While this approach has the above strengths, it is not without challenges. Current EHR software is not optimized to protect confidentiality of patient data during joint viewing from log on to log off. Care must be taken to not show other patient information. Because many current projectors use high-intensity lamps that can take 10 seconds to cycle off, it’s useful to have a quick and easy way of interrupting the projection while navigating—an oversize sticky note can be quickly moved in front of the projector to accomplish this.
Room lighting must be considered, as well as a projection surface or large LCD monitor. A mobile typing table for the laptop or keyboard is useful, as well as an additional small table for patients or case managers to help them manage their own paperwork and technology.
Edward Pontius, M.D., does outpatient and telepsychiatry practice, clinical teaching, and program development in Brunswick, Maine. Steven Daviss, M.D., is chair of the APA Committee on Electronic Health Records, an Assembly representative for Maryland, a member of the Health Standards Committee at URAC, and a HIE Policy Board member at the Maryland Health Care Commission. He is also a clinical assistant professor at the University of Maryland, chair of the Department of Psychiatry at Baltimore Washington Medical Center, and coauthor of the book Shrink Rap: Three Psychiatrists Explain Their Work. Dr. Daviss tweets at @hitshrink and blogs at http://hitshrink.blogspot.com/.