Preserving Patient Relationship-Centered Care while Utilizing EHRs

Abstract

Abstract While the electronic health record (EHR) can provide efficiency and enhance patient safety, it also has the potential to be disruptive technology. For example, health care providers often find it challenging to use the EHR during patient encounters without compromising that relationship. Although developing good communication skills is an integral part of medical school curricula, students must also learn how to integrate those communication skills into the patient encounter while utilizing an EHR. Despite the fact that many students are computer literate and easily learn new computer applications, integrating the EHR into the patient visit is a skill that can be very challenging. This resource is an online self-study module for health care professionals and medical students designed to provide awareness of the computer's impact on the provider-patient relationship. It also presents a framework for learners on using the EHR during a patient encounter. The module includes content sections on education, computer placement, and provider-patient relational aspects of using an EHR during patient visits. The education section stresses the importance of introducing the role of the computer to the patient and using it as a visual aid in patient health education. The section on computer placement demonstrates a positive open triadic position versus the closed or blocked position. In the relational skills section, the emphasis is on ways to maximize the provider-patient relationship and involves the patient in the EHR process. Instructional activities include narrated lectures, video examples, quizzes, and an online discussion question. We evaluated the effectiveness of the module based on changes in student behavior between the students who completed the module and those who did not. The initial findings showed that students in the experiment group demonstrated their learned EHR communication skills compared to the control group. Paired t tests showed that they retained their learned skills even 3 months after completing the training. Additionally, the standardized patient evaluations also showed a positive effect of the EHR training.

Keywords

• Communication Skills
• Physician-Patient Relations
• Electronic Health Records
• EHR
• Patient Centered-Care