Electronic medical record use and physician–patient communication: An observational study of Israeli primary care encounters

Margalit, Ruth; Roter, Debra; Dunevant, Mary Ann; Larson, Susan; Reis, Shmuel

doi:10.1016/j.pec.2005.03.004

Cited by 263 publications

(231 citation statements)

References 28 publications

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“…Negative EHR-related behaviors, such as poor eye contact and prolonged screen gazing, can undermine patient-centered communication [2,5]. Conversely, when communication is patient-centered, patient outcomes, understanding, and adherence to treatment, and cost utilization can improve [6].…”

Section: Introductionmentioning

confidence: 99%

Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use

Lee

Alkureishi

Wroblewski

et al. 2017

Medical Education Online

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Background: Integrating electronic health records (EHRs) into clinical care can prevent physicians from focusing on patients. Despite rapid EHR adoption, few curricula teach communication skills and best practices for patient-centered EHR use. Objective: We piloted a ‘Patient-centered EHR use’ curriculum, consisting of a lecture and group-observed structured clinical examination (GOSCE) for second-year students (MS2s). Design: During the lecture, students watched a trigger tape video, engaged in a reflective observation exercise, and learned best practices. During the GOSCE, one of four MS2s interacted with a standardized patient (SP) while using the EHR. Third-year students (MS3s) received no formal training and served as a historical control group by completing the same OSCE individually. All students completed post-GOSCE/OSCE surveys. The SP evaluated GOSCE/OSCE performance. Results: In 2013, 89 MS2s participated in the workshop and GOSCEs during their required Clinical Skills course and 96 MS3s participated in individual OSCEs during their end of year multi-station formative GOSCE exercise. Eighty MS2s (90%) and 88 MS3s (92%) post-GOSCE/OSCE surveys were analyzed. Compared to MS3s, significantly more MS2s rated their knowledge (19% vs 55%) and training (14% vs 39%) as good (≥4/5 point scale, P < .001 for both). Most learners (85% MS2s and 70% MS3s) thought training should be required for all students. SP ratings on GOSCE/OSCE performance was higher for the 20 MS2s compared to the 88 MS3 controls (73.5 [SD = 4.5] vs 58.1 [SD = 13.1] on 80 point scale, P < .001). Conclusions: A short workshop and GOSCE were effective in teaching patient-centered EHR use. This curriculum is now a permanent part of our Clinical Skills course. Clerkship students who did not receive our curriculum may have been exposed to negative role-modeling on the wards. To address this, training residents and faculty on patient-centered EHR use skills should be considered. Abbreviations: EHR: Electronic health record; EHR: Electronic health record; SP: Standardized patient

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Section: Introductionmentioning

confidence: 99%

Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use

Lee

Alkureishi

Wroblewski

et al. 2017

Medical Education Online

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show abstract

“…3,6,7 Combined with a national shortage of primary care physicians [8][9][10] and increasing physician burnout, 11 these concerns have sparked efforts to redistribute responsibilities in an expanded primary care team. 12,13 In particular, the role of medical assistants (MAs) and nurses have been expanded to include clinical scribing, also known as team documentation.…”

Section: Introductionmentioning

confidence: 99%

Physician, Scribe, and Patient Perspectives on Clinical Scribes in Primary Care

et al. 2016

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“…Our literature review 14 suggested that EMR use has an overall positive influence on the exchange of medical information, including questions about therapeutic regimens, and patients' disclosure of medical information. 15 Physicians who used EMRs accomplished information-related tasks-such as checking and clarifying information, encouraging patients to ask questions, and ensuring completeness at the end of patients' visits-to a greater extent than did physicians who used paper records. 16 The literature review also revealed, however, that EMR use often had a negative impact on patient-centeredness.…”

Section: Introductionmentioning

confidence: 99%

“…17 Physicians' screen gaze averaged about one quarter of the time they spent with their patients and was inversely related to their psychosocial questioning and emotional responsiveness. 15 Further, computer use often caused physicians to lose rapport with their patients. 15,16,18,19 It has been proposed that physicians' behavioral style, computer and communication skills, as well as their experience, affect patient-doctor communication in the context of EMR use.…”

Section: Introductionmentioning

confidence: 99%

Primary Care Physicians’ Use of an Electronic Medical Record System: A Cognitive Task Analysis

et al. 2009

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Electronic medical record use and physician–patient communication: An observational study of Israeli primary care encounters

Cited by 263 publications

References 28 publications

Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use

Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use

Physician, Scribe, and Patient Perspectives on Clinical Scribes in Primary Care

Primary Care Physicians’ Use of an Electronic Medical Record System: A Cognitive Task Analysis

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