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More screen time, less face time – implications for EHR design
Author(s) -
Asan Onur,
D. Smith Paul,
Montague Enid
Publication year - 2014
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12182
Subject(s) - medicine , electronic health record , medical record , chart , health records , family medicine , coding (social sciences) , affect (linguistics) , meaningful use , health care , psychology , communication , statistics , mathematics , economics , radiology , economic growth
Abstract Rationale, aims and objectives Understanding the impact of health information technology on doctor–patient interaction is vital to designing better electronic health records ( EHR s). This article quantitatively examines and compares clinically experienced physicians' interactions with patients using paper or EHR s in ambulatory primary care settings. Methods Clinical encounters using paper or EHR s were recorded with high‐resolution video cameras to capture physicians' interactions with the health records and patients. All videos were coded using quantified video coding methodology to understand how physicians interacted with EHR s and patients through measuring eye gaze durations. Statistical analysis was conducted to compare the results of the paper and EHR visits. Results Eight experienced family medicine physicians and 80 patients participated in the study. A total of 80 visits, 40 with paper and 40 with EHR s were recorded. The proportion of time physicians spent gazing at medical records during EHR visits was significantly more than in paper chart visits (35.2 versus 22.1%, P = 0.001). A significantly smaller proportion of physician time was spent gazing at the patient when using an EHR compared with when using a paper chart (52.6 versus 45.6%, P = 0.041).Conclusions For this group of family medicine physicians, more time was spent looking at the EHR screen than paper records and a little less time looking at the patient. These findings may negatively affect the patient perception of the visit with the physician and have implications for the design of future EHR s.