- A safety-net clinic pilot demonstrated the benefits of patient-provider collaboration in EHR technology to patient-provider communication in the exam room.
A new study found patient-entered electronic visit agendas between patients and providers improve patient-clinician communication.
Conducted by Anderson et al., the study found 79 percent of patients and 74 percent of clinicians agreed electronic visit notes in EHR technology enhanced patient care by promoting patient engagement and allowing for clear communication between patients and providers regarding health concerns.
“Patients attending a safety-net primary care clinic were interested and able to type their agenda into the EMR visit note,” wrote researchers. “Patients and clinicians felt this improved communication and both expressed interest in patient-written agendas in the future.”
While the benefits of EHR technology are many, patients and providers alike have voiced concern that the technology could discourage face-to-face interactions during visits, which is necessary for establishing a strong patient-provider relationship.
“Interacting with EMRs during patient interviews has eroded clinicians’ ability to connect with patients and led to clinician dissatisfaction with clinical practice, particularly in primary care,” Anderson et al. observed.
Despite the unfavorable reputation EHR systems have earned for negatively impacting patient-provider communication, learning to use EHR technology in new ways could be the key to solving this persistent problem in the form of allowing patients to enter their own information into clinic notes.
“Collaborative agenda setting is a communication skill that helps patients identify concerns early in the clinic visit, possibly diminishing the number of ‘Oh, by the way’ items at the end of visits,” explained researchers.
While potentially beneficial, setting a patient agenda prior to healthcare visits proved to be too time-consuming in the past to implement. However, EHR technology now grant patients a unique opportunity to quickly and easily share notes with providers through entering information into the clinic notes section of their records.
“This pilot study suggests a possible way for the EMR to offset the time and computer barriers to communication,” researchers noted. “By allowing patients to set agendas before appointments, patients and clinicians can optimize their time together.”
Through a study of a 67-clinician primary care clinic serving 5,000 patients annually between June 9 and July 22, 2015, researchers surveyed 101 patient participants on their experience typing agendas into their EHR visit notes prior to a physician visit.
The experience for patients and clinicians participating in the study was overwhelmingly positive, paving the way for similar studies to explore the value of preemptively outlining agendas in EHR systems to guide patient visits and promote clear communication.
Considering EHR technology has emerged as a frequently cited obstacle in recent years to open discussions between providers and their patients, research supporting utilizing the technology as a means of improving communication could mark a shift in how the healthcare industry views EHRs.
“In our current study, patients accepted the opportunity to directly contribute to their visit notes by typing their visit agendas,” concluded researchers. “Future studies could evaluate the relationships between agenda setting and other contributions to notes, and patient engagement.”
With no shortage of health IT vendors and innovators pouring time and resources into developing application programming interfaces (APIs) and new technologies to optimize EHR systems and health data exchange, apps specifically designed to promote clear communication between providers and patients could be on the way.
“The patient cogeneration of visit notes, facilitated by new EMR functionality, reflects a shift in the authorship and “ownership” of visit notes,” stated researchers. “Patient written visit agendas could increase the collaborative nature of the clinical encounter between patient and clinician, but require further study, including measurement of patient engagement and health outcomes.”