The role of electronic medical records in improving patient-centred care in outpatient encounters

Nedal Arar, John McGrath, Juan Rosales, Jacqueline Pugh

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective: Although electronic medical records (EMRs) have the potential to improve clinical care they inevitably affect the interaction between patients and providers. The primary aim of this study was to evaluate the role of EMRs on patient-centred care (PCC) during outpatient primary care encounters. Design: Cross-sectional, observational study. Setting: Single-centre veterans (VA) hospital in Texas, USA. Methods: Fifty out-patient encounters were videotaped and analysed to determine their duration, the proportion of time that the physician spent using the EMR during the encounter and the number of questions asked by the physician and by the patient. To objectively assess patient-involvement during the encounters, the ratio of patient questions and doctor responses, to doctor questions and patient responses was evaluated. This ratio is termed the encounter score and higher values indicate a greater degree of patient involvement or patient-centred care. Results: The average time for encounters among high EMR users (arbitrarily defined as EMR use >10% of the encounter time) was 25 minutes, compared to 16 minutes for encounters among low EMR users (EMR use <10% of the encounter time) (p <0.001). The average number of questions asked by patients was 8.4 (SD = 6.3) when encounters featured high use of EMR, compared to 2.9 (SD = 2.9) for encounters with low use of EMR (p < 0.05). Responses given by high EMR users were significantly more complete and more relevant than responses given by low EMR users (p < 0.05). Encounter scores were higher in high EMR users (0.32), compared to low EMR users (0.16), but this difference was not statistically significant (p > 0.05). Non-verbal communication between physicians and patients was limited by use of the EMR. Conclusions: Use of the EMR appears to facilitate shifting healthcare towards FCC. This is probably as a result of improved communication encouraging patients to participate in their encounters. Attention may need to be directed to the effect of EMR use on non-verbal communication patterns.

Original languageEnglish (US)
Pages (from-to)187-202
Number of pages16
JournalJournal on Information Technology in Healthcare
Volume2
Issue number3
StatePublished - Aug 4 2004

ASJC Scopus subject areas

  • Health Informatics
  • Health Information Management

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