J Am Med Inform Assoc - Effects of electronic health record use on the exam room communication skills of resident physicians: a randomized within-subjects study.

Tópicos

{ ehr(2073) health(1662) electron(1139) }
{ error(1145) method(1030) estim(1020) }
{ care(1570) inform(1187) nurs(1089) }
{ control(1307) perform(991) simul(935) }
{ use(1733) differ(960) four(931) }
{ record(1888) medic(1808) patient(1693) }
{ research(1218) medic(880) student(794) }
{ survey(1388) particip(1329) question(1065) }
{ method(1557) propos(1049) approach(1037) }
{ studi(2440) review(1878) systemat(933) }
{ assess(1506) score(1403) qualiti(1306) }
{ model(2341) predict(2261) use(1141) }
{ cost(1906) reduc(1198) effect(832) }
{ sequenc(1873) structur(1644) protein(1328) }
{ perform(999) metric(946) measur(919) }
{ perform(1367) use(1326) method(1137) }
{ group(2977) signific(1463) compar(1072) }
{ high(1669) rate(1365) level(1280) }
{ result(1111) use(1088) new(759) }
{ method(1969) cluster(1462) data(1082) }
{ model(3404) distribut(989) bayesian(671) }
{ measur(2081) correl(1212) valu(896) }
{ featur(3375) classif(2383) classifi(1994) }
{ motion(1329) object(1292) video(1091) }
{ case(1353) use(1143) diagnosi(1136) }
{ import(1318) role(1303) understand(862) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ decis(3086) make(1611) patient(1517) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ method(1219) similar(1157) match(930) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ take(945) account(800) differ(722) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ state(1844) use(1261) util(961) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ use(2086) technolog(871) perceiv(783) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ implement(1333) system(1263) develop(1122) }
{ estim(2440) model(1874) function(577) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: The effects of electronic health records (EHRs) on doctor-patient communication are unclear.OBJECTIVE: To evaluate the effects of EHR use compared with paper chart use, on novice physicians' communication skills.DESIGN: Within-subjects randomized controlled trial using observed structured clinical examination methods to assess the impact of use of an EHR on communication.SETTING: A large academic internal medicine training program.POPULATION: First-year internal medicine residents.INTERVENTION: Residents interviewed, diagnosed, and initiated treatment of simulated patients using a paper chart or an EHR on a laptop computer. Video recordings of interviews were rated by three trained observers using the Four Habits scale.RESULTS: Thirty-two residents completed the study and had data available for review (61.5% of those enrolled in the residency program). In most skill areas in the Four Habits model, residents performed at least as well using the EHR and were statistically better in six of 23 skills areas (p<0.05). The overall average communication score was better when using an EHR: mean difference 0.254 (95% CI 0.05 to 0.45), p = 0.012, Cohen's d of 0.47 (a moderate effect). Residents scoring poorly (>3 average score) with paper methods (n = 8) had clinically important improvement when using the EHR.LIMITATIONS: This study was conducted in first-year residents in a training environment using simulated patients at a single institution.CONCLUSIONS: Use of an EHR on a laptop computer appears to improve the ability of first-year residents to communicate with patients relative to using a paper chart.

