If you have seen a doctor in the last several years, the chances are good that he or she has entered your data into a computer during the visit. Electronic health records have become ubiquitous in health care settings, whether at a clinic, a doctor’s private office or in a hospital.
Such electronic health records were supposed to add efficiency to the doctor-patient interaction by allowing health care providers to access lab results, track patient progress, prescribe medicines and refer patients to other members of the healthcare team. Their adoption has received a lot of attention and some fiscal incentives under the ACA health care legislation.
What Could Go Wrong?
A new study suggests that there are some serious complications that were not foreseen by the computer gurus who designed these systems. Investigators from the University of California, San Francisco, analyzed data from patient-doctor interactions between 2011 and 2013.
They utilized data from designated safety-net clinics where the patients often had limited health literacy. These individuals suffered from heart failure, rheumatoid arthritis or type 2 diabetes. Each appointment was videotaped and patients were contacted after the visit to assess satisfaction with the interaction.
Less Computer Time and More Eye Contact Meant More Satisfaction:
Doctors who spent less time typing on the computer scored much higher in patient satisfaction, achieving excellent care ratings 80% of the time. Doctors who were deemed high computer users achieved an excellent rating less than half the time.
The researchers noted that high computer use by a clinician was linked to lower patient satisfaction and less rapport between patients and physicians.
JAMA Internal Medicine, Nov. 30, 2015
That is not to say that the baby should be thrown out with the bathwater. The idea of scrapping electronic health records is not viable. But doctors and patients should both be able to use these records easily.
Unfortunately, most electronic health records were designed primarily to make billing easier, so neither doctors nor patients find them user-friendly. Perhaps it is time to consider how to change that.
