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NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2016 Apr 28.
Published in final edited form as: JAMA. 2013 Nov 6;310(17):1858. doi: 10.1001/jama.2013.277990

Patient-Physician Interactions and Electronic Health Records

Amina A White 1, Marion Danis 1
PMCID: PMC4849530  NIHMSID: NIHMS772583  PMID: 24193089

In Reply

Mr Yang and Ms Kim thoughtfully suggest some complementary tools for patient activation, emphasize the importance of user-friendly EHR design, and underscore the need for medical education that prepares trainees to incorporate computers and other forms of technology into the clinical encounter.

Dr Shachak and colleagues offer further strategies for effective EHR use in the examination room. We agree that these additional elements are useful to consider, especially as the EHR becomes increasingly prominent in the patient-physician interaction.

Shachak and colleagues highlight the need to maintain patient-centeredness when interacting with patients who may wish to avoid computer screen viewing; we agree that this is an important issue for further consideration. A patient’s reluctance to engage in screen viewing during the encounter could stem from a number of distinct or overlapping factors, including a general lack of familiarity with computer technology, apprehension about viewing his or her own health trends, a desire to focus solely on building a face-to-face rapport with the clinician, a perception that monitor viewing is somewhat distracting, or other relevant concerns.

In some cases, particularly when patients hesitate to gaze at the screen due to limited computer skills, there may be opportunities over the course of the patient-physician relationship to slowly demystify aspects of the technology that may have prevented them from accessing helpful information in the past. On the other hand, even patients with adequate computer navigation skills may prefer to limit computer-related activities during the clinical encounter.

Our optimism about the utility of the EHR for enhancing collaboration in the examination room presupposes that clinicians offer the invitation but respect patient preferences when that invitation is declined. We propose that this invitation to engage in EHR collaboration, if offered in an appealing and nonjudgmental way, is a means of emphasizing the patient-centeredness of the clinical encounter.

Footnotes

Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Disclaimer: This letter reflects the views of the authors and not necessarily the policies of the National Institutes of Health or the US Department of Health and Human Services.

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