{"id":2420,"date":"2020-11-19T12:15:47","date_gmt":"2020-11-19T20:15:47","guid":{"rendered":"https:\/\/phcprimarycare.org\/?p=2420"},"modified":"2020-11-19T12:15:47","modified_gmt":"2020-11-19T20:15:47","slug":"bringing-the-patient-story-back-to-the-medical-record","status":"publish","type":"post","link":"https:\/\/phcprimarycare.org\/?p=2420","title":{"rendered":"Bringing the Patient Story Back to the Medical Record"},"content":{"rendered":"

By Robert L. Moore, MD, MPH, MBA, Chief Medical Officer<\/strong><\/p>\n

\u201cA story can put your whole brain to work.\u201d<\/p>\n

–Leo Widrich, co-founder, Buffer<\/p><\/blockquote>\n

Linguists have shown that humans that do not store their thoughts or memories in written form have a remarkable ability to remember and relate long stories orally, from generation to generation.\u00a0 Even with written language and now audio-visual capture of information, stories are easier to remember than a stream of facts, events or even a theoretical framework.\u00a0 (The early chapters of Sapiens: A Brief History of Humankind<\/em><\/a> offers a good summary.)<\/p>\n

There is a neurologic basis<\/a> for this.\u00a0 Streams of facts or ideas mainly stimulate the auditory processing portion of the brain, while stories activate the deep brain structures associated with emotions and long-term memory, as well as various portions of the cortex.\u00a0 A story puts our whole brain to work.<\/p>\n

This may explain why studies<\/a> of Electronic Health Records that segregate clinical tidbits into different discrete parts of the medical record decrease the ability of a subsequent reader to really understand what was going on with a patient.\u00a0 The patient story is lost, making the medical record a poor communication tool.<\/p>\n

A well written opinion article<\/a> in the September 1, 2020 Annals of Internal Medicine calls on clinicians to \u201cRestore the Story\u201d in clinical notes.\u00a0 The American College of Physicians created a \u201cRestoring the Story Task Force\u201d to promote this effort.\u00a0 The article summarizes the attributes of an ideal clinical note:<\/p>\n

\u201cThe ideal clinical note is more than a verbatim transcript.\u00a0 It is a coherent representation of relevant data that have been sifted through and examined in the context of the patient\u2019s life and priorities, yielding an assessment of the situation and rationale for recommended next steps.\u201d<\/p><\/blockquote>\n

In the electronic health record, the two most important places for telling the story are the history of present illness and the assessment.\u00a0 Utilizing the free text option in these two locations is essential to achieve this.<\/p>\n","protected":false},"excerpt":{"rendered":"

By Robert L. Moore, MD, MPH, MBA, Chief Medical Officer \u201cA story can put your whole brain to work.\u201d –Leo Widrich, co-founder, Buffer Linguists have shown that humans that do not store their thoughts or memories in written form have … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2420","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nBringing the Patient Story Back to the Medical Record - PHC Primary Care Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/phcprimarycare.org\/?p=2420\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Bringing the Patient Story Back to the Medical Record - PHC Primary Care Blog\" \/>\n<meta property=\"og:description\" content=\"By Robert L. Moore, MD, MPH, MBA, Chief Medical Officer \u201cA story can put your whole brain to work.\u201d –Leo Widrich, co-founder, Buffer Linguists have shown that humans that do not store their thoughts or memories in written form have … Continue reading →\" \/>\n<meta property=\"og:url\" content=\"https:\/\/phcprimarycare.org\/?p=2420\" \/>\n<meta property=\"og:site_name\" content=\"PHC Primary Care Blog\" \/>\n<meta property=\"article:published_time\" content=\"2020-11-19T20:15:47+00:00\" \/>\n<meta name=\"author\" content=\"RMoore\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"RMoore\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/phcprimarycare.org\/?p=2420\",\"url\":\"https:\/\/phcprimarycare.org\/?p=2420\",\"name\":\"Bringing the Patient Story Back to the Medical Record - PHC Primary Care Blog\",\"isPartOf\":{\"@id\":\"https:\/\/phcprimarycare.org\/#website\"},\"datePublished\":\"2020-11-19T20:15:47+00:00\",\"author\":{\"@id\":\"https:\/\/phcprimarycare.org\/#\/schema\/person\/e2261897cb15c2610b283200b210f79c\"},\"breadcrumb\":{\"@id\":\"https:\/\/phcprimarycare.org\/?p=2420#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/phcprimarycare.org\/?p=2420\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/phcprimarycare.org\/?p=2420#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/phcprimarycare.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Bringing the Patient Story Back to the Medical Record\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/phcprimarycare.org\/#website\",\"url\":\"https:\/\/phcprimarycare.org\/\",\"name\":\"PHC Primary Care Blog\",\"description\":\"Partnership HealthPlan of California\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/phcprimarycare.org\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/phcprimarycare.org\/#\/schema\/person\/e2261897cb15c2610b283200b210f79c\",\"name\":\"RMoore\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/phcprimarycare.org\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/f0ba7e9946a1ad594a0070ed009f75ea00cb69b3f7271511fd722377966e54bd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/f0ba7e9946a1ad594a0070ed009f75ea00cb69b3f7271511fd722377966e54bd?s=96&d=mm&r=g\",\"caption\":\"RMoore\"},\"url\":\"https:\/\/phcprimarycare.org\/?author=2\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Bringing the Patient Story Back to the Medical Record - PHC Primary Care Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/phcprimarycare.org\/?p=2420","og_locale":"en_US","og_type":"article","og_title":"Bringing the Patient Story Back to the Medical Record - PHC Primary Care Blog","og_description":"By Robert L. 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