EHR Connected Doctors May Be Disconnected from Patients Save

Reuters reports doctors who entered data into electronic health records (EHR) during patients' appointments tend to communicate less and receive lower ratings from their patients.

Researchers from the University of California, San Francisco examined public hospital encounters between 47 patients and 39 doctors between 2011 and 2013. (Citation source bit.ly/1NiCTWw)

Patients with chronic illnesses (diabetes, rheumatoid arthritis, congestive heart failure, etc) were videotaped and interviewed before and after the appointments. Physicians were rated on their computer use during the appointment on a scale from one to 12.

Physicians with high computer use were rated as providing “excellent care” by half of the patients, compared to more than 80% of encounters with low computer use. Doctors who spent more time using the computer spent less time making eye contact with patients and tended to engage in more “negative rapport building,” correcting patients about their medical history or drugs they’ve taken based on information in the electronic record.

Problems in care may lead to more computer use, which would explain the link between computer use and lower patient satisfaction. Patients may perceive that clinicians aren't listening to them.

Authors of the JAMA Internal Medicine article suggest physicians should introduce the patient to the computer and explain how and why they will be using it. In addition, doctors should look up frequently and make eye contact to reestablish the relationship.

Electronic health records are necessary in todays healthcare, but it should not usurp physician – patient communication.