Patients Unhappy With Computer Use During Clinical Encounters

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Compared with patients who had clinical encounters involving low computer use, those who experienced high computer use by their physicians were less likely to rate their care as excellent, a study reports.

Safety-net clinics are geared to serve low-income populations. A significantly high proportion of patients who use these services have limited health literacy and limited proficiency in English, which can lead to communication gaps. Now, a study published in JAMA Internal Medicine has found that use of computers by doctors at these clinics reduces patient satisfaction with their care.

The authors of the study evaluated 47 patients of either gender, with a mean age of about 56 years, at an academically-affiliated public hospital. A majority (57%) of the patients were Hispanic, and 55% reported Spanish as their primary language. Less than 50% of patients had some level of college or equivalent education. Over 90% surveyed earned less than $20,000 annually. Of the 39 participating physicians, nearly 64% were women. With an average age of 43 years, about 41% of physicians spoke to their patients in Spanish. Specialties included were type 2 diabetes, cardiology, and rheumatology.

The physicians were graded on the following, with respect to computer use: amount of review of computer data, typing or clicking the computer mouse, eye contact with patients, and noninteractive pauses. Patient encounters with their physicians were filmed and patients scored their encounter after visits over a 6-month period. Overall, compared with patients who had clinical encounters involving low computer use, those who experienced high computer use by their physicians were less likely to rate their care as excellent. While 83% of patients experiencing low computer use rated their care as excellent, only 48% did so in the second category.

Based on their study, the authors concluded, “High computer use by clinicians in safety-net clinics was associated with lower patient satisfaction and observable communication differences. Although social rapport building can build trust and satisfaction, concurrent computer use may inhibit authentic engagement, and multitasking clinicians may miss openings for deeper connection with their patients.”