Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Mar-Apr;4(2):124-31.
doi: 10.1370/afm.425.

Physicians, patients, and the electronic health record: an ethnographic analysis

William Ventres  1 , Sarah Kooienga, Nancy Vuckovic, Ryan Marlin, Peggy Nygren, Valerie Stewart
Affiliations

Physicians, patients, and the electronic health record: an ethnographic analysis

William Ventres et al. Ann Fam Med. 2006 Mar-Apr.

Abstract

Purpose: Little is known about the effects of the electronic health record (EHR) on physician-patient encounters. The objectives of this study were to identify the factors that influence the manner by which physicians use the EHR with patients.

Methods: This ethnographic study included 4 qualitative components: 80 hours of participant observation in 4 primary care offices in the Pacific Northwest; individual interviews with 52 patients, 12 office staff members, 23 physicians, and 1 nurse-practitioner; videotaped reviews of 29 clinical encounters; and 5 focus-group interviews with physicians and computer advocates. The main outcome measures were factors that influence how physicians use the EHR. Researchers qualitatively derived these factors through serial reviews of data.

Results: This study identified 14 factors that influence how EHRs are used and perceived in medical practice today. These factors were categorized into 4 thematic domains: (1) spatial--effect of the physical presence and location of EHRs on interactions between physicians and patients; (2) relational--perceptions of physicians and patients about the EHR and how those perceptions affected its use; (3) educational--issues of developing physicians' proficiency with and improving patients' understandings about EHR use; and (4) structural--institutional and technological forces that influence how physicians perceived their use of EHR.

Conclusions: This study found that the introduction of EHRs into practice influences multiple cognitive and social dimensions of the clinical encounter. It brings into focus important questions that through further inquiry can determine how to make best use of the EHR to enhance therapeutic relationships.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Themes and factors influencing electronic health record (EHR) use and physician-patient encounters.
See this image and copyright information in PMC

References

    1. Bodenheimer T, Grumbach K. Electronic technology: a spark to revitalize primary care? JAMA. 2003;290:259–264. - PubMed
    1. Martin JC, Avant RF, Bowman MA, et al. The future of family medicine: a collaborative project of the family medicine community. Ann Fam Med. 2004;2 Suppl 1:S3–32. - PMC - PubMed
    1. Institute of Medicine. The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press; 2002.
    1. Frist WH. Shattuck Lecture: health care in the 21st century. N Engl J Med. 2005;352:267–272. - PubMed
    1. Hersh WR. Medical informatics: improving health care through information. JAMA. 2002;288:1955–1958. - PubMed

Publication types