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Submitted on November 12, 2004
Accepted on March 23, 2005
Affiliation of the authors:
* To whom correspondence should be addressed.
Objective To evaluate the impact of introducing health information technology (HIT) on physician-patient interactions during outpatient visits.
Design Longitudinal pre-post study: two-months before, and one- and seven-months after introduction of exam room computers. Patient questionnaires (n=313) after primary care visits with physicians (n=8) within an integrated delivery system.
Measures Three patient satisfaction domains: (1) satisfaction with visit components; (2) comprehension of the visit; and (3) perceptions of the physician's use of the computer.
Results Patients reported that physicians used computers in 82.3% of visits. Compared with baseline, overall patient satisfaction with visits increased seven-months after the introduction of computers (OR=1.50, 95% CI: 1.01-2.22), as did satisfaction with physicians' familiarity with patients (OR=1.60, 95% CI: 1.01-2.52), communication about medical issues (OR=1.61, 95% CI: 1.05-2.47), and comprehension of decisions made during the visit (OR=1.63, 95% CI: 1.06-2.50). In contrast, there were no significant changes in patient satisfaction with comprehension of self-care responsibilities, communication about psychosocial issues, or available visit-time. Seven-months post-introduction patients were more likely to report that the computer helped the visit run in a more timely manner (OR=1.76, 95% CI: 1.28-2.42) compared with the first-month after introduction. There were no other significant changes in patient perceptions of the computer use over time.
Conclusion The exam room computers appeared to have positive effects on physician-patient interactions related to medical communication without significant negative effects on other areas such as time available for patient concerns. Further study is needed to better understand HIT use during outpatient visits.
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