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In a small study, patients treated for chronic conditions at safety-net clinics reported lower satisfaction with their care when it involved “high computer use” by clinicians.
Patients were significantly less likely to rate their care as “excellent” if clinicians spent a great deal of time on the computer during visits—silently reviewing data or typing and failing to make consistent eye contact.
Neda Ratanawongsa, MD, of the University of California, San Francisco, and her colleagues conducted this research and described the results in a letter to JAMA Internal Medicine.
The researchers noted that safety-net clinics serve populations with limited health literacy and limited proficiency in English who may experience communication barriers that can contribute to disparities in care and health.
So the team wanted to assess clinician computer use and communication with patients treated for chronic disease in safety-net clinics. The study was conducted over 2 years at an academically affiliated public hospital with a basic electronic health record.
The study included 47 patients who spoke English or Spanish and received primary and subspecialty care. The researchers recorded 71 encounters among 47 patients and 39 clinicians.
Clinician computer use was quantified by the amount of computer data reviewed, typing or clicking the computer mouse, eye contact with patients, and noninteractive pauses.
Compared with patients in clinical encounters with low computer use, patients who had encounters with high computer use were less likely to rate their care as excellent—48% vs 83% (P=0.04).
And clinicians in encounters with high computer use were significantly more likely to engage in more negative rapport building (P<0.01).
The researchers said this study revealed “observable communication differences” according to clinicians’ computer use. They noted that social rapport building can increase patient satisfaction, but concurrent computer use may inhibit authentic engagement. 
Photo courtesy of NIH
In a small study, patients treated for chronic conditions at safety-net clinics reported lower satisfaction with their care when it involved “high computer use” by clinicians.
Patients were significantly less likely to rate their care as “excellent” if clinicians spent a great deal of time on the computer during visits—silently reviewing data or typing and failing to make consistent eye contact.
Neda Ratanawongsa, MD, of the University of California, San Francisco, and her colleagues conducted this research and described the results in a letter to JAMA Internal Medicine.
The researchers noted that safety-net clinics serve populations with limited health literacy and limited proficiency in English who may experience communication barriers that can contribute to disparities in care and health.
So the team wanted to assess clinician computer use and communication with patients treated for chronic disease in safety-net clinics. The study was conducted over 2 years at an academically affiliated public hospital with a basic electronic health record.
The study included 47 patients who spoke English or Spanish and received primary and subspecialty care. The researchers recorded 71 encounters among 47 patients and 39 clinicians.
Clinician computer use was quantified by the amount of computer data reviewed, typing or clicking the computer mouse, eye contact with patients, and noninteractive pauses.
Compared with patients in clinical encounters with low computer use, patients who had encounters with high computer use were less likely to rate their care as excellent—48% vs 83% (P=0.04).
And clinicians in encounters with high computer use were significantly more likely to engage in more negative rapport building (P<0.01).
The researchers said this study revealed “observable communication differences” according to clinicians’ computer use. They noted that social rapport building can increase patient satisfaction, but concurrent computer use may inhibit authentic engagement.
Photo courtesy of NIH
In a small study, patients treated for chronic conditions at safety-net clinics reported lower satisfaction with their care when it involved “high computer use” by clinicians.
Patients were significantly less likely to rate their care as “excellent” if clinicians spent a great deal of time on the computer during visits—silently reviewing data or typing and failing to make consistent eye contact.
Neda Ratanawongsa, MD, of the University of California, San Francisco, and her colleagues conducted this research and described the results in a letter to JAMA Internal Medicine.
The researchers noted that safety-net clinics serve populations with limited health literacy and limited proficiency in English who may experience communication barriers that can contribute to disparities in care and health.
So the team wanted to assess clinician computer use and communication with patients treated for chronic disease in safety-net clinics. The study was conducted over 2 years at an academically affiliated public hospital with a basic electronic health record.
The study included 47 patients who spoke English or Spanish and received primary and subspecialty care. The researchers recorded 71 encounters among 47 patients and 39 clinicians.
Clinician computer use was quantified by the amount of computer data reviewed, typing or clicking the computer mouse, eye contact with patients, and noninteractive pauses.
Compared with patients in clinical encounters with low computer use, patients who had encounters with high computer use were less likely to rate their care as excellent—48% vs 83% (P=0.04).
And clinicians in encounters with high computer use were significantly more likely to engage in more negative rapport building (P<0.01).
The researchers said this study revealed “observable communication differences” according to clinicians’ computer use. They noted that social rapport building can increase patient satisfaction, but concurrent computer use may inhibit authentic engagement.