Computers in the exam room: differences in physician-patient interaction may be due to physician experience. J Gen Intern Med 2007 Jan;22(1):43-8
Date
03/14/2007Pubmed ID
17351838Pubmed Central ID
PMC1824776DOI
10.1007/s11606-007-0112-9Scopus ID
2-s2.0-34248532316 (requires institutional sign-in at Scopus site) 100 CitationsAbstract
BACKGROUND: The use of electronic medical records can improve the technical quality of care, but requires a computer in the exam room. This could adversely affect interpersonal aspects of care, particularly when physicians are inexperienced users of exam room computers.
OBJECTIVE: To determine whether physician experience modifies the impact of exam room computers on the physician-patient interaction.
DESIGN: Cross-sectional surveys of patients and physicians.
SETTING AND PARTICIPANTS: One hundred fifty five adults seen for scheduled visits by 11 faculty internists and 12 internal medicine residents in a VA primary care clinic.
MEASUREMENTS: Physician and patient assessment of the effect of the computer on the clinical encounter.
MAIN RESULTS: Patients seeing residents, compared to those seeing faculty, were more likely to agree that the computer adversely affected the amount of time the physician spent talking to (34% vs 15%, P = 0.01), looking at (45% vs 24%, P = 0.02), and examining them (32% vs 13%, P = 0.009). Moreover, they were more likely to agree that the computer made the visit feel less personal (20% vs 5%, P = 0.017). Few patients thought the computer interfered with their relationship with their physicians (8% vs 8%). Residents were more likely than faculty to report these same adverse effects, but these differences were smaller and not statistically significant.
CONCLUSION: Patients seen by residents more often agreed that exam room computers decreased the amount of interpersonal contact. More research is needed to elucidate key tasks and behaviors that facilitate doctor-patient communication in such a setting.
Author List
Rouf E, Whittle J, Lu N, Schwartz MDAuthor
Jeffrey Whittle MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAttitude to Computers
Communication
Cross-Sectional Studies
Faculty, Medical
Female
Humans
Internship and Residency
Male
Medical Records Systems, Computerized
Physician-Patient Relations
Primary Health Care
Surveys and Questionnaires
Time Factors
Virginia
