Patients Less Satisfied When Doctors Use Computers During Appointments: Study

Computers are increasingly helpful in keeping a patient's records. However, a recent study has found that when attending physicians establish a weaker personal connection to their respective patients due to computer use, patients are generally less satisfied.

“Many clinicians worry that electronic health records keep them from connecting with their patients,” Dr. Neda Ratanawongsa of the University of California, San Francisco, who co-authored the study, told Reuters.

The study, which is published in JAMA Internal Medicine, looked at data from appointments held by 47 patients and 39 doctors at a public hospital between 2011 and 2013. The patients, who were able to speak English or Spanish, either had one or more of the following conditions: rheumatoid arthritis, type 2 diabetes or congestive heart failure.

The researchers interviewed the patients by phone before their appointment, had the appointment videotaped and then interviewed the patients after the checkup.

A doctor's use of the computer was then rated by the help of the recorded video. Computers were used to retrieve electronic health records useful in reviewing test results, health care maintenance, prescribing medicine and referring patients to various specialists.

The researchers asked the patients during the post-appointment interview to rate the quality of care that they received from their doctors over the past six months.

They found that of the 25 appointments where there was high computer use, about half was rated as “excellent.” This is lower compared the 19 appointments with low computer use, of which more than 80 percent gave “excellent” as the rating.

Doctors, who spent more time using the computer, made less eye contact and were more likely to correct their patients about their medical history and the drugs that they are taking – which the researchers called “negative rapport building.”

Although computers are helpful in medical practice, balance is still key, according to Regenstrief Institute Investigator and Indiana University School of Medicine Professor of Medicine Richard Frankel, Ph.D.

Frankel, who wrote a commentary accompanying the study, said in a press release that "Medicine is fundamentally a human enterprise that is still practiced one conversation at a time. Our challenge is to find the best ways to incorporate computers [as care process partners] in the examination room without losing the heart and soul of medicine, the physician-patient relationship."

Study co-author Ratanawongsa added that electronic health records “need to be more usable so clinicians with varying computer proficiency can use them without struggling and diverting focus from patients.”