PATIENTS REACTIONS TO PHYSICIAN USE OF A COMPUTERIZED MEDICAL RECORD SYSTEM DURING CLINICAL ENCOUNTERS

Background. As physicians begin to use computer technology in front of patients during clinical encounters, concern has been raised that suc h computer use may exert a dehumanizing effect on the physician-patien t relationship. To investigate this concern, we measured patient react ions to physician use of a computerized medical record system during c linical encounters. Methods. Adult patients who presented for clinical care were randomized into three groups. With the first group, the phy sician used a standard paper-and-pencil charting system during the enc ounter. With the second group, the physician used a computerized medic al record system with keyboard input. With the third group, the physic ian used the computerized medical record system with voice input. Pati ent reactions were measured with a questionnaire that the patients com pleted after the clinical encounter. Results. For most components of t he physician-patient relationship studied in this report, questionnair e scores did not differ significantly among the three study groups. Pa tients in the voice input group rated physician explanations of patien t problems significantly higher than patients in the other two groups. There was a trend for patient confidence in the physician to be highe r in the keyboard input group. Although measured encounter durations w ere significantly shorter in the computer groups, there were no differ ences in patient satisfaction with encounter duration among the three groups. Conclusions. Physician use of computers during clinical encoun ters was not associated with a decline in the perceived quality of the physician-patient relationship.