The rapid move to electronic health records has created valuable opportunities to make patient care more effective and efficient. But for most physicians, EHRs have also meant a new addition to the exam room: the desktop computer. Recent research finds that patients prefer doctors who don’t use computers in the exam room.
“One possible explanation for our findings is that patients might value undivided attention,” the researchers explain in an article published in JAMA Oncology last year. They also propose that patients perceive physicians using a computer to be more distracted. This is an important reminder that doctors who use computers in the exam room need to be especially intentional about engaging patients during their visit.
Lower ratings for computers in the exam room
The research was conducted with 120 patients from the palliative care clinic at MD Anderson Cancer Center in Houston. The patients watched scripted video vignettes of two scenarios before responding to questions about the physicians.
In the first scene, a doctor used a paper notepad to document the visit. In the second scene, a doctor used an exam room computer to access information and type notes with minimal disruption. Both vignettes used an identical script, so the only the difference was the computer in the exam room.
After watching each video, patients completed a questionnaire rating the physician’s compassion, communications skills, and professionalism. They were also asked to indicate their preference for one of the two doctors.
Most patients (71 percent) preferred the physician who didn’t use the computer. The visit without a computer also received higher scores for compassion, communication skills, and professionalism. In short, patients prefer doctors who don’t use computers in the exam room.
How to guarantee patient satisfaction
EHRs aren’t going anywhere, and as the study authors conclude it’s important that doctors develop strategies to “mitigate the negative effects of [exam room computers] on physician-patient communication.”
Fortunately, there are steps any physician can take to guarantee patient satisfaction, even while taking notes directly into the EHR during the patient exam. Here are 6 simple tips every provider should incorporate.
1. Make eye contact
Research shows that physicians who consistently make eye contact are perceived by patients as being more empathetic. Busy providers will benefit from making eye contact a regular part of patient interactions, even if only during the initial greeting.
2. Give patients time to speak
Clinicians are trained to elicit the patient agenda, but a recent study found that clinicians usually interrupted patients after just 11 seconds. Try to let patients talk for at least 30 seconds about their agenda before redirecting the conversation.
3. Know the patient’s name
Similar to making eye contact, using a patient’s name makes them feel more cared for. This is as simple as making sure to glance at their chart or have an aid brief you before entering the exam room.
4. Have your literature ready
Educational materials and other resources are an important component of patient engagement. There are now software solutions that can save you time by customizing links, attachments and product recommendations relevant to your common cases.
5. Use effective clinical communication
What you say to patients may be the most important facet of the clinical encounter. There are many well-developed models and approaches designed to help healthcare professionals communicate with patients in a way that decreases patient anxiety, increases compliance, and improves clinical outcomes.
6. Switch to a mobile device
Many doctors now use their smartphone or tablet as a less intrusive way to efficiently document care while meeting with patients. Apps like Mobius Clinic are designed so that busy physicians can use their smartphone to dictate patient notes directly into the EHR. Mobile devices can also be used to facilitate conversation and engage patients in their care, turning clinical documentation into a meaningful patient interaction.
Research shows that using a computer in the exam room detracts from patients’ perceptions of providers. Evidence also suggests that how clinicians interact with patients has real consequences for their outcomes. Health care with EHRs therefore demands new interpersonal skills from busy physicians, and also creative new clinical documentation solutions. Consider mobile documentation as a way to streamline your clinical workflow and prioritize face-to-face time with patients.
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