Patient-centered communication in the era of electronic health records: What does the evidence say?

Rathert, Cheryl; Mittler, Jessica; Banerjee, Sudeep; McDaniel, Jennifer

doi:10.1016/j.pec.2016.07.031

Cited by 92 publications

(97 citation statements)

References 66 publications

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“…Of the seven relevant articles, three (42.9%) examined the effects of more than one eHealth system: 3,5,12 CDSS were studied in six (85.7%) articles, 3,5,[12][13][14][15] EMRs were studied in three (42.9%), [3][4][5] ePrescribing was studied in three (42.9%) 3,5,12 and CPOE was studied in two (28.6%). 3,5 Only two studies (28.6%) were high quality; 13,14 three (42.9%) were of intermediate quality 4,12,15 and two (28.6%) were of low quality. 3,5 The characteristics of the studies included are given in Appendix 1.…”

Section: Resultsmentioning

confidence: 99%

“…2 However, negative unintended consequences are being increasingly reported, with clinicians using eHealth technologies in unanticipated ways. 3 Moreover, some clinicians resist using these systems 4 and develop workarounds compromising patient care. 5 This has prompted the US government to incentivise 'meaningful use' of eHealth technologies, but it is still uncertain how effective these incentives have been.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of eHealth on hospital practice: synthesis of the current literature

Eden¹,

Burton‐Jones²,

Scott³

et al. 2018

Aust. Health Review

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The transition to digital hospitals is fast-moving. Although US hospitals are further ahead than some others in implementing eHealth technologies, their early experiences are not necessarily generalisable to contemporary healthcare because both the systems and technologies have been rapidly evolving. It is important to provide up-to-date assessments of the evidence available. The aim of this paper is to provide an assessment of the current literature on the effects to be expected from hospital implementations of eHealth technologies. A narrative review was conducted of systematic reviews investigating the effects of eHealth technologies (clinical decision support systems (CDSS), computerised provider order entry (CPOE), ePrescribing, electronic medical records (EMRs)) published between November 2015 and August 2017 and compared the findings with those of a previous narrative review that examined studies published between January 2010 and October 2015. The same search strategy and selection criteria were used in both studies. Of the seven relevant articles, three (42.9%) examined the effects of more than one eHealth system: only two (28.6%) studies were high quality, three (42.9%) were of intermediate quality and two (28.6%) were of low quality. We identified that EMRs are largely associated with conflicting findings. Previous reviews suggested that CPOE are associated with significant positive results of cost savings, organisational efficiency gains, less resource utilisation and improved individual performance. However, these effects were not investigated in the more recent reviews, and only mixed findings for communication between clinicians were reported. Similarly, for ePrescribing, later reviews reported limited evidence of benefits, although when coupled with CDSS, more consistent positive findings were reported. This overview can help inform other hospitals in Australia and elsewhere of the likely effects resulting from eHealth technologies. The findings suggest that the effects of these systems are largely mixed, but there are positive findings, which encourage ongoing digital transformation of hospital practice. Governments are increasingly devoting substantial resources towards implementing eHealth technologies in hospital practice with the goals of improving clinical and financial outcomes. Yet, these outcomes are yet to be fully realised in practice and conflicting findings are often reported in the literature. This paper extends a previous narrative review of systematic reviews and categorises the effects of eHealth technologies into a typology of outcomes to enable overall findings to be reported and comparisons to be made. In doings so, we synthesise 7 years of eHealth effects. Mixed results are largely reported for EMRs, with many benefits being compromised by practices stemming from resistance to EMRs. Limited evidence of effectiveness exists for CPOE and ePrescribing. CDSS are associated with the most consistent positive findings for clinician- and hospital-level effects. We observed renewed int...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of eHealth on hospital practice: synthesis of the current literature

Eden¹,

Burton‐Jones²,

Scott³

et al. 2018

Aust. Health Review

View full text Add to dashboard Cite

show abstract

“…35 However, providing patients with access to health records might interfere with doctors' collection of psychosocial and emotional information, leading to a call for improvements so that portals and EHRs can capture useful data without disturbing patients' and physicians' ability to communicate. 38 Evidence of time and resource efficiency due to patient portals has been largely descriptive. US doctors using portals found that the technology made their indirect care work easier and it 'just saved time' by reducing telephone tag and providing automatic documentation of patient-provider asynchronous communications.…”

