing other tasks
• Position of the computer: Position the computer so the patient is able to see the screen when necessary by putting the computer in the patient-provider-EHR triad, which allows the patient to be aware of what you are doing and increases their involvement.
• Engagement position: Be in the engagement position during critical conversation with the patient, which includes eye contact, body fully aligned, proper body movement, and a non-distracted environment. This tells patient through body language that you are fully “engaged” in the conversation and reduces chance of inhibiting the patient’s communication through non-verbal communication.
• Computer confidence: Value the computer, speak positively about the EHR, both of which can increase patient confidence in the EHR and in you.
• Teach: Teach the patient through use of the EHR, which Improves value of EHR and uses resources that are available to the fullest. 
• Summarize and Sign out: Verbally and, simultaneously, provide a written summary for the patient. Then be sure to sign out of the computer at the end of the visit. These together increase patient recall of their instructions and potentially improves compliance by improving recall, and assure patient that their record is confidential and reduces risk of confidentially breach.

Access or download the handout through the links below.