Physicians who use electronic health records in the exam room spend about a third of their visits looking at a computer screen, according to study results published in the International Journal of Medical Informatics.
When physicians spend too much time looking at the computer screen, they may miss nonverbal cues and may not pay attention and communicate effectively with patients.
“When doctors spend that much time looking at the computer, it can be difficult for patients to get their attention,” Edith Montague, PhD, assistant professor in medicine, general internal medicine and geriatrics at Northwestern University Feinberg School of Medicine and an assistant professor in industrial engineering at the McCormick School of Engineering and Applied Science, stated in a press release. “It’s likely that the ability to listen, problem-solve and think creatively is not optimal when physicians’ eyes are glued to the screen.”
Researchers observed and recorded 100 patient visits in a primary care clinic. Videos were coded for gaze behaviors between patients and physicians and their gaze at artifacts, such as electronic health records.
Study results showed all doctor-initiated gaze patterns were followed by patient gaze patterns, whereas only some patient-initiated gaze patterns were also followed by doctor gaze patterns. Researchers found gaze patterns related to electronic health records differ from patterns identified in previous studies with paper charts. The researchers concluded health information technology contributes to these new significant patterns.
“We found that physician-patient eye-gaze patterns are different during a visit in which electronic health records vs. a paper-chart visit are used. Not only does the doctor spend less time looking at the patient, the patient also almost always looks at the computer screen, whether or not the patient can see or understand what is on the screen,” Montague said.
Understanding physicians’ eye gaze pattern and the effects on patients can contribute to more effective training guidelines and better designed technology, for example, more interactive screen sharing between physicians and patients.
“The purpose of electronic health records is to enable health care workers to provide more effective, efficient, coordinated care,” Montague said. “By understanding the dynamic nature of eye-gaze patterns and how technology impacts these patterns, we can contribute to future EHR designs that foster more effective doctor-patient interaction.”
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Disclosure: This research was supported by a grant from the Clinical and Translational Science Award program of the National Center for Research Resources, the National Institutes of Health, as well as the Wisconsin Research and Education Network.