Resumo Limpo

ckground effect electron health record ehr doctorpati communic unclearobject evalu effect ehr use compar paper chart use novic physician communic skillsdesign withinsubject random control trial use observ structur clinic examin method assess impact use ehr communicationset larg academ intern medicin train programpopul firstyear intern medicin residentsintervent resid interview diagnos initi treatment simul patient use paper chart ehr laptop comput video record interview rate three train observ use four habit scaleresult thirtytwo resid complet studi data avail review enrol resid program skill area four habit model resid perform least well use ehr statist better six skill area p overal averag communic score better use ehr mean differ ci p cohen d moder effect resid score poor averag score paper method n clinic import improv use ehrlimit studi conduct firstyear resid train environ use simul patient singl institutionconclus use ehr laptop comput appear improv abil firstyear resid communic patient relat use paper chart

Resumos Similares

Int J Med Inform - Health information exchange in small-to-medium sized family medicine practices: motivators, barriers, and potential facilitators of adoption. ( 0,64994744087867 )
Inform Health Soc Care - Developing nurse educators' computer skills towards proficiency in nursing informatics. ( 0,640847520161485 )
Inform Health Soc Care - Adopting nursing health record standards. ( 0,633384787076728 )
Appl Clin Inform - Adoption of electronic health records: a qualitative study of academic and private physicians and health administrators. ( 0,630705588134908 )
J Am Med Inform Assoc - Organizational complements to electronic health records in ambulatory physician performance: the role of support staff. ( 0,629907187810584 )
BMC Med Inform Decis Mak - Analysis of the quality of hospital information systems Audit Trails. ( 0,622222313617315 )
J Am Med Inform Assoc - Measuring value for money: a scoping review on economic evaluation of health information systems. ( 0,612124925397071 )
J Am Med Inform Assoc - Using a medical simulation center as an electronic health record usability laboratory. ( 0,611502238782914 )
Int J Med Inform - Evaluation of a comprehensive EHR based on the DeLone and McLean model for IS success: approach, results, and success factors. ( 0,600579577709308 )
J Am Med Inform Assoc - Same organization, same electronic health records (EHRs) system, different use: exploring the linkage between practice member communication patterns and EHR use patterns in an ambulatory care setting. ( 0,598945322001991 )
Int J Med Inform - The IT productivity paradox in health: a stakeholder's perspective. ( 0,593929013194868 )
J Med Syst - Use and satisfaction with electronic health record by primary care physicians in a health district in Brazil. ( 0,592259723250738 )
J Biomed Inform - Computer-interpretable clinical guidelines: a methodological review. ( 0,59077051107244 )
Appl Clin Inform - CAH to CAH: EHR implementation advice to critical access hospitals from peer experts and other key informants. ( 0,589355476887656 )
J Med Syst - Challenges, alternatives, and paths to sustainability for health information exchange efforts. ( 0,588439721033458 )
Appl Clin Inform - Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site. ( 0,58644703163664 )
Inform Health Soc Care - Attitudes of health professionals towards electronic health records in primary health care settings: a questionnaire survey. ( 0,583109128320704 )
Appl Clin Inform - A pilot study on usability analysis of emergency department information system by nurses. ( 0,581936947695402 )
J Am Med Inform Assoc - Data standards to support health information exchange between poison control centers and emergency departments. ( 0,57985883800426 )
BMC Med Inform Decis Mak - Use and satisfaction with key functions of a common commercial electronic health record: a survey of primary care providers. ( 0,575351849545697 )
J Am Med Inform Assoc - A qualitative study identifying the cost categories associated with electronic health record implementation in the UK. ( 0,570168945165898 )
J Biomed Inform - Usability standards meet scenario-based design: challenges and opportunities. ( 0,567316757585652 )
J Am Med Inform Assoc - The marginal value of pre-visit paper reminders when added to a multifaceted electronic health record based quality improvement system. ( 0,565649066673601 )
J Am Med Inform Assoc - ICU nurses' acceptance of electronic health records. ( 0,56549902402713 )
Appl Clin Inform - Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes. ( 0,563408332774553 )
J Med Syst - Emergency healthcare process automation using mobile computing and cloud services. ( 0,560215831351182 )
J Am Med Inform Assoc - Portability of an algorithm to identify rheumatoid arthritis in electronic health records. ( 0,558178347053831 )
