. 2016 Jan 14;23(3):654–665. doi: 10.1093/jamia/ocv178

Table 3:

Clinician Styles of Interacting with HIT and the patient

Study	Classification basis	Styles identified	Style characteristics
Pearce et al.⁶⁵	Lower body orientation	Unipolar	Maintains fixed lower body orientation toward the computer; often asks questions driven by the computer; enters data during the consultation; lower and upper body orientation often in different directions (eg, turning gaze toward the patient while maintaining lower body orientation toward the screen).
Pearce et al.⁶⁵	Lower body orientation	Bipolar	Alternates lower body orientation between the patient and the computer; indicates switching attention between the two by changing body orientation.
Montague and Asan³⁵	Amount of typing	Technology-centered	Extensive typing (>15% of visit time); types continuously throughout the patient-clinician encounter; spends the largest amount of time looking at the computer screen; often talks to the patient while typing and uses affirmative speech and nodding to indicate that the patient has their attention while they are working on the computer.
		Optimizing	Intermediate amount of typing (5-15% of visit time); employs brief typing periods in which they focus on the computer; stops typing and shifts gaze to the patient when speaking with the patient; maintains posture that allows for facing the patient most of the time.
		Human-centered	Least amount of typing (<5% of the visit time) and screen gaze time; characterized by slow “hunt and peck” typing style; often uses aids such as paper or dictation for data entry; “higher amounts of positive verbal and nonverbal communication style.”
Asan and Montague⁵¹	Screen sharing	Active information-sharing	Inclusive office set-up (see ‘Physical Setting’ above); turns the screen toward the patient; verbally invites patients to look at the monitor; uses the computer to explain results and retrieve and share information with the patient; high percentage of conjugate gaze at the computer (see “Patient Styles” section, below).
		Passive information-sharing	Semi-inclusive, patient-controlled setting; high amount of clinician typing and looking at the computer; shifts gaze back and forth between the computer and patient; patients tend to look at the computer while clinicians enter data.
		Technology withdrawal	No screen sharing; minimal computer use, with clinician typing mostly toward the end of the visit; clinicians mostly focus on the patient, with brief gazes at the computer.
Chan et al.⁶⁷	Observation (criteria for classification are not specified)	Continuous users	Consistent use of the computer throughout the encounter for reviewing and entering data; often engages patients with the computer.
		Minimal users	Minimal use of the computer during the patient visit (mostly for printing prescriptions).
		End users	Leaves most of the computer usage for the end of the patient visit; types in notes before prescribing.
Rhodes et al.⁶⁶	Screen gaze	Bureaucratic	Body orientation is toward computer, and the focus of attention is mostly on the screen; uses changes in gaze to indicate the relative importance of topics to the patient.
Rhodes et al.⁶⁶	Screen gaze	Participative/patient-centered	Body orientation is mostly toward the patient; maintains eye contact most of the time; shifts in attention are indicated by changing lower body orientation.