Cited by 12Electronic Health Records SystemsMedical Coding and Health InformationPrimary Care and Health Outcomes

What factors influence the use of electronic health records during the first 10 minutes of the clinical encounter?

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Lanier, Cédric, Cerutti, Bernard, Dominicé Dao, Melissa, Hudelson, Patricia, Junod Perron, Noëlle·2018·International Journal of General Medicine

Abstract

Purpose: The use of electronic health records (EHRs) by physicians during the consultation is common and can be problematic. Factors influencing the use of EHRs during clinical encounters include physician and patient characteristics, consultation type as well as spatial organization of the room and type of EHR template. Their relative importance is however not well known. This study aimed to explore to what extent several physician, patient and consultation factors were associated with EHR use during the first 10 minutes of primary care consultations. Methods: We examined EHR use of 17 residents in 142 videotaped consultations at the Primary Care Division of the Geneva University Hospitals, Switzerland. We conducted univariable and multivariable analyses with patient, physician and consultation variables to predict EHR use: sex and age of the patient; physician’s sex, age, postgraduate experience and EHR-use self-perception; and language, type of consultation (new/follow-up) and content of the consultation using the Roter interaction analysis system (RIAS), the main variable being the percentage of utterances in relation to EHR use during the first 10 minutes. Results: Male physicians (residents) and those with less clinical experience and conducting a new consultation or addressing biomedical content were positively correlated with EHR use (+5.3% for male physicians, P =0.101; +0.6% per year of experience, P =0.021; +6.0% for new consultation, P =0.097; +0.4% per 1% of biomedical content increase; P =0.018). Conclusion: Only a small number of physician, patient and consultation factors appear to have an impact on the use of EHR during primary care consultations, and this impact remains modest. Given the influence of EHR use on physician–patient relationship, further research should explore what other factors are implicated in EHR use and whether they can be changed or improved. Keywords: computer use, primary care, predicting factors, electronic health record

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  1. [1]Crampton NH Reis S Shachak A Computers in the clinical encounter: a scoping review and thematic analysis J Am Med Inform Assoc 2016 23 3 654 665 26769911 PMC7839926
  2. [2]Hippisley-Cox J Pringle M Cater R The electronic patient record in primary care--regression or progression? A cross sectional study BMJ 2003 326 7404 1439 1443 12829558 PMC162256
  3. [3]Doyle RJ Wang N Anthony D Borkan J Shield RR Goldman RE Computers in the examination room and the electronic health record: physicians’ perceived impact on clinical encounters before and after full installation and implementation Fam Pract 2012 29 5 601 608 22379185
  4. [4]Morton ME Wiedenbeck S EHR acceptance factors in ambulatory care: a survey of physician perceptions Perspect Health Inf Manag 2010 7 1c 1c PMC2805555 20697466
  5. [5]Asan O Kushner K Montague E Exploring Residents’ Interactions With Electronic Health Records in Primary Care Encounters Fam Med 2015 47 9 722 726 26473566 PMC6716379
  6. [7]Noordman J Verhaak P van Beljouw I van Dulmen S Consulting room computers and their effect on general practitioner-patient communication Fam Pract 2010 27 6 644 651 20660530
  7. [8]Frankel R Altschuler A George S Effects of exam-room computing on clinician-patient communication: a longitudinal qualitative study J Gen Intern Med 2005 20 8 677 682 16050873 PMC1490186
  8. [9]Rouf E Whittle J Lu N Schwartz MD Computers in the exam room: differences in physician-patient interaction may be due to physician experience J Gen Intern Med 2007 22 1 43 48 17351838 PMC1824776
  9. [11]Saleem JJ Flanagan ME Russ AL You and me and the computer makes three: variations in exam room use of the electronic health record J Am Med Inform Assoc 2014 21 e1 e147 e151 24001517 PMC3957404
  10. [12]Chan WS Stevenson M Mcglade K Do general practitioners change how they use the computer during consultations with a significant psychological component? Int J Med Inform 2008 77 8 534 538 18036885
  11. [13]Ventres W Kooienga S Marlin R Vuckovic N Stewart V Clinician style and examination room computers: a video ethnography Fam Med 2005 37 4 276 281 15812698
  12. [14]Pearce C Dwan K Arnold M Phillips C Trumble S Doctor TS Doctor, patient and computer--a framework for the new consultation Int J Med Inform 2009 78 1 32 38 18752989
  13. [15]Voran D Using Technology to Enhance Patient-Physician Interactions Pm R 2017 9 5S S26 S33 28527500
  14. [16]Almquist JR Kelly C Bromberg J Bryant SC Christianson TH Montori VM Consultation room design and the clinical encounter: the space and interaction randomized trial HERD 2009 3 1 41 782009 21165880
  15. [17]Asan O Providers’ perceived facilitators and barriers to EHR screen sharing in outpatient settings Appl Ergon 2017 58 301 307 27633226
  16. [18]Alkureishi MA Lee WW Lyons M Impact of Electronic Medical Record Use on the Patient-Doctor Relationship and Communication: A Systematic Review J Gen Intern Med 2016 31 5 548 560 26786877 PMC4835363
  17. [19]Asan O Young HN Chewning B Montague E How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care Patient Educ Couns 2015 98 3 310 316 25534022 PMC4319541
  18. [20]Makoul G Curry RH Tang PC The use of electronic medical records: communication patterns in outpatient encounters J Am Med Inform Assoc 2001 8 6 610 615 11687567 PMC130071
  19. [21]Margalit RS Roter D Dunevant MA Larson S Reis S Electronic medical record use and physician-patient communication: an observational study of Israeli primary care encounters Patient Educ Couns 2006 61 1 134 141 16533682
  20. [22]Street RL Liu L Farber NJ Provider interaction with the electronic health record: the effects on patient-centered communication in medical encounters Patient Educ Couns 2014 96 3 315 319 2014/09// 24882086 PMC4339111
  21. [23]Silverman J Kurtz S Draper J Skills for Communicating With Patients 3rd revised ed Oxford Radcliffe Publishing Ltd 2013
  22. [24]Lanier C Dominicé Dao M Hudelson P Cerutti B Junod Perron N Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents BMC Fam Pract 2017 18 1 69 28549460 PMC5446676
  23. [25]Roter D Larson S The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions Patient Educ Couns 2002 46 4 243 251 11932123
  24. [26]Duke P Frankel RM Reis S How to integrate the electronic health record and patient-centered communication into the medical visit: a skills-based approach Teach Learn Med 2013 25 4 358 3652013 24112206
  25. [29]Weir CR Nebeker JJ Hicken BL Campo R Drews F Lebar B A cognitive task analysis of information management strategies in a computerized provider order entry environment J Am Med Inform Assoc 2007 14 1 65 75 17068345 PMC2215066

Authors
Lanier, C., Cerutti, B., Dominicé Dao, M., Hudelson, P., & Junod Perron, N.
Affiliations
  • University of Geneva (CH)
  • University Hospital of Geneva (CH)
Corresponding author
Lanier, Cédric
Venue
International Journal of General Medicine
Published
2018-10
Volume
Volume 11
Pages
393-398
ISSN
1178-7074 (ISSN-L)
OpenAlex
W2894597935
Cited by
12
References
4
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2019: 3
FWCI
1.58
Type
journal article
Language
en
Open access
Locations
  • International Journal of General Medicine (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
electronic health records, primary care visits, physician characteristics, patient characteristics, physician-patient relationship, Roter Interaction Analysis System, medical residents, clinical experience

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