The patient and the computer in the primary care consultation

Pearce, Christopher; Arnold, Michael; Phillips, Christine; Trumble, Steve; Dwan, Kathryn

doi:10.1136/jamia.2010.006486

Cited by 134 publications

(66 citation statements)

References 27 publications

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“…38 That being said, patients have different styles and may have differing levels of comfort with the computer; the physician must assess this and modulate the amount of screen sharing if needed. 55 …”

Section: Setting the Stage 1 Room Set Upmentioning

confidence: 99%

How to Integrate the Electronic Health Record and Patient-Centered Communication Into the Medical Visit: A Skills-Based Approach

Duke

Frankel

Reis

2013

Teaching and Learning in Medicine

106

101

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Background: Implementation of the electronic health record (EHR) has changed the dynamics of doctor-patient communication. Physicians train to use EHRs from a technical standpoint, giving only minimal attention to integrating the human dimensions of the doctor-patient relationship into the computer-accompanied medical visit. Description: This article reviews the literature and proposes a model to help clinicians, residents, and students improve physician-patient communication while using the EHR. Evaluation: We conducted a literature search on use of communication skills when interfacing with the EHR. We observed an instructional gap and developed a model using evidence-based communication skills. Conclusion: This model integrates patient-centered interview skills and aims to empower physicians to remain patient centered while effectively using EHRs. It may also serve as a template for future educational and practice interventions for use of the EHR in the examination room.

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Section: Setting the Stage 1 Room Set Upmentioning

confidence: 99%

How to Integrate the Electronic Health Record and Patient-Centered Communication Into the Medical Visit: A Skills-Based Approach

Duke

Frankel

Reis

2013

Teaching and Learning in Medicine

106

101

View full text Add to dashboard Cite

show abstract

“…29,30,50 Eight studies described variation in the amount and manner in which the EMR was used. 15,36,39,41,46,48,51,54 Four studies examined typing behaviors 33,37,42,48 and six reported on screen positioning, with only 8-10 % active screen sharing during the visit. 29,30,33,37,38,52 Interestingly, one study noted patients had a more positive attitude towards the EMR when they were shown the screen.…”

Section: Characterizing Emr Communication Behaviorsmentioning

confidence: 99%

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

et al. 2016

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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.

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“…Researchers are investigating how specific EHR features or single communication modalities (i.e. speech) correlate with EHR use, as well as how the introduction of new computing devices start to play the role of a third entity in the medical office environment, thereby enabling a novel triadic interaction between physician, patient and EHR [43]. For instance, Darmon and colleagues [11] studied 15 EHRs in France to assess functionalities across systems.…”

Section: Related Workmentioning

confidence: 98%

LAB-IN-A-BOX: semi-automatic tracking of activity in the medical office

Weibel

Rick

Emmenegger

et al. 2014

Pers Ubiquit Comput

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Patient-centered healthcare and increased efficiency are major goals of modern medicine, and physicianpatient interaction and communication are a cornerstone of clinical encounters. The introduction of the electronic health record (EHR) has been a key component in shaping not only organization, clinical workflow and ultimately physicians' clinical decision making, but also patientphysician communication in the medical office. In order to inform the design of future EHR interfaces and assess their impact on patient-centered healthcare, designers and researchers must understand the multimodal nature of the complex physician-patient-EHR system interaction. However, characterizing multimodal activity is difficult and expensive, often requiring manual coding of hours of video data. We present our Lab-in-a-Box solution that enables the capture of multimodal activity in real-world settings. We focus here on the medical office where our Lab-in-a-Box system exploits a range of sensors to track computer-based activity, speech interaction, visual attention and body movements, and automatically synchronize and segment this data. The fusion of multiple sensors allows us to derive initial activity segmentation and to visualize it for further interactive analysis. By empowering researchers with cutting-edge data collection tools and accelerating analysis of multimodal activity in the medical office, our Lab-in-a-Box has the potential to uncover important insights and inform the next generation of Health IT systems.

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The patient and the computer in the primary care consultation

Cited by 134 publications

References 27 publications

How to Integrate the Electronic Health Record and Patient-Centered Communication Into the Medical Visit: A Skills-Based Approach

How to Integrate the Electronic Health Record and Patient-Centered Communication Into the Medical Visit: A Skills-Based Approach

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

LAB-IN-A-BOX: semi-automatic tracking of activity in the medical office

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