Posted on June 12, 2014 by Simon Hagens
Do computers in the exam room impact patient-provider interaction? This is a topic of much debate, but less concrete evidence. To add to the conversation, we analysed data from a survey conducted by Harris Decima to measure public attitudes and understanding of health information and communication technology (ICT). The survey was in field in February and March 2014 and collected perspectives from 1,512 Canadian adults.
The survey asked Canadians about how their physician looks up information about them (which has proven a reliable method for understanding digital health uptake by physicians) and asked “thinking of the last time you received care or treatment, did your doctor pay attention to what you said?” The results confirmed that physicians receive high marks for listening to their patients, with 92% saying yes. Importantly, analysis of these responses by digital health uptake also confirmed no difference across fully computerized, paper/electronic combination or fully paper physician practices. Regardless of technology, patients are generally happy with their interaction. Of course, this analysis reflects only a single point in time, we only asked about one aspect of patient-clinician interaction, and the highly positive responses about patient-physician communication in general may create a ceiling effect.
To understand how these results compare to what others have found, we turned to a 2011 systematic review of on perspectives around implementation of electronic records by McGinn et al. This paper identified seven studies which looked at how users such as physicians and nurses viewed the impact of electronic records on patient and health professional interaction. There were some consistent concerns:
“The most cited interaction change reported by clinicians and managers was a loss of both physical and relational contact with the patient due to interaction with the technology and perceptions that EHRs interrupt rather than support nurses' ability to provide direct patient care.”
This review also found four papers which looked at patient perspective, with some differing views. Two of these were not related to interaction within the exam room. The remaining two, were consistent with our survey results: computers did not impact the patient-clinician relationship.
Further investigation is clearly required; however the evidence here suggests that while clinicians may have concerns, they do not appear to be shared by their patients.
McGinn CA, Grenier S, Duplantie J, Shaw N, Sicotte C, Mathieu L, Leduc Y, Legare F, Gagnon MP: Comparison of user groups’ perspectives of barriers and facilitators to implementing electronic health records: a systematic review.
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Simon Hagens leads performance analytics at Canada Health Infoway, informing Infoway and our partners with the evidence to deliver and optimize digital health for the benefit of Canadians and our health system.