Capsule Commentary on Lee et al., Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study
J Gen Intern Med
Capsule Commentary on Lee et al., Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study
Elizabeth G. Hunter 0 1
OTR/L 0 1
0 Compliance with Ethical Standards:
1 Graduate Center for Gerontology, University of Kentucky , Lexington, KY , USA
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ee et al.1 describe positive and negative patient
perspecL tives of outpatient EMR use. From 108 telephone
interviews, two major themes and six subthemes were identified.
Overall, 85 % of patient perceptions of EMR use were
positive. Of the negative perceptions, 66 % were related to lack of
eye contact and attention from the provider and not sharing the
screen with the patient. Only 7 % reported that EMR made it
harder to talk with their doctors.
While EMR use in healthcare is important, there has been
limited research exploring its impact on patient–provider
communication.2 A systematic review revealed that EMR use
often had a positive impact on information exchange, but
diminished patient-centeredness and patient rapport.2 Both
computer skills and behavioral style had the ability to
overcome some of the negative influence that emerged.2
Physicians might employ three different methods of sharing
information using the EMR. They can use active information
sharing, in which they show the computer screen to the
patient; passive information sharing, where the screen is not
shown to the patient but they can lean in and look at the
screen; or finally, technology withdrawal, where the screen is
never shared with the patient.3 While there is no going back to
paper records, it must be acknowledged that the EMR has
dramatically changed the patient–provider encounter. One
potential key for lessening the negative impact of a computer
screen in the middle of a communication encounter is to
actually introduce the EMR and explain what is being done
at the beginning of the encounter.4
The sharing of information related to the EMR has the
potential to enhance patient engagement and improve
communication.4 However, the EMR also has the potential
to compete with the patient for the provider’s attention.5
Screen-driven communication can limit patient narratives
and hide clues about psychosocial and emotional concerns.5
Unfortunately, there seems to be little time spent training
providers on how best to incorporate EMR into the clinical
encounter.1 25 Increasing this communication training can
result in enhanced rather than diminished communication
and relationships.
Conflict of Interest: The author has no conflict of interest with the
material in this article.
1. Lee WW , Alkureishi MA , Ukabiala O , Venable LR , Ngooi SS , Staisiunas DD , Wrobleswski KE , Arora VM . Patient perceptions of electronic medical record use by faculty and resident physicians: a mixed methods study . J Gen Intern Med . 2016 . doi: 10 .1007/s11606-016-3774-3.
2. Shachak A , Reis S. The impact of electronic medical records on patientdoctor communication during consultation: a narrative literature review . J Eval Clin Pract . 2009 ; 15 ( 4 ): 641 - 9 .
3. Asan O , Montague E . Technology-mediated information sharing between patients and clinicians in primary care encounters . Behav Inform Technol . 2014 ; 33 ( 3 ): 259 - 70 .
4. White A , Danis M. Enhancing patient-centered communication and collaboration by using the electronic health record in the examination room . JAMA . 2013 ; 309 ( 22 ): 2327 - 8 .
5. Lown BA , Rodriguez D. Commentary : lost in translation? How electronic health records structure communication, relationships, and meaning . Acad Med . 2012 ; 87 ( 4 ): 392 - 4 . (...truncated)