Work system factors influencing physicians' screen sharing behaviors in primary care encounters. Int J Med Inform 2015 Oct;84(10):791-8
Date
06/08/2015Pubmed ID
26049312Pubmed Central ID
PMC6697902DOI
10.1016/j.ijmedinf.2015.05.006Scopus ID
2-s2.0-84940894955 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
OBJECTIVE: While the use of electronic health records (EHRs) in primary care has increased dramatically, its potential benefits need to be considered in light of potential negative impacts on physician-patient interactions and the increase in physician cognitive workload. This study aims to understand work system factors contributing to physicians' use of the EHR as a communication tool during primary-care encounters.
METHODS: We interviewed 14 primary care physicians on their use of EHRs as a communication tool in patient visits. A qualitative content analysis guided by the work system model identified factors influencing physicians' decisions to share or not share the computer screen with their patients.
RESULTS: The analysis revealed 26 factors that influenced physicians' decisions to share the screen, most related to the "task" (reviewing lab records), "tools and technology" (using algorithm calculators for risk prediction), or "individual" (patient interest) elements of the work system. The analysis revealed 15 factors that influenced physicians' decisions not to share the screen, most related to the "individual" (patient's acute pain), "organization" (insufficient time), or "task" (documenting embarrassing information) elements of the work system.
CONCLUSION: Eleven physicians made individual decisions to share or not to share the screen in a particular visit based on work-system related factors. Three doctors always shared the screen, based on the idea that it is polite and builds trust. However, several physicians also reported that it was time consuming and caused unnecessary distractions. Understanding these factors is essential to effective EHR redesign and training for improving physician-patient communication.
Author List
Asan O, Carayon P, Beasley JW, Montague EMESH terms used to index this publication - Major topics in bold
AdultAttitude of Health Personnel
Attitude to Computers
Communication
Female
Humans
Male
Middle Aged
Patient Education as Topic
Physician-Patient Relations
Physicians, Primary Care
Practice Patterns, Physicians'
Primary Health Care
User-Computer Interface
Utilization Review
Wisconsin
Workflow
Workload
