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Journal of General Internal Medicine
Erschienen in: Journal of General Internal Medicine 5/2016

19.01.2016 | Review Paper

Impact of Electronic Medical Record Use on the Patient–Doctor Relationship and Communication: A Systematic Review

verfasst von: Maria Alcocer Alkureishi, MD, FAAP, Wei Wei Lee, MD, MPH, Maureen Lyons, MD, Valerie G. Press, MD, MPH, Sara Imam, BA, Akua Nkansah-Amankra, BA, Deb Werner, BA, MLIS, Vineet M. Arora, MD, MAPP

Erschienen in: Journal of General Internal Medicine | Ausgabe 5/2016

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ABSTRACT

BACKGROUND

While Electronic Medical Record (EMR) use has increased dramatically, the EMR’s impact on the patient–doctor relationship remains unclear. This systematic literature review sought to understand the impact of EMR use on patient–doctor relationships and communication.

METHODS

Parallel searches in Ovid MEDLINE, PubMed, Scopus, PsycINFO, Cochrane Library, reference review of prior systematic reviews, meeting abstract reviews, and expert reviews from August 2013 to March 2015 were conducted. Medical Subject Heading terms related to EMR use were combined with keyword terms identifying face-to-face patient–doctor communication. English language observational or interventional studies (1995–2015) were included. Studies examining physician attitudes only were excluded. Structured data extraction compared study population, design, data collection method, and outcomes.

RESULTS

Fifty-three of 7445 studies reviewed met inclusion criteria. Included studies used behavioral analysis (28) to objectively measure communication behaviors using video or direct observation and pre-post or cross-sectional surveys to examine patient perceptions (25). Objective studies reported EMR communication behaviors that were both potentially negative (i.e., interrupted speech, low rates of screen sharing) and positive (i.e., facilitating questions). Studies examining overall patient perceptions of satisfaction, communication or the patient–doctor relationship (n = 22) reported no change with EMR use (16); a positive impact (5) or showed mixed results (1). Study quality was not assessable. Small sample sizes limited generalizability. Publication bias may limit findings.

DISCUSSION

Despite objective evidence that EMR use may negatively impact patient–doctor communication, studies examining patient perceptions found no change in patient satisfaction or patient–doctor communication. Therefore, our findings should encourage providers to adopt the EMR as a communication tool. Future research is needed to better understand how to enhance patient–doctor- EMR communication. This research should correlate observed physician behavior to patient satisfaction, focus on physician communication skills training, and explore inpatient experiences.
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Metadaten
Titel
Impact of Electronic Medical Record Use on the Patient–Doctor Relationship and Communication: A Systematic Review
verfasst von
Maria Alcocer Alkureishi, MD, FAAP
Wei Wei Lee, MD, MPH
Maureen Lyons, MD
Valerie G. Press, MD, MPH
Sara Imam, BA
Akua Nkansah-Amankra, BA
Deb Werner, BA, MLIS
Vineet M. Arora, MD, MAPP
Publikationsdatum
19.01.2016
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 5/2016
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-015-3582-1

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