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Whose System is it Anyway? How Clients and Providers Evaluate the Impact of Session EHR Use on Communication in Mental Health Treatment

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Abstract

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.

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References

  • Ajami, S., & Bagheri-Tadi, T. (2013). Barriers for adopting electronic health records (EHRs) by physicians. Acta Informatica Medica,21(2), 129–134.

    Article  Google Scholar 

  • 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.

    Chapter  Google 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.

    Article  Google Scholar 

  • Blumenthal, D. (2010). Launching HITECH. New England Journal of Medicine,362(5), 382–385.

    Article  CAS  Google Scholar 

  • Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: Care of the patient requires care of the provider. Annals of Family Medicine,12(6), 573–576.

    Article  Google Scholar 

  • Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011). The benefits of health information technology: A review of the recent literature shows predominantly positive results. Health Affairs,30(3), 464–471.

    Article  Google Scholar 

  • Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., et al. (2016). The impact of electronic health records on healthcare quality: A systematic review and meta-analysis. European Journal of Public Health,26(1), 60–64.

    Article  Google 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.

    Article  Google Scholar 

  • Cromer, R., Denneson, L. M., Pisciotta, M., Williams, H., Woods, S., & Dobscha, S. K. (2017). Trust in mental health clinicians among patients who access clinical notes online. Psychiatric Services,68(5), 520–523.

    Article  Google 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.

    Article  Google Scholar 

  • Denneson, L. M., Pisciotta, M., Hooker, E. R., Trevino, A., & Dobscha, S. K. (2019). Impacts of a web-based educational program for veterans who read their mental health notes online. Journal of the American Medical Informics Association,26(1), 3–8.

    Article  Google Scholar 

  • Dowell, A., Stubbe, M., Scott-Dowell, K., Macdonald, L., & Dew, K. (2013). Talking with the alien: Interaction with computers in the GP consultation. Australian Journal Primary Health,19(4), 275–282.

    Article  Google Scholar 

  • Finney Rutten, L. J., Vieux, S. N., St Sauver, J. L., Arora, N. K., Moser, R. P., Beckjord, E. B., et al. (2014). Patient perceptions of electronic medical records use and ratings of care quality. Patient Related Outcome Measures,5, 17–23.

    Article  Google 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).

  • 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.

  • Gold, M. R., McLaughlin, C. G., Devers, K. J., Berenson, R. A., & Bovbjerg, R. R. (2012). Obtaining providers’ ‘buy-in’ and establishing effective means of information exchange will be critical to HITECH’s success. Health Affairs,31(3), 514–526.

    Article  Google Scholar 

  • Heath, S. (2016). Outpatient EHR adoption reaches 92%, nears market saturation. Electronic Health Record (EHR/EMR) News. Retrieved from http://www.ehrintelligence.com.

  • Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology,38(2), 139–149.

    Article  Google Scholar 

  • 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.

  • Klein, J. W., Peacock, S., Tsui, J. I., O’Neill, S. F., DesRoches, C. M., & Elmore, J. G. (2018). Perceptions of primary care notes by patients with mental health diagnoses. Annals of Family Medicine,16(4), 343–345.

    Article  Google Scholar 

  • Kobus, A. M., Harman, J. S., Do, H. D., & Garvin, R. D. (2013). Challenges to depression care documentation in an EHR. Family Medicine,45(4), 268–271.

    PubMed  Google Scholar 

  • Legler, A., Price, M., Parikh, M., Nebeker, J. R., Ward, M. C., Wedemeyer, L., et al. (2019). Effect on VA patient satisfaction of provider’s use of an integrated viewer of multiple electronic health records. Journal of General Internal Medicine,1, 132–136.

    Article  Google Scholar 

  • Levinson, W., Kao, A., Kuby, A., & Thisted, R. A. (2005). Not all patients want to participate in decision-making: A national study of public preferences. Journal of General Internal Medicine,20(6), 531–535.

    Article  Google Scholar 

  • 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).