J Med Syst - Evaluation of the medical records system in an upcoming teaching hospital-a project for improvisation. ( 0,558100941240683 )
J Med Syst - EHR implementation in a new clinic: a case study of clinician perceptions. ( 0,557749171604887 )
Int J Med Inform - Adoption of a clinical decision support system to promote judicious use of antibiotics for acute respiratory infections in primary care. ( 0,55771697830324 )
BMC Med Inform Decis Mak - Stage 1 of the meaningful use incentive program for electronic health records: a study of readiness for change in ambulatory practice settings in one integrated delivery system. ( 0,557708363123198 )
Methods Inf Med - Why the hell do we need electronic health records?. EHR acceptance among physicians in private practice in Austria: a qualitative study. ( 0,552717843389486 )
J Am Med Inform Assoc - Transitioning between ambulatory EHRs: a study of practitioners' perspectives. ( 0,551466947276781 )
Int J Med Inform - Physicians' potential use and preferences related to health information exchange. ( 0,551403267733809 )
J Am Med Inform Assoc - A method for controlling complex confounding effects in the detection of adverse drug reactions using electronic health records. ( 0,550880584070666 )
J Biomed Inform - Implementations of the HL7 Context-Aware Knowledge Retrieval (Infobutton) Standard: challenges, strengths, limitations, and uptake. ( 0,54845005316917 )
Int J Med Inform - Contingency planning for electronic health record-based care continuity: a survey of recommended practices. ( 0,548318339526116 )
AMIA Annu Symp Proc - A mixed methods approach for measuring the impact of delivery-centric interventions on clinician workflow. ( 0,54730737471869 )
Int J Med Inform - Rates, levels, and determinants of electronic health record system adoption: a study of hospitals in Riyadh, Saudi Arabia. ( 0,545790450066856 )
Methods Inf Med - It's time for health record banking! ( 0,545662486268992 )
Healthc (Amst) - Use of patient ethnography to support quality improvement in benign prostatic hyperplasia. ( 0,545064281000448 )
J Med Syst - A review of analytics and clinical informatics in health care. ( 0,545017579289409 )
AMIA Annu Symp Proc - Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation. ( 0,544616312174493 )
Inform Health Soc Care - Nurses' use of an integrated electronic health record: results of a case site analysis. ( 0,544099669066208 )
Appl Clin Inform - Diffusion of Electronic Health Records and electronic communication in Norway. ( 0,542598348623986 )
BMC Med Inform Decis Mak - Methods to identify, study and understand end-user participation in HIT development. ( 0,542247392474121 )
J Am Med Inform Assoc - Evaluating and classifying the readiness of technology specifications for national standardization. ( 0,541535240962284 )
J Am Med Inform Assoc - Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research. ( 0,54131443178424 )
J Am Med Inform Assoc - You and me and the computer makes three: variations in exam room use of the electronic health record. ( 0,54049239226037 )
AMIA Annu Symp Proc - The EHR's roles in collaboration between providers: A qualitative study. ( 0,539425474298814 )
J Am Med Inform Assoc - Phased implementation of electronic health records through an office of clinical transformation. ( 0,538920001564989 )
Int J Med Inform - Adoption of electronic health records in Korean tertiary teaching and general hospitals. ( 0,538423411507789 )
Healthc (Amst) - Do family physicians electronic health records support meaningful use? ( 0,538208854477515 )
Appl Clin Inform - Electronic Health Record Adoption - Maybe It's not about the Money: Physician Super-Users, Electronic Health Records and Patient Care. ( 0,537387718240921 )
BMC Med Inform Decis Mak - A qualitative evaluation of general practitioners' views on protocol-driven eReferral in Scotland. ( 0,536550112431907 )
Perspect Health Inf Manag - Use of health information technology by office-based physicians: comparison of two contemporaneous public-use physician surveys. ( 0,535204748775182 )
Telemed J E Health - Teledentistry in practice: literature review. ( 0,53488474096627 )
Int J Med Inform - Unintended adverse consequences of introducing electronic health records in residential aged care homes. ( 0,534619300028215 )
Int J Med Inform - Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: an intervention study. ( 0,534578359648043 )
Appl Clin Inform - Predictors of success for electronic health record implementation in small physician practices. ( 0,531930910090116 )
Int J Med Inform - The benefits of introducing electronic health records in residential aged care facilities: a multiple case study. ( 0,531152006635127 )
J Med Syst - Factors associated with health information exchange system usage in a safety-net ambulatory care clinic setting. ( 0,529904475004447 )
J Am Med Inform Assoc - Assessing the process of designing and implementing electronic health records in a statewide public health system: the case of Colima, Mexico. ( 0,528139648216517 )
