A new observational study suggests that high-intensity computer use in the exam room by physicians leads to significantly lower satisfaction scores.

In an observational study, researchers videotaped 71 encounters between 47 patients and 39 clinicians over a two-year period in safety net clinics. The patients were called prior to the visit and afterward. In the second call, they were asked about their satisfaction of care over the last six months.

Reporting online in the November 30 edition of JAMA Internal Medicine, the researchers said 48% of patients with high-intensity use physicians said their care was “excellent,” while 83% patients with low-intensity use physicians said they received “excellent” care.

"Although social rapport building can build trust and satisfaction, concurrent computer use may inhibit authentic engagement, and multitasking clinicians may miss openings for deeper connection with their patients," the authors wrote. Their observation may be an unintentional consequence of the electronic health record, they said, noting that completing it while caring for patients "may trigger disagreement by clinicians as they detect and clarify patient misunderstandings."

Our Take: This little-known study echoes what some doctors have been complaining about—that an increased emphasis on technology gets in the way of patient care. But EHRs aren’t going anywhere. Considering that CMS has prioritized the patient experience within its quality measures across the board, clinicians and caregivers need to find ways of using technology without alienating patients.

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