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

Shachak, Aviv; Hadas-Dayagi, Michal; Ziv, Amitai; Reis, Shmuel

doi:10.1007/s11606-008-0892-6

Cited by 156 publications

(143 citation statements)

References 38 publications

(44 reference statements)

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“…Another is keeping patients engaged by sharing the screen with them or reading out loud while typing. 38,48 Ten tips for physicians on how to incorporate the computer into consultation were suggested by Ventres et al 49 and have recently been modified and are integrated into our proposed model 38 ( Table 1). As of April 2012, we could find only four examples in the literature of educational modules for integrating communications skills with examination room computing.…”

Section: Examination Room Computing and Communication Researchmentioning

confidence: 99%

“…47 Research has emphasized that the biopsychosocial and emotional aspects of the interview are best accomplished when the physician moves her head, eyes, and torso toward the patient; removes her hands from the keyboard or mouse; pushes the monitor away; and gives the patient her undivided attention. 43,47,48 …”

Section: Table 4 Examination Room Computing Transition Skillsmentioning

confidence: 99%

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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

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105

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: Examination Room Computing and Communication Researchmentioning

confidence: 99%

Section: Table 4 Examination Room Computing Transition Skillsmentioning

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

Self Cite

105

101

View full text Add to dashboard Cite

show abstract

“…6 We conducted a systematic literature review on the effect of the EMR on the patient-physician relationship and communication. 7 While observational studies identified behaviors that researchers believe promoted communication (i.e., clarification of information, facilitation of discussion), [8][9][10][11] potentially negative behaviors (i.e., increased speech interruption and unsuccessful physician multitasking) [12][13][14][15][16] have been noted as well. 7 A limitation of most of these studies however is their lack of correlation between researcher-observed behaviors and the patient's own experience.…”

Section: Introductionmentioning

confidence: 99%

Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study

et al. 2016

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BACKGROUND: While concerns remain regarding Electronic Medical Records (EMR) use impeding doctor-patient communication, resident and faculty patient perspectives post-widespread EMR adoption remain largely unexplored. OBJECTIVE: We aimed to describe patient perspectives of outpatient resident and faculty EMR use and identify positive and negative EMR use examples to promote optimal utilization. DESIGN: This was a prospective mixed-methods study. PARTICIPANTS: Internal medicine faculty and resident patients at the University of Chicago's primary care clinic participated in the study. APPROACH: In 2013, one year after EMR implementation, telephone interviews were conducted with patients using open-ended and Likert style questions to elicit positive and negative perceptions of EMR use by physicians. Interview transcripts were analyzed qualitatively to develop a coding classification. Satisfaction with physician EMR use was examined using bivariate statistics. RESULTS: In total, 108 interviews were completed and analyzed. Two major themes were noted: (1) Clinical Functions of EMR and (2) Communication Functions of EMR; as well as six subthemes: (1a) Clinical Care (i.e., clinical efficiency), (1b) Documentation (i.e., proper record keeping and access), (1c) Information Access, (1d) Educational Resource, (2a) Patient Engagement and (2b) Physical Focus (i.e., body positioning). Overall, 85 % (979/1154) of patient perceptions of EMR use were positive, with the majority within the BClinical Care^subtheme (n = 218). Of negative perceptions, 66 % (115/175) related to the BCommunication Functions^theme, and the majority of those related to the BPhysical Focus^subtheme (n = 71). The majority of patients (90 %, 95/106) were satisfied with physician EMR use: 59 % (63/107) reported the computer had a positive effect on their relationship and only 7 % (8/108) reported the EMR made it harder to talk with their doctors. CONCLUSIONS: Despite concerns regarding EMRs impeding doctor-patient communication, patients reported largely positive perceptions of the EMR with many patients reporting high levels of satisfaction. Future work should focus on improving doctors Bphysical focus^when using the EMR to redirect towards the patient.KEY WORDS: electronic health records; patient-centered care; physician patient relations; communication skills.

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“…22,23 Doing so can be laborious, cumbersome, and necessitates a reliable retrieval system. 24 Automatic recording systems can be helpful, such as glucometers with built-in memory chips and cameras with digital images that can retrieve years of past data.…”

Section: Unwanted Forgetfulnessmentioning

confidence: 99%

Judging Whether a Patient is Actually Improving: More Pitfalls from the Science of Human Perception

Redelmeier

Dickinson

2012

J GEN INTERN MED

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

Cited by 156 publications

References 38 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

Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study

Judging Whether a Patient is Actually Improving: More Pitfalls from the Science of Human Perception

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