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We present findings of an international conference of diverse participants exploring the influence of electronic health records (EHRs) on the patient–practitioner relationship. Attendees united around a belief in the primacy of this relationship and the importance of undistracted attention. They explored administrative, regulatory, and financial requirements that have guided United States (US) EHR design and challenged patient-care documentation, usability, user satisfaction, interconnectivity, and data sharing. The United States experience was contrasted with those of other nations, many of which have prioritized patient-care documentation rather than billing requirements and experienced high user satisfaction. Conference participants examined educational methods to teach diverse learners effective patient-centered EHR use, including alternative models of care delivery and documentation, and explored novel ways to involve patients as healthcare partners like health-data uploading, chart co-creation, shared practitioner notes, applications, and telehealth. Future best practices must preserve human relationships, while building an effective patient–practitioner (or team)-EHR triad.

No one was more surprised than the physician himself. The drawing was unmistakable. It showed the artist-a 7-year-old girl-on the examining table. Her older sister was seated nearby in a chair, as was her mother, cradling her baby sister. The physician sat staring at the computer, his back to the patient-and everyone else. All were smiling. The picture was carefully drawn with beautiful colors and details, and you couldn't miss the message. When he saw the drawing, the physician wrote a caption for it: "The economic stimulus bill has directed $20 billion to health care information technology, largely funding electronic medical record incentives. I wonder how much this technology will really cost?"Why was the physician so surprised? Let me tell you about this guy. He joined our pediatrics residency with the rest of the new interns after a two-year stint as the medical officer aboard an aircraft carrier in the Persian Gulf, a position he had assumed after a single year of general internship in the navy. During the assignment, he had seen this floating city of more than 2500 through every conceivable medical problem from homesickness to pre-eclampsia, traumatic amputation, and myocardial infarction. He learned to make decisions as significant as diverting an entire aircraft carrier in order to get a patient to a tertiary-care hospital in Bahrain. When you spend a moment with this young physician, you sense innate kindness, humility, and connection to a larger purpose, be this family, country, patients, or hospital. He also has charisma. Students, colleagues, faculty, parents, and kids of every age connect with him. The enjoyment seems mutual. You find him crouching down to mee his young patients at eye level. Evidence of his love for children has grown outside the hospital as well. He and his wife have had three kids during his residency. He was an obvious choice for chief resident and is now in that position. This is a physician's physician, a doctor who delivers humanity and competence throughout the day, although if you asked him about these attributes, I'll bet he'd say they are some of his aspirations, not accomplishments.So it came as a stunning piece of feedback-not surprisingly out of the crayon of a babe-that his patients might be seeing him in a new way since the rollout of the electronic medical record. From my perspective of 20 years practicing primary care pediatrics and internal medicine and more than two years into juggling the needs of patients with those of the computer, this child's drawing powerfully expressed the deep frustration and concern of many physicians, including me.When a physician focuses on a patient with complete attention, this simple act of caring creates a connection between two human beings. Almost immediately, the patient begins to feel, well, cared for, and this becomes a first step toward helping that person feel better. This connection between people is also one of the

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