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Do EHRs Undermine Patient Care?

As we transition to value-based care, patients need to be more involved in their own health decisions and outcomes. Patient-provider collaboration must become the new norm. Without that, reforms will amount to marginal improvements at best.

Unfortunately, many physicians find that EHRs interfere with patient care and collaboration. EHRs are essentially focused on coding and billing. These functions don’t depend on patient participation, and sometimes actively discourage it.

Observational studies have looked at eye contact as a measure of physician interaction with patients while using an electronic health record in the exam room. Surveys have asked physicians about face-to-face time with patients. Here’s what they found:

Study 1: EHRs can prevent eye contact in the exam room

  • Physicians spent, on average, 33% of the exam looking at their EHR.
  • The patient’s gaze was unknown 25% of the time.1

Study 2: EHRs can silence patient-provider conversation

  • The doctor spent nearly 40% of the appointment looking at the EHR.
  • 32% of the total time in the exam room was spent in silence.2

Study 3: EHRs can interfere with patient care decisions

  • 70% of physicians say their EHR cuts down on face time with patients.
  • 26% say it decreases their ability to manage treatment.3
The results all point to one conclusion: using an EHR can get in the way of patient care.  

1 Onur, A., Young, H. N., Chewning, B., & Montague, E. (2015). How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care. Patient Education and Counseling, 98(3), 310-316.

2 Street,R.L.,Jr.,Liu,L.,Farber,N.J.,Chen,Y.,Calvitti,A.,Zuest,D., . . . Agha, Z.(2014). Provider interaction with the electronic health record: The effects on patient-centered communication in medical encounters. Patient Education and Counseling, 96, 315-319.

3 Kane, L., Chesanow, N. (2014). Medscape HER Report 2014 [PowerPoint slides]. Available at: http://www.medscape.com/features/slideshow/public/ehr2014#29.

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