  • Liu, J., Luo, L., Zhang, R., & Huang, T. (2013). Patient satisfaction with electronic medical/health record: A systematic review. Scandanavian Journal Caring Sciences,27(4), 785–791.

    Article  Google Scholar 

  • Lu, W., Deen, D., Rothstein, D., Santana, L., & Gold, M. R. (2011). Activating community health center patients in developing question-formulation skills. A qualitative study. Health Educaton & Behavior,38(6), 637–645.

    Article  Google Scholar 

  • Margalit, R. S., Roter, D., Dunevant, M. A., Larson, S., & Reis, S. (2006). Electronic medical record use and physician-patient communication: An observational study of Israeli primary care encounters. Patient Education and Counseling,61(1), 134–141.

    Article  Google Scholar 

  • Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal Consuling andt Clinical Psychology,68(3), 438–450.

    Article  CAS  Google Scholar 

  • Matthews, E. B. (2017). Integrating the electronic health record into behavioral health encounters: Strategies, barriers, and implications for practice. Administration and Policy in Mental Health and Mental Health Services Research,44(4), 512–523.

    Article  Google Scholar 

  • Mishna, F., Bogo, M., Root, J., Sawyer, J.-L., & Khoury-Kassabri, M. (2012). ‘It just crept in’: The digital age and implications for social work practice. Clinical Social Work Journal,40(3), 277–286.

    Article  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.

    Article  Google Scholar 

  • Patel, M. R., Vichich, J., Lang, I., Lin, J., & Zheng, K. (2017). Developing an evidence base of best practices for integrating computerized systems into the exam room: A systematic review. Journal of The American Medical Informatics Association: JAMIA,24(e1), e207–e215.

    PubMed  Google Scholar 

  • Powell, K. R. (2017). Patient-perceived facilitators of and barriers to electronic portal use: A systematic review. CIN: Computers, Informatics, Nursing,35(11), 565–573.

    PubMed  Google Scholar 

  • Rief, J. J., Hamm, M. E., Zickmund, S. L., Nikolajski, C., Lesky, D., Hess, R., et al. (2017). Using health information technology to foster engagement: Patients’ experiences with an active patient health record. Health Communication,32(3), 310–319.

    Article  Google Scholar 

  • Salyers, M. P., Fukui, A. L., Rollins, A. L., Firmin, R., Gearhart, T., Noll, J. P., et al. (2015). Burnout and self-reported wuality of care in community mental health. Administration and Policy in Mental Health and Mental Health Services Research,42(1), 61–69.

    Article  Google Scholar 

  • Ser, G., Robertson, A., & Sheikh, A. (2014). A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals. PLoS ONE,9(1), e77669.

    Article  Google 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.

    Article  Google 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.

    Article  Google Scholar 

  • Shank, N., Willborn, E., PytlikZillig, L., & Noel, H. (2012). Electronic health records: Eliciting behavioral health providers’ beliefs. Community Mental Health Journal,48(2), 249–254.

    Article  Google Scholar 

  • Stewart, R. F., Kroth, P. J., Schuyler, M., & Bailey, R. (2010). Do electronic health records affect the patient-psychiatrist relationship? A before & after study of psychiatric outpatients. BMC Psychiatry,10, 1–9.

    Article  Google Scholar 

  • Tryon, G. S., Blackwell, S. C., & Hammel, E. F. (2007). A meta-analytic examination of client-therapist perspectives of the working alliance. Psychotherapy Research,17(6), 629–642.

    Article  Google Scholar 

  • Whittington, J. W., Nolan, K., Lewis, N., & Torres, T. (2015). Pursuing the triple aim: The first 7 years. The Milbank Quarterly,93(2), 263–300.

    Article  Google Scholar 

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  1. Graduate School of Social Service, Fordham University, 113 W. 60th St, New York, NY, 10023, USA

    Elizabeth B. Matthews

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Matthews, E.B. Whose System is it Anyway? How Clients and Providers Evaluate the Impact of Session EHR Use on Communication in Mental Health Treatment. Community Ment Health J 56, 540–548 (2020). https://doi.org/10.1007/s10597-019-00511-8

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