Telemed J E Health - Telephotography in trauma: a 2-year clinical experience. ( 0,527707968242505 )
Perspect Health Inf Manag - Lessons learned from implementation of voice recognition for documentation in the military electronic health record system. ( 0,527324753796543 )
Appl Clin Inform - Dealing with the archetypes development process for a regional EHR system. ( 0,527066660627791 )
J Biomed Inform - Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region. ( 0,525685696012574 )
J Am Med Inform Assoc - Method of electronic health record documentation and quality of primary care. ( 0,523547937870281 )
Inform Health Soc Care - Information practices of health care professionals related to patient discharge from hospital. ( 0,523141106304051 )
J Telemed Telecare - Mobile computing and the quality of home care nursing practice. ( 0,522069053423186 )
Perspect Health Inf Manag - Adding a genomic healthcare component to a health information management curriculum. ( 0,521938240622468 )
J Am Med Inform Assoc - Factors associated with difficult electronic health record implementation in office practice. ( 0,520617797886464 )
J Am Med Inform Assoc - Towards public health decision support: a systematic review of bidirectional communication approaches. ( 0,51964691802218 )
Int J Med Inform - The trends in EMR and CPOE adoption in Japan under the national strategy. ( 0,51960469306287 )
J Am Med Inform Assoc - Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use. ( 0,518406612817956 )
J Am Med Inform Assoc - Governance for clinical decision support: case studies and recommended practices from leading institutions. ( 0,518236770671646 )
Int J Med Inform - Does e-pain plan improve management of sickle cell disease associated vaso-occlusive pain crisis? a mixed methods evaluation. ( 0,51798131822367 )
AMIA Annu Symp Proc - Examining the Multi-level Fit between Work and Technology in a Secure Messaging Implementation. ( 0,51789933833036 )
BMC Med Inform Decis Mak - The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments. ( 0,517004564617233 )
Int J Med Inform - The interplay between global standards and local practice in nursing. ( 0,5164722556553 )
J Med Syst - Factors related to health information exchange participation and use. ( 0,515696534308833 )
BMC Med Inform Decis Mak - The effect of clinical experience, judgment task difficulty and time pressure on nurses' confidence calibration in a high fidelity clinical simulation. ( 0,514419209606186 )
AMIA Annu Symp Proc - Usage analysis of a shared care planning system. ( 0,513811112343848 )
J Am Med Inform Assoc - Consumer experience with and attitudes toward health information technology: a nationwide survey. ( 0,513751274143394 )
J. Med. Internet Res. - Health literacy and task environment influence parents' burden for data entry on child-specific health information: randomized controlled trial. ( 0,513679741846161 )
Appl Clin Inform - The impact of geography on hospital electronic health records implementation in alabama: implications for meaningful use. ( 0,513573538566782 )
Int J Med Inform - Collaboration in electronic medical evidence development: a case study of the Social Security Administration's MEGAHIT System. ( 0,513571938540849 )
J. Med. Internet Res. - Conducting research on the Internet: medical record data integration with patient-reported outcomes. ( 0,51238478014532 )
Perspect Health Inf Manag - The impact of electronic health record usage on cancer registry systems in Alabama. ( 0,512295577523902 )
Int J Med Inform - How physicians document outpatient visit notes in an electronic health record. ( 0,511873295678043 )
J Med Syst - Usability evaluation of paper-based Hajji Health Record format. ( 0,511587171487739 )
J Am Med Inform Assoc - Validity of electronic health record-derived quality measurement for performance monitoring. ( 0,511256333422262 )
Int J Med Inform - Use of a human factors approach to uncover informatics needs of nurses in documentation of care. ( 0,51090053984231 )
Appl Clin Inform - Lessons learned for collaborative clinical content development. ( 0,510443292579669 )
Health Info Libr J - EBLIP: bridging the language barrier. ( 0,510331627340649 )
J Am Med Inform Assoc - The use of open source electronic health records within the federal safety net. ( 0,510170152988568 )
Perspect Health Inf Manag - Workflow and electronic health records in small medical practices. ( 0,509946772869645 )
AMIA Annu Symp Proc - The Knowledge Program: an innovative, comprehensive electronic data capture system and warehouse. ( 0,509697321808572 )
Int J Med Inform - The impact of medical record technologies on collaboration in emergency medicine. ( 0,509346932940869 )
J Med Syst - Benefits and challenges of electronic health record system on stakeholders: a qualitative study of outpatient physicians. ( 0,508769569251707 )