Technology-mediated information sharing between patients and clinicians in primary care encounters

Abstract

Objective: The aim of this study was to identify and describe the use of electronic health records (EHRs) for information sharing between patients and clinicians in primary-care encounters. This topic is particularly important as computers and other technologies are increasingly implemented in multi-user health-care settings where interactions and communication between patients and clinicians are integral to interpersonal and organisational outcomes. Method: An ethnographic approach was used to classify the encounters into distinct technology-use patterns based on clinicians’ interactions with the technology and patients. Each technology-use pattern was quantitatively analysed to assist with comparison. Quantitative analysis was based on duration of patient and clinician gaze at EHR. Findings: Physicians employed three different styles to share information using EHRs: (1) active information sharing, in which a clinician turns the monitor towards the patient and uses the computer to actively share information with the patient; (2) passive information sharing, when a clinician does not move the monitor, but the patient might see the monitor by leaning in if they choose and (3) technology withdrawal, when a clinician does not share the monitor with the patient. Conclusion: A variety of technology-mediated information-sharing styles may be effective in providing patient-centred care. New EHR designs may be needed to facilitate information sharing between patients and clinicians.

Keywords:

• collaborative learning
• CSCW
• human–machine interface
• electronic health records system

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Erratum

Acknowledgements

This research was supported by grant 1UL1RR025011 from the Clinical and Translational Science Award (CTSA) programme of the National Center for Research Resources (NCRR), National Institutes of Health (NIH). We thank undergraduate research assistants who assisted with data analysis and graduate research assistants who assisted with data collection.