EHR viewing can affect doctor-patient interaction

Doctors who use electronic health records (EHRs) spend a considerable amount of time looking at a computer screen when meeting with patients, which could negatively affect physician-patient communication.

In a paper in the International Journal of Medical Informatics, researchers from Northwestern University reported that primary care physicians who use EHRs spent about a third of their time looking at a computer screen while in the exam room with patients. Analysis of video recordings from 100 doctor-patient visits showed that this led to different communication patterns than those reported in the literature for physicians using paper charts, according to a team led by Enid Montague, PhD (Int J Med Inform, March 2014, Vol. 83:3, pp. 225-234).

Not only did doctors spend less time looking at patients, patients almost always looked at the computer screen as well, regardless of whether or not they could see or understand the information, Montague said in a statement. It can be difficult for patients to get physicians' attention, and it's also likely that physicians' ability to listen, problem-solve, and think creatively isn't optimal when their eyes are glued to the screen, she said.

"Physician gaze largely influences patient gaze in the primary encounter, which means that any intervention that influences physicians to focus on technology will subtract from patient-physician eye contact and any intervention to increase eye contact, or EHR information sharing, will likely need to be targeted to the physician," the authors concluded in their paper. "These findings illustrate the importance of designing work systems that allow and encourage physicians to be patient-centered."

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