Sometimes our patients push us into our discomfort zone. Thanks to one of my long-time patients, who, as a former smoker, wanted to discuss the risks and benefits of low-dose CT scan Lung Cancer Screening. She had heard of this opportunity at her employer, and wanted to see if I could get her set up for one.
Knowing that we had an entire Lung Cancer Screening clinic set up to discuss this with candidate patients, and to discuss how to think about and address the inevitable “what do I do with THIS tiny nodule in my lung, which is likely benign, but who knows” and “how high IS my risk of cancer exactly, and what is the chance that this will make a difference in my life?”
So, I heavily weighted our discussion: “You could either work with ME and I can figure out some stuff, OR you could go see the EXPERTS who do this all day long and have a thoughtful discussion.”
My patient tells me: “Nah, I want to work with you, and I don’t want another co-pay.”
So there it is. Knowing that we have documentation templates and guides, I dove right in, on the exam-room computer. It does take some humility (see previous post) to discover things in front of your patient (after all, are we NOT supposed to KNOW EVERYTHING?!). But, soon, we discovered there was a nicely structured template, searching “LUNG CANCER SCREEN” in our EHR, that asked the right questions, and then sent me to the above website, which then created a spectacular graph display (for Shared Decision-Making with Patient).
CMIO’s take? Having ‘discoverable’ EHR tools that link to sites of external knowledge, really cool. This is a glimpse into our future, where researchers and knowledge discovery, fully vetted, can be created ANYWHERE and used by ANYONE to improve the care of patients universally. There are more smart people who DON’T work for you, than who DO.
