Eye Movement and EHRs

September 11, 2007

In this report from the Boston Globe, titled “Eyes shift from patient to keyboard, the writers bring to light an important issue in implementation of an EMR – its affect on the physician-patient relationship. One study quoted in the articled noted that “about a quarter of patients felt as though computers reduced the amount of time their doctors spent talking with, looking at, and examining them. But just 8 percent felt that the computer actually interfered with the doctor-patient relationship.” On suggested approach is to “apologizing to her patients for turning away from them.” It also notes that using an EMR can add time to the visit. Part of this can be the tendency to review old notes (although one must wonder the amount of time it took to review paper records, especially for patients with chronic illnesses, or did the doctor just not bother because the information was too difficult to extract?). Is the trade-off here, less personal but perhaps safer medical care? Or at least better documented?

Related to this is a study reported in the Journal of the American Medical Informatics Association titled, “Electronic Health Records in Specialty Care: A Time-Motion Study”. This study of 15 physicians and 157 patients concluded that, “Following EHR implementation, the average adjusted total time spent per patient across all specialties increased slightly but not significantly.”

Both of these reports contribute to the ongoing attention needed to the social impacts of EMRs on provider-patient relationships.

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