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Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents

BACKGROUND: The Electronic Health Record (EHR) is now widely used in clinical encounters. Because its use can negatively impact the physician-patient relationship, several recommendations on the “patient-centered” use of the EHR have been published. However, the impact of training to improve EHR use...

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Autores principales: Lanier, Cédric, Dominicé Dao, Melissa, Hudelson, Patricia, Cerutti, Bernard, Junod Perron, Noëlle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446676/
https://www.ncbi.nlm.nih.gov/pubmed/28549460
http://dx.doi.org/10.1186/s12875-017-0640-2
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author Lanier, Cédric
Dominicé Dao, Melissa
Hudelson, Patricia
Cerutti, Bernard
Junod Perron, Noëlle
author_facet Lanier, Cédric
Dominicé Dao, Melissa
Hudelson, Patricia
Cerutti, Bernard
Junod Perron, Noëlle
author_sort Lanier, Cédric
collection PubMed
description BACKGROUND: The Electronic Health Record (EHR) is now widely used in clinical encounters. Because its use can negatively impact the physician-patient relationship, several recommendations on the “patient-centered” use of the EHR have been published. However, the impact of training to improve EHR use during clinical encounters is not well known. The aim of this study was to assess the impact of training on residents’ EHR-related communication skills and explore whether they varied according to the content of the consultation. METHODS: We conducted a pre-post intervention study at the Primary Care Division of the Geneva University Hospitals, Switzerland. Residents were invited to attend a 3-month training course that included 2 large group sessions and 2–4 individualized coaching sessions based on videotaped encounters. Outcomes were: 1) residents’ perceptions regarding the use of EHR, measured through a self-administered questionnaire and 2) objective use of the EHR during the first 10 min of patient encounters. Changes in practice were measured pre and post intervention using the Roter interaction analysis system (RIAS) and EHR specific items. RESULTS: Seventeen out of 27 residents took part in the study. Participants used EHR in about 30% of consultations. After training, they were less likely to consider EHR to be a barrier to the physician-patient relationship, and felt more comfortable using the EHR. After training, participants increased the use of signposting when using the EHR (pre: 0.77, SD 1.69; post: 1.80, SD3.35; p 0.035) and decreased EHR use when psychosocial issues appeared (pre: 24.5% and post: 9.76%, p < 0.001). CONCLUSIONS: This study suggests that training can improve residents’ EHR-related communication skills, especially in situations where patients bring up sensitive psychosocial issues. Future research should focus on patients’ perceptions of the relevance and usefulness of such skills.
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spelling pubmed-54466762017-05-30 Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents Lanier, Cédric Dominicé Dao, Melissa Hudelson, Patricia Cerutti, Bernard Junod Perron, Noëlle BMC Fam Pract Research Article BACKGROUND: The Electronic Health Record (EHR) is now widely used in clinical encounters. Because its use can negatively impact the physician-patient relationship, several recommendations on the “patient-centered” use of the EHR have been published. However, the impact of training to improve EHR use during clinical encounters is not well known. The aim of this study was to assess the impact of training on residents’ EHR-related communication skills and explore whether they varied according to the content of the consultation. METHODS: We conducted a pre-post intervention study at the Primary Care Division of the Geneva University Hospitals, Switzerland. Residents were invited to attend a 3-month training course that included 2 large group sessions and 2–4 individualized coaching sessions based on videotaped encounters. Outcomes were: 1) residents’ perceptions regarding the use of EHR, measured through a self-administered questionnaire and 2) objective use of the EHR during the first 10 min of patient encounters. Changes in practice were measured pre and post intervention using the Roter interaction analysis system (RIAS) and EHR specific items. RESULTS: Seventeen out of 27 residents took part in the study. Participants used EHR in about 30% of consultations. After training, they were less likely to consider EHR to be a barrier to the physician-patient relationship, and felt more comfortable using the EHR. After training, participants increased the use of signposting when using the EHR (pre: 0.77, SD 1.69; post: 1.80, SD3.35; p 0.035) and decreased EHR use when psychosocial issues appeared (pre: 24.5% and post: 9.76%, p < 0.001). CONCLUSIONS: This study suggests that training can improve residents’ EHR-related communication skills, especially in situations where patients bring up sensitive psychosocial issues. Future research should focus on patients’ perceptions of the relevance and usefulness of such skills. BioMed Central 2017-05-26 /pmc/articles/PMC5446676/ /pubmed/28549460 http://dx.doi.org/10.1186/s12875-017-0640-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lanier, Cédric
Dominicé Dao, Melissa
Hudelson, Patricia
Cerutti, Bernard
Junod Perron, Noëlle
Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents
title Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents
title_full Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents
title_fullStr Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents
title_full_unstemmed Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents
title_short Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents
title_sort learning to use electronic health records: can we stay patient-centered? a pre-post intervention study with family medicine residents
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446676/
https://www.ncbi.nlm.nih.gov/pubmed/28549460
http://dx.doi.org/10.1186/s12875-017-0640-2
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