Physician interactions with electronic health records in primary care

Asan, Onur; Montague, Enid

doi:10.1057/hs.2012.11

Cited by 39 publications

(58 citation statements)

References 24 publications

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“…They helped to determine that the office visit tasks that involved the use of the EHR to actually ‘review or communicate with others’ were augmented, while the tasks that involved the use of the EHR on top of other cognitive tasks appeared to increase cognitive load as was predicted 3 , 8 , 18…”

Section: Resultsmentioning

confidence: 99%

“…It is possible that the provider/preceptors reported a negative effect of the EHR on the patient–provider connection due to the cognitive demands of multitasking data entry and extraction along with patient communication, which could lead to feelings of being ineffective at all three 18. However, there is some evidence that providers can change their computer use behavior based on their patients’ psychological needs 19.…”

Section: Discussionmentioning

confidence: 99%

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Electronic Health Record's Effects on the Outpatient Office Visit and Clinical Education

Sandoval

Palumbo

Hart

2017

jhi

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Background Providers have the important cognitive task of attending to the patient while using the electronic health record (EHR) during an office visit. Prior literature has demonstrated that the EHR has had various effects on the office visit. This study focused on providers who were medical and nurse practitioner student preceptors, to determine their perception of the EHR on multiple distinct aspects of the office visit and clinical education. Methods Utilizing survey research, provider's EHR utilization and perceptions were collected and summarized using descriptive statistics. The relationship between the time spent using the EHR and the distinct aspects of the visit was tested using Chi-square tests of association. Results Provider/preceptors (n = 83) reported a negative effect of EHR on the patient-provider connection, but a positive effect on the review of medications/ medical records, communication between providers, review of results with patients and review of follow-up to testing results with patients. We observed no correlation between the provider's time spent using the EHR and their perception of its effectiveness.Those who responded that the EHR negatively affected their ability to teach (34%) were significantly more likely to also report that the EHR negatively affected their ability to communicate with the patient while taking a history (p = 0.04). Conclusions Providers reported a positive perceived effect of the EHR on distinct aspects of the office visit, yet they also reported a negative perceived effect of EHR on patient-provider connection. Impacts on the perceived ability of some providers to teach students were also demonstrated.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Electronic Health Record's Effects on the Outpatient Office Visit and Clinical Education

Sandoval

Palumbo

Hart

2017

jhi

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“…25 Another study used multi-channel video recording focusing on the patient’s face, the physician’s face and the overall interaction to capture eye gaze patterns. 27,28 …”

Section: Considerations For Collecting Video Data In Primary Carementioning

confidence: 99%

“…Software packages can help quantify all continuous behavior (such as gazing or typing) to obtain relevant data with respective time frames. 27 It is also possible to visualize the sequence of the behaviors using software. Qualitative analysis might be a thematic description of a practitioner’s behavior during the entire visit, such as patient-focused or computer-focused.…”

Section: Video Data Management and Analysismentioning

confidence: 99%

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Using video-based observation research methods in primary care health encounters to evaluate complex interactions

Asan¹,

Montague²

2014

Journal of Innovation in Health Informatics

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109

118

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Objective The purpose of this paper is to describe the use of video-based observation research methods in primary care environment and highlight important methodological considerations and provide practical guidance for primary care and human factors researchers conducting video studies to understand patient-clinician interaction in primary care settings. Methods We reviewed studies in the literature which used video methods in health care research and, we also used our own experience based on the video studies we conducted in primary care settings. Results This paper highlighted the benefits of using video techniques such as multi-channel recording and video coding and compared “unmanned” video recording with the traditional observation method in primary care research. We proposed a list, which can be followed step by step to conduct an effective video study in a primary care setting for a given problem. This paper also described obstacles researchers should anticipate when using video recording methods in future studies. Conclusion With the new technological improvements, video-based observation research is becoming a promising method in primary care and HFE research. Video recording has been under-utilized as a data collection tool because of confidentiality and privacy issues. However, it has many benefits as opposed to traditional observations, and recent studies using video recording methods have introduced new research areas and approaches.

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All eyes on the patient: the influence of oncologists’ nonverbal communication on breast cancer patients’ trust

Hillen

Haes

Tienhoven

et al. 2015

Breast Cancer Res Treat

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Trust in the oncologist is crucial for breast cancer patients. It reduces worry, enhances decision making, and stimulates adherence. Optimal nonverbal communication by the oncologist, particularly eye contact, body posture, and smiling, presumably benefits patients’ trust. We were the first to experimentally examine (1) how the oncologist’s nonverbal behavior influences trust, and (2) individual differences in breast cancer patients’ trust. Analogue patients (APs) viewed one out of eight versions of a video vignette displaying a consultation about chemotherapy treatment. All eight versions varied only in the oncologist’s amount of eye contact (consistent vs. inconsistent), body posture (forward leaning vs. varying), and smiling (occasional smiling vs. no smiling). Primary outcome was trust in the observed oncologist (Trust in Oncologist Scale). 214 APs participated. Consistent eye contact led to stronger trust (β = −.13, p = .04). This effect was largely explained by lower educated patients, for whom the effect of consistent eye contact was stronger than for higher educated patients (β = .18, p = .01). A forward leaning body posture did not influence trust, nor did smiling. However, if the oncologist smiled more, he was perceived as more friendly (rs = .31, p < .001) and caring (rs = .18, p = .01). Older (β = .17, p = .01) and lower educated APs (β = −.25, p < .001) were more trusting. Trust was weaker for more avoidantly attached APs (β = −.16, p = .03). We experimentally demonstrated the importance of maintaining consistent eye contact for breast cancer patients’ trust, especially among lower educated patients. These findings need to be translated into training for oncologists in how to optimize their nonverbal communication with breast cancer patients while simultaneously managing increased time pressure and computer use during the consultation.Electronic supplementary materialThe online version of this article (doi:10.1007/s10549-015-3486-0) contains supplementary material, which is available to authorized users.

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Physician interactions with electronic health records in primary care

Cited by 39 publications

References 24 publications

Electronic Health Record's Effects on the Outpatient Office Visit and Clinical Education

Electronic Health Record's Effects on the Outpatient Office Visit and Clinical Education

Using video-based observation research methods in primary care health encounters to evaluate complex interactions

All eyes on the patient: the influence of oncologists’ nonverbal communication on breast cancer patients’ trust

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