Level II-2 Level Case-Control Study (EHR)

EHR’s are very useful, reliable, and informative and to fully understand its potential, we must understand how its predecessor of paper records were used, to create better physician-patient interactions. The article “More screen time, less face time – implications for EHR design” expands on this understanding via a level II-2 level case-control study directly comparing the two types of recording. The study compared the physician patient interaction when using a paper chart versus an EHR. Eight experienced family medicine physicians and 80 patients participated in the study with 80 visits in total, half of which used paper charts while the other half used EHRs. The study occurred at the University of Wisconsin–Madison family medicine clinics.

The study was measured to find duration time of gaze. The physician gaze at the patient in the paper chart versus the EHR setting was 52.6% and 45.6% of the time respectively. The patient gaze at the physician in the paper chart versus the EHR setting was 39.1% and 52.2% respectively. Mutual gaze in the paper chart versus the EHR setting was 28.5% versus 33.9% respectively. Before making any concrete conclusions, it is important to know that certain controllable and uncontrollable confounding variables might have influence the results such as gender of patient, age, visits were at different times, and each physician has their unique notes. The study concluded by stating that physicians spent much more time looking at the EHR’s and less time looking at the patients and can negatively affect the patient’s perception of their physician when visiting them (Asan et al, 2014). Although the study itself is not perfect, it can still provide a lot of information about using EHR’s effectively while still keeping patient-physician interaction up to satisfactory standards for both

It provides a surface amount of information and a large amount of interpretation about the physician-patient interaction based off of the numbers. Each physician-patient interaction is unique and depends on the circumstances of the visit. With that knowledge in mind, however, I do think there is a general pattern of interaction depending on the type of information input and output is used. This study did have a lot of details and variables that can take up time and must be taken into consideration when interpreting the numbers. These variable and details that take up more time include the fact that the EHR has more information to process by the physician, the EHR’s interface and format, clinical tasks are preformed on the EHR, and other EHR systems and decision support are also on the EHR. All these necessary and useful factors take up time away from the patient-physician interaction, according to the study at