Section: Discussionmentioning

confidence: 99%

Perspectives of New Zealand patients and GPs at the beginning of patient portal implementation

et al. 2019

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INTRODUCTION: New Zealand health policy encourages patient access to their electronic medical records via portals.AIM: To discover patient and general practitioner (GP) perspectives of access to electronic medical records and e-messaging in the early portal implementation phase. METHODS:In 2014, Auckland primary health organisations and an Accident & Medical organisation were asked to invite their GPs to complete an online survey and consent for a researcher to attend their waiting room and invite patients to complete a survey. RESULTS:In total, 421 patients (13% Maori, 18% Pacific, 7% Asian, 53% NZ European/Other) participated from 13 general practices. Most (77%) knew they were entitled to see their medical records and 90% were interested in viewing them. Over two-thirds thought that viewing their records online and e-messaging their practice was a good idea. Over 80% disagreed that they would be worried, confused or embarrassed by seeing their records, with 59% expecting portals to facilitate understanding of their medical conditions. Internet security and privacy concerned 40% of patients. Among 83 GPs who completed the survey, six (7%) had already implemented portals. Few were comfortable to open up the whole health record, especially visit notes. While GPs thought that portal access may help patients better understand their plan of care, their main concerns related to causing confusion and worry. Portal implementation was expected to change GP documentation and increase practice workload and costs without demonstrable benefit to practices. DISCUSSION:At the beginning of portal adoption, patients were interested. GPs were more reticent, unsure whether the benefits would outweigh the downsides for their patients and practice workload.

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“…, Rathert et al. , Shachak and Reis ). In fact, one study shows that HIT can worsen providers’ communication skills, if those providers already were prone to poor communication (Frankel et al.…”

Section: Hypotheses Developmentmentioning

confidence: 98%

“…On the other hand, while HIT can provide operational transparency, it can also interfere with communication. Use of HIT while in a room with a patient may result in reduced eye contact, less frequent checking of patient understanding and overall decreased patient satisfaction with a given provider (Ratanawongsa et al 2016, Rathert et al 2016, Shachak and Reis 2009. In fact, one study shows that HIT can worsen providers' communication skills, if those providers already were prone to poor communication (Frankel et al 2005).…”

Section: Hit Communication Quality and Lawsuitsmentioning

confidence: 99%

The Impact of Information Technology and Communication on Medical Malpractice Lawsuits

Sharma

Queenan

Öztürk

2019

Production and Operations Management

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Health care organizations have substantially invested in Health Information Technology (HIT) as part of an effort to improve quality. However, many hospitals fail to generate positive returns on this significant investment, based on reimbursements for quality measures through the Affordable Care Act (ACA). Given the high cost of lawsuits, we investigate if HIT adoption reduces lawsuits, and their attendant costs, as another consideration in HIT payoffs. We use operational transparency theory to develop hypotheses on the individual and joint impact of HIT and communication quality in influencing patients’ likelihood to file a lawsuit. We combine data on 168 hospitals in the state of Florida from 2007 to 2011 in order to investigate these relationships. Analysis using a fractional response model indicates that HIT has a direct impact in reducing the number of lawsuits, this effect being higher for hospitals with higher communication quality scores. These results remain consistent irrespective of the type of caregiver (physician vs nurse) communicating with the patient or the severity of injury resulting in the lawsuit. Our results also remain robust under different operationalization of key independent variables and alternate model specifications. These results provide a better understanding of the mechanisms that reduce lawsuits.

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Patient-centered communication in the era of electronic health records: What does the evidence say?

Cited by 92 publications

References 66 publications

Effects of eHealth on hospital practice: synthesis of the current literature

Effects of eHealth on hospital practice: synthesis of the current literature

Perspectives of New Zealand patients and GPs at the beginning of patient portal implementation

The Impact of Information Technology and Communication on Medical Malpractice Lawsuits

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