Writing Narrative Medicine into the Electronic Health Record

Physicians’ relationships with their patients can add meaning and a sense of perseverance to their work. However, the use of electronic health record systems (EHR) contributes to feelings of career burnout by inserting a technological barrier that stagnates the formation of physician-patient relationships. Cumbersome EHR designs can prevent efficient medical documentation and often structure clinical notes without the narrative quality that natural communication takes, which leads to an oversight in documenting potentially relevant social details. Narrative medicine, a model of medical communication that fosters empathetic and culturally competent relationships through critical self-reflection, can aid physicians in finding meaning in their daily clinical experiences. This project aims to perform a literature review over the use and implementation of narrative medicine in order to create a standardized definition that acknowledges the predominant differing views in the field. Clarifying the necessary components of narrative medicine will expedite its inclusion in standard medical practices. Furthermore, the standardized definition can be used to inform potential EHR design changes and future training to incorporate narrative medicine into daily medical practice. These changes will include updates to current free-text abilities and novel discussion questions designed to help physicians engage patients in discussion and reflect on their clinical experience. Any design suggestions will take into account the efficiency of documentation and subsequent financial implications. Continued study in healthcare communication and documentation will ensure that patients are receiving a high quality of care while maintaining physician well-being and lowering rates of career burnout.