Technology-mediated information sharing between patients and clinicians in primary care encounters

Objective: The aim of this study was to identify and describe the use of electronic health records (EHRs) for information sharing between patients and clinicians in primary-care encounters. This topic is particularly important as computers and other technologies are increasingly implemented in multi-user health-care settings where interactions and communication between patients and clinicians are integral to interpersonal and organisational outcomes. Method: An ethnographic approach was used to classify the encounters into distinct technology-use patterns based on clinicians' interactions with the technology and patients. Each technology-use pattern was quantitatively analysed to assist with comparison. Quantitative analysis was based on duration of patient and clinician gaze at EHR. Findings: Physicians employed three different styles to share information using EHRs: (1) active information sharing, in which a clinician turns the monitor towards the patient and uses the computer to actively share information with the patient; (2) passive information sharing, when a clinician does not move the monitor, but the patient might see the monitor by leaning in if they choose and (3) technology withdrawal, when a clinician does not share the monitor with the patient. Conclusion: A variety of technology-mediated information-sharing styles may be effective in providing patient-centred care. New EHR designs may be needed to facilitate information sharing between patients and clinicians.