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Shmuel Reis - One of the best experts on this subject based on the ideXlab platform.
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the impact of electronic medical records on patient doctor Communication during consultation a narrative literature review
Journal of Evaluation in Clinical Practice, 2009Co-Authors: Aviv Shachak, Shmuel ReisAbstract:Rationale, aims and objective The effect of Electronic Medical Record (EMR) use on Patient–Doctor Communication (PDC) has rarely been studied. As data accumulate, the purpose of this article is to review the literature on EMR effect on PDC, to identify recurring themes and to offer preliminary guidelines and future directions for medical education and research. Method A database search was conducted and 14 articles that met inclusion criteria (published in the past 10 years, empirical investigations, direct assessment of the EMR impact on patient–doctor Communication) were selected for review. A qualitative, grounded theory-like approach was employed to analyse the data. Results EMR use often has a positive impact on information exchange, but exerts a negative influence on patient centredness. Some physician characteristics such as their computer skills and behavioural style assist in overcoming this negative influence. Conclusion The use of EMR exerts both positive and negative impacts on physician–patient relationships. The negative impacts can be overcome by some simple means as well as better designs of EMR systems and medical education interventions. Physicians’ everyday practices of integrating EMR use into the clinical encounter as well as better design of EMR systems and EMR and Communication training may facilitate PDC in computerized settings.
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primary care physicians use of an electronic medical record system a cognitive task analysis
Journal of General Internal Medicine, 2009Co-Authors: Aviv Shachak, Michal Hadasdayagi, Amitai Ziv, Shmuel ReisAbstract:OBJECTIVE To describe physicians’ patterns of using an Electronic Medical Record (EMR) system; to reveal the underlying cognitive elements involved in EMR use, possible resulting errors, and influences on patient–doctor Communication; to gain insight into the role of expertise in incorporating EMRs into clinical practice in general and communicative behavior in particular.
Aviv Shachak - One of the best experts on this subject based on the ideXlab platform.
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the impact of electronic medical records on patient doctor Communication during consultation a narrative literature review
Journal of Evaluation in Clinical Practice, 2009Co-Authors: Aviv Shachak, Shmuel ReisAbstract:Rationale, aims and objective The effect of Electronic Medical Record (EMR) use on Patient–Doctor Communication (PDC) has rarely been studied. As data accumulate, the purpose of this article is to review the literature on EMR effect on PDC, to identify recurring themes and to offer preliminary guidelines and future directions for medical education and research. Method A database search was conducted and 14 articles that met inclusion criteria (published in the past 10 years, empirical investigations, direct assessment of the EMR impact on patient–doctor Communication) were selected for review. A qualitative, grounded theory-like approach was employed to analyse the data. Results EMR use often has a positive impact on information exchange, but exerts a negative influence on patient centredness. Some physician characteristics such as their computer skills and behavioural style assist in overcoming this negative influence. Conclusion The use of EMR exerts both positive and negative impacts on physician–patient relationships. The negative impacts can be overcome by some simple means as well as better designs of EMR systems and medical education interventions. Physicians’ everyday practices of integrating EMR use into the clinical encounter as well as better design of EMR systems and EMR and Communication training may facilitate PDC in computerized settings.
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primary care physicians use of an electronic medical record system a cognitive task analysis
Journal of General Internal Medicine, 2009Co-Authors: Aviv Shachak, Michal Hadasdayagi, Amitai Ziv, Shmuel ReisAbstract:OBJECTIVE To describe physicians’ patterns of using an Electronic Medical Record (EMR) system; to reveal the underlying cognitive elements involved in EMR use, possible resulting errors, and influences on patient–doctor Communication; to gain insight into the role of expertise in incorporating EMRs into clinical practice in general and communicative behavior in particular.
Carol Teutsch - One of the best experts on this subject based on the ideXlab platform.
