Electronic medical record use and physician–patient communication: An observational study of Israeli primary care encounters

摘要: Abstract Objectives Within the context of medical care there is no greater reflection information revolution than electronic record (EMR). Current estimates suggest that EMR use by Israeli physicians now so high as to represent an almost fully immersed environment. This study examines relationships between extent and physician–patient communication within primary care. Methods Based on videotapes 3 30 their patients, computer was measured number seconds gazing at screen levels active keyboarding. Communication dynamics were analyzed through application a new Hebrew translation adaptation Roter Interaction Analysis System (RIAS). Results Physicians spent close one-quarter visit time screen, in some cases much 42%; heavy keyboarding throughout evident 24% studied visits. Screen gaze both positively correlated with length ( r =.51, p F (2,27)=2.83, (2,27)=4.22, (2,27)=3.85, =−.39, =−.30, (2,27)=4.78, (2,27)=10.38, (2,27)=3.40, =−.33, (2,27)=3.19, Discussion The has become ‘party' demanded significant portion time. Gazing monitor inversely related physician engagement psychosocial questioning emotional responsiveness patient limited socio-emotional exchange during visit. Keyboarding activity contribution dialogue. Patients may regard physicians' engrossment tasks computing disinterested or disengaged. Increase associated be attributed gazing. Conclusions suggests way which computers examination room can negatively affect patient-centered practice diminishing dialogue, particularly realm. appears disruptive inquiry responsiveness, suggesting visual attentiveness rather eye contact inhibit sensitive full disclosure. Practical implications We believe training help optimize interpersonal educationally effective EMR. assist overcoming distancing, verbally non-verbally, associated. Collaborative reading contribute improved quality care, enhance decision-making process, empower patients participate own