The good, the bad and the early adopters: providers' attitudes about a common, commercial <scp>EHR</scp>

Makam, Anil N.; Lanham, Holly J.; Batchelor, Kim; Moran, Brett; Howell-Stampley, Temple S; Kirk, Lynne M.; Cherukuri, Manjula; Samal, Lipika; Santini, Noel O.; Leykum, Luci K.; Halm, Ethan A.

doi:10.1111/jep.12076

Cited by 39 publications

(30 citation statements)

References 19 publications

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“…An EMR could be redesigned to merge the benefits of patient involvement and the information necessary for practicing clinical medicine (37). Our data are consistent with similar studies demonstrating the importance of patient-centered principles in redesigning EMR formats (23,24). However, the optimal mode of redesigning the EMR remains to be seen.…”

Section: Discussionsupporting

confidence: 92%

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Physician and Parent Perspectives on Psychosocial and Emotional Data Entry in the Electronic Medical Record in a Pediatric Setting

Busack

Daskalakis

Rosen

2016

Journal of Patient Experience

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Objective:This pilot study was conducted to evaluate physician and patient preferences for documentation of emotional and psychosocial information in the electronic medical record (EMR).Methods:Pediatricians from an academic medical center and parents of patients in an academic pediatric rheumatology practice were surveyed on 10 different elements using Likert-type scale items (1 = not at all important, 10 = extremely important). The importance of the proposed categories was evaluated by means testing and pairwise comparisons of the responses.Results:Responses were obtained from 45 physicians and 35 parents. The overall mean scores for physicians and parents were 7.70 and 7.44, respectively. Scores on personality, friends, and school differed between physicians and parents, but those differences were not significant after adjustment for multiple comparisons (P = .13, .17, and .26, respectively). Fears, special requests, and special needs were in the high-score group for both physicians and parents.Conclusion:Physicians and parents reported that the incorporation of emotional and psychosocial information into the EMR added value to the health care of children.

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Section: Discussionsupporting

confidence: 92%

“…Similarly, physicians may value a place for documentation of special considerations due to the movement toward more patient-centered medicine (23,24). …”

Section: Background and Significancementioning

confidence: 99%

Physician and Parent Perspectives on Psychosocial and Emotional Data Entry in the Electronic Medical Record in a Pediatric Setting

Busack

Daskalakis

Rosen

2016

Journal of Patient Experience

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“…Recent studies examining patient-centered communication have focused on eye contact and mutual gaze [20-21]. Researchers have found that the use of computers during healthcare visits negatively impacts doctor-patient communication, including decreased eye contact [22], and taking a physician's attention away from the patient in the form of gaze and body positioning [23,24]. …”

Section: Introductionmentioning

confidence: 99%

How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care

Asan

Young

Chewning

et al. 2015

Patient Education and Counseling

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Objective Use of electronic health records (EHRs) in primary-care exam rooms changes the dynamics of patient-physician interaction. This study examines and compares doctor-patient non-verbal communication (eye-gaze patterns) during primary care encounters for three different screen/information sharing groups: 1) active information sharing, 2) passive information sharing, and 3) technology withdrawal. Methods Researchers video recorded 100 primary-care visits and coded the direction and duration of doctor and patient gaze. Descriptive statistics compared the length of gaze patterns as a percentage of visit length. Lag sequential analysis determined whether physician eye-gaze influenced patient eye gaze, and vice versa, and examined variations across groups. Results Significant differences were found in duration of gaze across groups. Lag sequential analysis found significant associations between several gaze patterns. Some, such as DGP-PGD (“doctor gaze patient” followed by “patient gaze doctor”) were significant for all groups. Others, such DGT-PGU (“doctor gaze technology” followed by “patient gaze unknown”) were unique to one group. Conclusion Some technology use styles (active information sharing) seem to create more patient engagement, while others (passive information sharing) lead to patient disengagement. Practice Implications Doctors can engage patients in communication by using EHRs in the visits. EHR training and design should facilitate this.

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“…13 Difficulty associated with the usability of EHRs remains an important source of professional dissatisfaction; early adopters report the technology can at times interfere with communication during visits and patient-clinician eye contact. 13,15 Evidence suggests some physicians using EHRs may also engage patients in fewer physician-initiated gaze patterns (signaling a lack of attention toward the patient), and that EHR use may contribute to a sense of separation among some patients when the EHR monitor is kept away from the patient's view. 16,17 In response to concerns like these, a recently published primary care consensus statement concluded that many EHR systems need marked refinement to promote greater patient engagement.…”

mentioning

confidence: 99%

The Use of Medical Scribes in Health Care Settings: A Systematic Review and Future Directions

Shultz

Holmstrom

2015

The Journal of the American Board of Family Medicine

120

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Background: Electronic health records (EHRs) hold promise to improve productivity, quality, and outcomes; however, using EHRs can be cumbersome, disruptive to workflow, and off-putting to patients and clinicians. One proposed solution to this problem is the use of medical scribes. The purpose of this systematic review is to summarize the literature investigating the effect of medical scribes on health care productivity, quality, and outcomes. Implications for future research are discussed.Methods: A keyword search of the Cochrane Library, OvidSP Medline database, and Embase database from January 2000 through September 2014 was performed using the terms scribe or scribes in the title or abstract. To ensure no potentially eligible articles were missed, a second search was done using Google Scholar. English-language, peer-reviewed studies assessing the effect of medical scribes on health care productivity, quality, and outcomes were retained. Identified studies were assessed and the findings reported.Results: Five studies were identified. Three studies assessed scribe use in an emergency department, 1 in a cardiology clinic, and 1 in a urology clinic. Two of 3 studies reported scribes had no effect on patient satisfaction; 2 of 2 reported improved clinician satisfaction; 2 of 3 reported an increase in the number of patients; 2 of 2 reported an increase in the number of relative value units per hour; 1 of 1 reported increased revenue; 3 of 4 reported improved time-related efficiencies; and 1 of 1 reported improved patient-clinician interactions.Conclusions: Available evidence suggests medical scribes may improve clinician satisfaction, productivity, time-related efficiencies, revenue, and patient-clinician interactions. Because the number of studies is small, and because each study suffered important limitations, confidence in the reliability of the evidence is significantly constrained. Given the nascent state of the science, methodologically rigorous and sufficiently powered studies are greatly needed. (J Am Board Fam Med 2015;28:371-381.)

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The good, the bad and the early adopters: providers' attitudes about a common, commercial EHR

Cited by 39 publications

References 19 publications

Physician and Parent Perspectives on Psychosocial and Emotional Data Entry in the Electronic Medical Record in a Pediatric Setting

Physician and Parent Perspectives on Psychosocial and Emotional Data Entry in the Electronic Medical Record in a Pediatric Setting

How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care

The Use of Medical Scribes in Health Care Settings: A Systematic Review and Future Directions

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