Whose System is it Anyway? How Clients and Providers Evaluate the Impact of Session EHR Use on Communication in Mental Health Treatment
- 10 Downloads
Electronic health records are common in mental health settings. While providers often express concern that in-session computing will damage client-provider communication, some work suggests that clients do not share this worry. As the majority of this research has been conducted in medical settings, less is known about how clients evaluate in session computing in mental health treatment, and whether this pattern of discordance persists in this setting. This study describes and compares the perceived impact of in-session computing on communication in mental health treatment from the clients and provider perspective, and examined sources of variation in client ratings. Thirteen providers and 53 clients participated in this study, representing 53 unique client-provider dyads. Results suggest that providers perceived in-session computing as more harmful to communication than clients. Client ratings varied by race, age and visit type but were not influenced by how often the computer was used during session.
KeywordsElectronic health records Mental health services Client satisfaction Communication
Compliance with Ethical Standards
Conflict of interest
This author has nothing to disclose.
- Alkureishi, M. L., Lee, W. W., & Frankel, R. M. (2017). Patient-centered technology use: Best practices and curricular strategies. In A. Shachak, E. M. Borycki, & S. P. Reis (Eds.), Health professionals’ education in the age of clinical information systems, mobile computing and social networks (pp. 201–232). Cambridge, MA: Academic Press.CrossRefGoogle Scholar
- Ancker, J. S., Kern, L. M., Edwards, A., Nosal, S., Stein, D. M., Hauser, D., et al. (2014). How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use. Journal of the American Medical Informatics Association,21(6), 1001–1008.PubMedPubMedCentralCrossRefGoogle Scholar
- Cifuentes, M., Davis, M., Fernald, D., Gunn, R., Dickinson, P., & Cohen, D. J. (2015). Electronic health record challenges, workarounds, and solutions observed in practices integrating behavioral health and primary care. Journal of the American Board of Family Medicine: JABFM,28, S63–S72.PubMedCrossRefGoogle Scholar
- Denneson, L. M., Cromer, R., Williams, H. B., Pisciotta, M., & Dobscha, S. K. (2017). A qualitative analysis of how online access to mental health notes is changing clinician perceptions of power and the therapeutic relationship. Journal of Medical Internet Research,19(6), e208–219.PubMedPubMedCentralCrossRefGoogle Scholar
- Friedberg, M. W., Chen, P. G., Van Busum, K. R., Aunon, F., Pham, C., Caloyeras, J. et al. (2014). Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy. Retrieved from http://www.rand.org/content/dam/rand/pubs/research_reports/ RR400/RR439/RAND_RR439.pdf.
- Gadd, C. S., & Penrod, L. E. (2000). Dichotomy between physicians’ and patients’ attitudes regarding EMR use during outpatient encounters. Proceedings from AMIA symposium (pp. 275–279).Google Scholar
- Gawande, A. (2018). Why doctor’s hate their computers. The New Yorker, November 18, 2018. Retrieved from https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers.
- Heath, S. (2016). Outpatient EHR adoption reaches 92%, nears market saturation. Electronic Health Record (EHR/EMR) News. Retrieved from http://www.ehrintelligence.com.
- Jha, A. K., Illif, A. R., Chaoui, A. A., Defossez, S., Bombaugh, M. C., & Miller, Y. R. (2019). A crisis in health care: A call to action on physician burn out. Retrieved from http://www.massmed.org/News-and-Publications/MMS-News-Releases/Physician-Burnout-Report-2018.
- Linder, J. A., Schnipper, J. L., Tsurikova, R., Melnikas, A. J., Volk, L. A., & Middleton, B. (2006). Barriers to electronic health record use during patient visits. AMIA annual symposium proceedings (pp. 499–503).Google Scholar
- National Council for Community Behavioral Healthcare. (2012). HIT adoption and readiness for meaningful use in community behavioral health: Report on the 2012 National Council Survey. Washington, DC: National Council for Community Behavioral Healthcare. Retrieved from https://www.thenationalcouncil.org/wp-content/uploads/2012/10/HIT-Survey-Full-Report.pdf.
- Panagioti, M., Geraghty, K., Johnson, J., Zhou, A., Panagopoulou, E., Chew-Graham, C., et al. (2018). Association between physician burnout and patient safety, professionalism, and patient satisfaction: A systematic review and meta-analysis. JAMA Internal Medicine,178(10), 1317–1330.PubMedPubMedCentralCrossRefGoogle Scholar
- Shachak, A., Reis, S., Drake, R. E., Deegan, P. E., O’Brien, A., Fahmy, R., et al. (2009). The impact of electronic medical records on patient-doctor communication during consultation: A narrative literature review. Journal of Evaluation in Clinical Practice,15(4), 641–649.PubMedCrossRefGoogle Scholar
- Shanafelt, T. D., Dyrbye, L. N., Sinsky, C., Hasan, O., Satele, D., Sloan, J., et al. (2016). Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clinic Proceedings,91(7), 836–848.PubMedCrossRefGoogle Scholar