Use of the Electronic Health Record During Clinical Encounters: An Experience Survey

Abstract

PURPOSE Use of the electronic health record (EHR) during face-to-face clinical encounters affects communication, and prior research has been inconclusive regarding its effect. This survey study assessed health care practitioner use of EHR-specific communication skills and patient and practitioner experiences and attitudes regarding EHR use during clinical encounters.METHODS For this US-based study, we distributed previously validated surveys to practitioners and adult patients (aged >18 years) at academic primary care practices from July 1, 2018 through August 31, 2018. The electronic practitioner survey was completed first; a paper survey was administered to patients after appointments. Descriptive statistics were calculated, and the Cochran-Armitage test was used to assess for associations between key variables. RESULTSThe practitioner response was 72.9% (43/59); patient response, 45.2% (452/1,000). Practitioners reported maintaining less eye contact (79.1%), listening less carefully (53.5%), focusing less on patients (65.1%), and visits feeling less personal (62.8%). However, patients reported that practitioners provided sufficient eye contact (96.8%) and listened carefully (97.0%); they disagreed that practitioners focused less on them (86.7%) or that visits felt less personal (87.2%). Patients thought EHR use was positive (91.7%); only one-third of practitioners (37.2%) thought that patients would agree with that statement. Practitioners reported stress, burnout, and a lack of sufficient time for EHR documentation.CONCLUSIONS A discrepancy existed in this study between patient and practitioner experiences and attitudes about EHR use, which appeared to negatively affect the experience of health care practitioners but not patients. Organizations should adopt formal strategies to improve practitioner experiences with EHR use.

Electronic Health Record for the Orthopaedic Providers

“…A survey of practitioners and adult patients found that practitioners reported lack of sufficient time for their EHR documentation and felt more stress, leading to burnout 23 . Similar reports have also found related results, including physicians attributing increased administrative stresses to the EHR system 24 .…”

Uplifting Primary Care Through the Electronic Health Record

“…1,2 We highlight 4 papers in this issue that allow us to understand the current state of EHR use, identify unmet needs, provide evidence on their potential to uplift clinical practice and research, and their future potential to improve patient outcomes and address the perpetual problem of the "forgetful health system". [3][4][5][6] Although numerous studies have focused on assessing clinician experience with their EHR systems, few have in parallel obtained the patient's perspective. Meltzer et al, 3 in a survey of health practitioners and their patients from 2 primary care sites, finds discrepancies in experience and attitudes regarding EHR use between patient and clinician.…”

“…[3][4][5][6] Although numerous studies have focused on assessing clinician experience with their EHR systems, few have in parallel obtained the patient's perspective. Meltzer et al, 3 in a survey of health practitioners and their patients from 2 primary care sites, finds discrepancies in experience and attitudes regarding EHR use between patient and clinician. Clinicians provide a poorer self-assessment of patient experience compared with the patients themselves.…”