Computer use in primary care and patient-physician communication

Sobral, Dilermando; Rosenbaum, Marcy; Figueiredo-Braga, Margarida

doi:10.1016/j.pec.2015.07.002

Cited by 18 publications

(23 citation statements)

References 49 publications

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“…As found in other studies, patient satisfaction remained high with physician EHR usage. However, we found that physicians' perceptions vary more, a dichotomy also noted by Gadd and Penrod 1 and Sobral et al 6 Our findings show that, compared with patients, more physicians perceive a negative impact of EHRs on the patient-physician relationship, though the difference between patient and physician perceptions is not as large as the findings of Gadd and Penrod. 1 Other studies have documented the association or lack of association between physician perceptions of EHRs and various physician attributes.…”

Section: Discussionsupporting

confidence: 63%

“…1,2,5 Physicians have reported a negative effect of EHRs on their ability to maintain eye contact with patients and their ability to actively listen to patients. 6 Additionally, physicians looking at an EHR during the clinical encounter may appear distracted or disinterested, potentially impacting the patient's perceptions of the physician. 7 Despite these initial negative perceptions of EHR implementation, research reveals improved efficiency in hospitals and outpatient clinics, 2 clinician acceptance and approval of the EHR systems, 2,5,8 and overall patient satisfaction 1,2,[8][9][10][11][12][13][14] with EHR use.…”

mentioning

confidence: 99%

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Patient and Physician Perceptions of the Impact of Electronic Health Records on the Patient–Physician Relationship

Eberts

Capurro

2019

Appl Clin Inform

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Objectives Limited studies have been performed in South America to assess patient and physician perceptions of electronic health record (EHR) usage. We aim to study the perceptions of patients and physicians regarding the impact of EHRs on the patient–physician relationship. Methods We use a survey instrument to assess the physician computer experience and opinions regarding EHR impact on various aspects of patient care. An additional survey is used to assess patient opinions related to their medical visit. Surveys are administered in two outpatient clinics in a private, academic health care network. Results While a majority of physicians believed that EHRs have an overall positive impact on the quality of health care, many physicians had negative perceptions of the impact of EHRs on the patient–physician relationship. A majority of patients felt comfortable with their physician's use of the EHR and felt that their physician was able to maintain good personal contact while using the computer. Conclusion Although physicians believe EHRs have a generally positive impact on the overall quality of care, the EHR's impact on the patient–physician relationship is still of concern. Patients do not perceive a negative interference from the EHR on the patient–physician relationship.

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Section: Discussionsupporting

confidence: 63%

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confidence: 99%

Patient and Physician Perceptions of the Impact of Electronic Health Records on the Patient–Physician Relationship

Eberts

Capurro

2019

Appl Clin Inform

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“…Interaction between the nurse and computer commonly seen in general practice adds complexity to the GPN–patient relationship (James et al, 2020). While decreases in nurse–computer eye contact time during the consultation were not significant, previous research indicates that clinicians perceive computer use as having a negative impact on patient‐centred communication (Sobral, Rosenbaum, & Figueiredo‐Braga, 2015). Our findings may be related to the prioritisation of other actions undertaken by the GPN during CDM consultations and between analysis time points.…”

Section: Discussionmentioning

confidence: 63%

Nonverbal communication between registered nurses and patients during chronic disease management consultations: Observations from general practice

James

Desborough

McInnes

et al. 2020

Journal of Clinical Nursing

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Aims and objectives This study explores nonverbal communication behaviours between general practice nurses and patients during chronic disease consultations. Background Nonverbal communication is an important aspect of nurse–patient lifestyle risk reduction conversations. Despite the growing role of general practice nurses in lifestyle risk modification when managing chronic disease, few studies have investigated how this communication occurs. Design Observational study within a concurrent mixed methods project. Methods Thirty‐six consultations by 14 general practice nurses were video‐recorded between August 2017 and March 2018. Video analysis used the Nonverbal Accommodation Analysis System. The STROBE checklist was used to guide this paper. Results Joint convergence of nurse–patient behaviours such as laughing, smiling and eye contact was most common (44%; n = 157). Patient–nurse eye contact time decreased significantly across the consultation, while nurse gesturing increased significantly. No significant relationship between consultation length and convergent to divergent behaviour categorisation or nurse–computer use across the consultation was found. Conclusions The high levels of convergent behaviours are promising for person‐centred care. However, scope exists to enhance nonverbal interactions around lifestyle risk reduction. Supporting nurses with skills and improved environments for lifestyle risk communication has potential to improve therapeutic relationships and patient outcomes. Relevance to clinical practice These results indicate that nurses support patients through nonverbal interactions during conversations of lifestyle risk reduction. However, there are opportunities to improve this practice for future interventions.

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“…This is somewhat puzzling because a large number of studies have reported on the effect of aspects of the interior of consultation rooms (or even of adjacent waiting areas) on patient stress and patient disclosure (Okken, van Rompay, and Pruyn 2013;Huisman et al 2012;Ajiboye et al 2015;Miwa 2006;Liu et al 2014;Dahlgaard et al 2008;Sobral, Rosenbaum, and Figueiredo-Braga 2015;Charise et al 2011;Baskaya 2004;Noordman et al 2010;Frankel et al 2005;Almquist et al 2009). For example, Okken et al (2013) found that brightness of the consultation room might influence the communication between the healthcare professional and patient.…”

Section: Current Interventions To Improve Sdmmentioning

confidence: 99%

The potential of service design for improving the implementation of shared decision-making

et al. 2017

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This paper addresses the potential contribution of service design for improving the implementation of shared decisionmaking in healthcare. The iterative approach of design research is compared with the more linear, (social) scientific approaches often seen in health services research. Five foundational principles of service design are explored regarding their potential contribution to the improvement of the implementation of shared decision-making. Thus, this position paper can be seen as a call on service designers and healthcare professionals to combine their efforts to improve the implementation of shared decision-making in healthcare.

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Computer use in primary care and patient-physician communication

Abstract: Consultation support can represent a challenge to physicians who recognize its negative impact in patient centered orientation. Medical education programs aiming to enhance specific communication skills and to better integrate computer use in primary care settings are needed.

Cited by 18 publications

References 49 publications

Patient and Physician Perceptions of the Impact of Electronic Health Records on the Patient–Physician Relationship

Patient and Physician Perceptions of the Impact of Electronic Health Records on the Patient–Physician Relationship

Nonverbal communication between registered nurses and patients during chronic disease management consultations: Observations from general practice

The potential of service design for improving the implementation of shared decision-making

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