Computers in the examination room and the electronic health record: physicians' perceived impact on clinical encounters before and after full installation and implementation

Doyle, Richard J.; Wang, Na; Anthony, David; Borkan, Jeffrey; Shield, Renée; Goldman, Roberta E.

doi:10.1093/fampra/cms015

Cited by 62 publications

(51 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For instance, some studies show EMR use can prevent doctors from focusing on patients, impede communication, and be detrimental to the patient-doctor relationship. [12][13][14][15] In order to provide patient-centered care in the digital age, it is critical to understand how EMR use impacts the quality of communication and the patient-doctor relationship.…”

Section: Introductionmentioning

confidence: 99%

Impact of Electronic Medical Record Use on the Patient–Doctor Relationship and Communication: A Systematic Review

et al. 2016

View full text Add to dashboard Cite

BACKGROUND: While Electronic Medical Record (EMR) use has increased dramatically, the EMR's impact on the patient-doctor relationship remains unclear. This systematic literature review sought to understand the impact of EMR use on patient-doctor relationships and communication.METHODS: Parallel searches in Ovid MEDLINE, PubMed, Scopus, PsycINFO, Cochrane Library, reference review of prior systematic reviews, meeting abstract reviews, and expert reviews from August 2013 to March 2015 were conducted. Medical Subject Heading terms related to EMR use were combined with keyword terms identifying face-to-face patient-doctor communication. English language observational or interventional studies were included. Studies examining physician attitudes only were excluded. Structured data extraction compared study population, design, data collection method, and outcomes. RESULTS: Fifty-three of 7445 studies reviewed met inclusion criteria. Included studies used behavioral analysis (28) to objectively measure communication behaviors using video or direct observation and pre-post or crosssectional surveys to examine patient perceptions (25). Objective studies reported EMR communication behaviors that were both potentially negative (i.e., interrupted speech, low rates of screen sharing) and positive (i.e., facilitating questions). Studies examining overall patient perceptions of satisfaction, communication or the patient-doctor relationship (n=22) reported no change with EMR use (16); a positive impact (5) or showed mixed results (1). Study quality was not assessable. Small sample sizes limited generalizability. Publication bias may limit findings. DISCUSSION: Despite objective evidence that EMR use may negatively impact patient-doctor communication, studies examining patient perceptions found no change in patient satisfaction or patient-doctor communication. Therefore, our findings should encourage providers to adopt the EMR as a communication tool. Future research is needed to better understand how to enhance patientdoctor-EMR communication. This research should correlate observed physician behavior to patient satisfaction, focus on physician communication skills training, and explore inpatient experiences.

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of Electronic Medical Record Use on the Patient–Doctor Relationship and Communication: A Systematic Review

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Unlike numerous studies qualifying this technological integration, which are often post hoc surveys, a study by Doyle et al (2012) offers a comparative pre-post approach: two sets of physician qualitative interviews conducted prior to and following the installation of computers and EHRs. This method allows for analysis of the progression of the physicians' perspectives on their interactions with patients.…”

Section: Resultsmentioning

confidence: 99%

“…Initially, Doyle et al (2012) found that physicians expressed concerns about "possible breaches of patient confidentiality" and "decreased eye contact" (p. 603-4) negatively affecting the physician-patient interaction. By the second set of interviews, concerns about privacy and confidentiality seemed to have largely dissipated and physicians felt that the EHR served as a communication and collaboration tool with patients (p. 605).…”

Section: Resultsmentioning

confidence: 99%

“…Interestingly, Doyle et al (2012) are able to demonstrate, through their study, the effect of this technological integration by analyzing the before and after conditions, illustrating how the physician perspective changed drastically with the implementation of EHRs (p. 246). Benefits of the EHRs seem to not only include the efficiency of these computerized medical records, but also its role as an education tool in increasing the patients' ownership of their own treatment plans.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Electronic Health Records: Patient Care Quality

2016

RISS-IJHS

View full text Add to dashboard Cite

Résumé :(traduction) L'avancement de la technologie et son intégration dans une grande variété de domaines a un impact important sur le domaine des communications. Malgré la crainte que l'introduction des technologies de l'information rend la pratique de la médecine plus impersonnelle, son implémentation a un effet positif sur la qualité des soins. On réfère à l'échange d'informations sur la santé par moyen électronique, tel que les dossiers de santé électroniques, par les technologies de l'information de santé, domaine au centre un important effort de recherche. De nombreux supporteurs de ces technologies promeuvent les bénéfices qui leur sont associés : comme l'augmentation de l'efficacité du stockage d'informations et un accès plus facile. D'autres sont plus hésitants, argumentant que la confidentialité et la sécurité de l'information sont remises en question. Des études ont démontré que malgré ces scrupules, une fois l'intégration complète, la qualité des soins augmente. Mots-clés :Technologies de l'information pour la santé (TIS), santé, qualité des soins aux patients, dossier de santé électronique (DSE), relation médecin-patient Abstract:The advancement of technology has led to its integration in widespread fields, heavily impacting areas such as communications. While there is concern that the introduction of information technology into healthcare renders the medical practice impersonal, its implementation has a positive effect on patient care quality. The exchange of health information via an electronic medium, such as the electronic health record (EHR), is known as health information technology (HIT) and has been the focus of many studies. Many supporters of HIT promote the benefits associated with the general rise in technology, such as the increase in convenience and efficiency of information storage; but others are hesitant, often citing privacy and security breaches as primary concerns. Studies show that despite various initial qualms about EHR integration, once the integration is complete, the quality of patient care increases.

show abstract

“…Cada paciente requirió por término medio 26,9 ± 4,1 clics (mediana: 28,4 clics/paciente). No existen diferencias estadística-mente significativas entre los diferentes tipos de consulta aceptado por profesionales y por pacientes 5,6 ; sin embargo, su uso y su presencia no debe ser un elemento de alejamiento o distanciamiento en la relación médico-paciente.…”

Section: Sr Editorunclassified