Physician Interactions with Electronic Health Records in Primary Care.
Physician Interactions with Electronic Health Records in Primary Care.
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DOI：
10.1057/hs.2012.11
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发表时间：
2012-12-01
期刊：
影响因子：
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通讯作者：
Asan O
中科院分区：
文献类型：
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作者：
Montague E;Asan O
设计促进医患之间适当互动的技术和系统至关重要。本研究探讨了医生如何与电子健康档案（EHR）互动，以了解医生与电子健康档案之间互动的质量，这可能有助于积极的医患互动。100个医疗咨询的录像观察被用来评估医生和电子病历之间的互动模式。量化观察方法用于促进生态效度。10名初级保健医生和来自5个诊所的100名患者参与了这项研究。用摄像机记录临床接触，并使用经过验证的客观编码方法进行编码，以检查医生如何与电子健康记录互动。确定了医生与电子病历互动的三种不同风格：以技术为中心、以人为中心和混合。使用以技术为中心风格的医生在就诊期间花更多时间打字和盯着电脑。使用混合风格的医生在整个访问过程中在患者和技术之间转移他们的注意力和肢体语言。使用以人为中心风格的医生花在打字上的时间最少，更多地关注病人。各种电子病历互动方式可能有效地促进以患者为中心的护理。然而，每种风格都存在潜在的缺点，并进行了讨论。本文还讨论了未来对这一主题的研究以及在初级保健中使用有效卫生信息技术的设计策略。
It is essential to design technologies and systems that promote appropriate interactions between physicians and patients. This study explored how physicians interact with Electronic Health Records (EHRs) to understand the qualities of the interaction between the physician and the EHR that may contribute to positive physician-patient interactions. Video-taped observations of 100 medical consultations were used to evaluate interaction patterns between physicians and EHRs. Quantified observational methods were used to contribute to ecological validity. Ten primary care physicians and 100 patients from five clinics participated in the study. Clinical encounters were recorded with video cameras and coded using a validated objective coding methodology in order to examine how physicians interact with electronic health records. Three distinct styles were identified that characterize physician interactions with the EHR: technology-centered, human-centered, and mixed. Physicians who used a technology-centered style spent more time typing and gazing at the computer during the visit. Physicians who used a mixed style shifted their attention and body language between their patients and the technology throughout the visit. Physicians who used the human-centered style spent the least amount of time typing and focused more on the patient. A variety of EHR interaction styles may be effective in facilitating patient-centered care. However, potential drawbacks of each style exist and are discussed. Future research on this topic and design strategies for effective health information technology in primary care are also discussed.