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patient doctor Communication
Medical Clinics of North America, 2003Co-Authors: Carol TeutschAbstract:Communication is an important component of patient care. Traditionally, Communication in medical school curricula was incorporated informally as part of rounds and faculty feedback, but without a specific or intense focus on skills of communicating per se. The reliability and consistency of this teaching method left gaps, which are currently getting increased attention from medical schools and accreditation organizations. There is also increased interest in researching Patient-Doctor Communication and recognizing the need to teach and measure this specific clinical skill. In 1999, the Accreditation of Council for Graduate Medical Education implemented a requirement for accreditation for residency programs that focuses on "interpersonal and Communications skills that result in effective information exchange and teaming with patients, their families, and other health professionals." The National Board of Medical Examiners, Federation of State Medical Boards. and the Educational Commission for Foreign Medical Graduates have proposed an examination between the. third and fourth year of medical school that "requires students to demonstrate they can gather information from patients, perform a physical examination, and communicate their findings to patients and colleagues" using standardized patients. One's efficiency and effectiveness in Communication can be improved through training, but it is unlikely that any future advances will negate the need and value of compassionate and empathetic two-way Communication between clinician and patient. The published literature also expresses belief in the essential role of Communication. "It has long been recognized that difficulties in the effective delivery of health care can arise from problems in Communication between patient and provider rather than from any failing in the technical aspects of medical care. Improvements in provider-patient Communication can have beneficial effects on health outcomes". A systematic review of randomized clinical trials and analytic studies of physician-patient Communication confirmed a positive influence of quality Communication on health outcomes. Continuing research in this arena is important. For a successful and humanistic encounter at an office visit, one needs to be sure that the patient's key concerns have been directly and specifically solicited and addressed. To be effective, the clinician must gain an understanding of the patient's perspective on his or her illness. Patient concerns can be wide ranging, including fear of death, mutilation, disability; ominous attribution to pain symptoms; distrust of the medical profession; concern about loss of wholeness, role, status, or independence; denial of reality of medical problems; grief; fear of leaving home; and other uniquely personal issues. Patient values, cultures, and preferences need to be explored. Gender is another element that needs to be taken into consideration. Ensuring key issues are verbalized openly is fundamental to effective Patient-Doctor Communication. The clinician should be careful not to be judgmental or scolding because this may rapidly close down Communication. Sometimes the patient gains therapeutic benefit just from venting concerns in a safe environment with a caring clinician. Appropriate reassurance or pragmatic suggestions to help with problem solving and setting up a structured plan of action may be an important part of the patient care that is required. Counseling around unhealthy or risky behaviors is an important Communication skill that should be part of health care visits. Understanding the psychology of behavioral change and establishing a systematic framework for such interventions, which includes the five As of patient counseling (assess, advise, agree, assist, and arrange) are steps toward ensuring effective Patient-Doctor Communication. Historically in medicine, there was a paternalistic approach to deciding what should be done for a patient: the physician knew best and the patient accepted the recommendation without question. This era is ending, being replaced with consumerism and the movement toward shared decision-making. Patients are advising each other to "educate yourself and ask questions". Patient satisfaction with their care, rests heavily on how successfully this transition is accomplished. Ready access to quality information and thoughtful Patient-Doctor discussions is at the fulcrum of this revolution.
Vineet M Arora - One of the best experts on this subject based on the ideXlab platform.
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impact of electronic medical record use on the patient doctor relationship and Communication a systematic review
Journal of General Internal Medicine, 2016Co-Authors: Maria Alcocer Alkureishi, Wei Wei Lee, Maureen D Lyons, Valerie G Press, Sara Imam, Akua Nkansahamankra, Deb Werner, Vineet M AroraAbstract:While Electronic Medical Record (EMR) use has increased dramatically, the EMR’s impact on the patient–doctor relationship remains unclear. This systematic literature review sought to understand the impact of EMR use on patient–doctor relationships and Communication. Parallel searches in Ovid MEDLINE, PubMed, Scopus, PsycINFO, Cochrane Library, reference review of prior systematic reviews, meeting abstract reviews, and expert reviews from August 2013 to March 2015 were conducted. Medical Subject Heading terms related to EMR use were combined with keyword terms identifying face-to-face patient–doctor Communication. English language observational or interventional studies (1995–2015) were included. Studies examining physician attitudes only were excluded. Structured data extraction compared study population, design, data collection method, and outcomes. Fifty-three of 7445 studies reviewed met inclusion criteria. Included studies used behavioral analysis (28) to objectively measure Communication behaviors using video or direct observation and pre-post or cross-sectional surveys to examine patient perceptions (25). Objective studies reported EMR Communication behaviors that were both potentially negative (i.e., interrupted speech, low rates of screen sharing) and positive (i.e., facilitating questions). Studies examining overall patient perceptions of satisfaction, Communication or the patient–doctor relationship (n = 22) reported no change with EMR use (16); a positive impact (5) or showed mixed results (1). Study quality was not assessable. Small sample sizes limited generalizability. Publication bias may limit findings. Despite objective evidence that EMR use may negatively impact patient–doctor Communication, studies examining patient perceptions found no change in patient satisfaction or patient–doctor Communication. Therefore, our findings should encourage providers to adopt the EMR as a Communication tool. Future research is needed to better understand how to enhance patient–doctor- EMR Communication. This research should correlate observed physician behavior to patient satisfaction, focus on physician Communication skills training, and explore inpatient experiences.
Stephen Clarke - One of the best experts on this subject based on the ideXlab platform.
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cancer patient disclosure and patient doctor Communication of complementary and alternative medicine use a systematic review
Oncologist, 2012Co-Authors: Esther L Davis, Phyllis Butow, Barbara Mullan, Stephen ClarkeAbstract:Objective. To explore the nondisclosure of complementary and alternative medicine (CAM) use among cancer patients, including reasons for and outcomes from nondisclosure of CAM use, within the context of Patient-Doctor Communication. Method. A systematic review was conducted exploring investigations surrounding the Communication of CAM use for patients with cancer published until August 2011. Results.Atotalof21studieswerelocated,whichreporteda prevalence of CAM use among patients with cancer ranging between11%and95%;ofthesepatients,20%to77%didnot disclose their CAM use. The main reasons for nondisclosure werethedoctor’slackofinquiry;patient’santicipationofthe doctor’s disapproval, disinterest, or inability to help; and patient’s perception that disclosure of CAM use is irrelevant to their conventional care. There is some evidence to suggest that Patient-Doctor Communication about the use of CAM was associated with an enhanced Patient-Doctor relationship and higher patient satisfaction. Conclusions. Although the use of CAM by patients with