Annals of Family Medicine: Emerging Research Documents Changing Landscape of Electronic Health Records in Primary Care

Five articles highlight expanding role of EHRs in primary care, impact on doctor-patient relationships.

ANN ARBOR, Mich., July 26, 2022 /PRNewswire/ -- In Use of the Electronic Health Record During Clinical Encounters: An Experience Survey, researchers conducted a survey to assess the impact of EHR practices on doctor-patient communication. Describing experiences with EHRs during clinical encounters, most clinicians reported less eye contact with patients (80%), listening less carefully (54%), and less focus (65%). Only one-third of clinicians thought patients saw EHR use as a positive experience. 

However, most patients surveyed (91.7%) reported positive experiences with EHR use. Patients reported clinicians provided sufficient eye contact (96.8%), listening (97.0%), and clinician focus (86.7%). The authors argue this gap in experiences indicates clinician stress and burnout with patient data documentation and the need to address clinicians' user experience of EHR.

In Communication Gaps Persist Between Primary Care and Specialist Physicians, researchers studied the impact of the Comprehensive Primary Care Plus (CPC+) model, which leverages EHRs to increase information sharing between primary care physicians and specialists about referred patients.

The authors found gaps in communication between primary care physicians and specialists have persisted over the last decade. They argue that although EHR technology was developed to improve care coordination, physicians do not always intentionally engage in communication on referrals and consultations. This communication gap can impact patients negatively, increasing the likelihood of delayed diagnoses, unnecessary testing, and patient and physician dissatisfaction.

However, opportunities to improve patient outcomes through EHRs do exist. In Impact of Home Blood Pressure Data Visualization on Hypertension Medical Decision Making in Primary Care, new research explores how clinicians might incorporate at-home blood pressure readings into a patient's EHR to help control hypertension.

The researchers developed and implemented a visualization tool that combines clinical and home blood pressure readings, and displays aggregated data in a single chart within each patient's EHR. Through analyzing doctor-patient interactions, researchers found that the visualization tool promoted shared decision-making in hypertension management in the primary care setting.

The article Designing and Implementing an Electronic Health Record–Embedded Card Study in Primary Care: Methods and Considerations describes how EHRs can help streamline data collection in the clinic. The authors report on the development and implementation of EHR-embedded digital surveys to replace paper-based surveys at community health centers. The research team developed a digital alternative to paper studies to reduce complexity and costs for users, and to facilitate rich analyses by linking participant responses to clinic and patient data.

In an accompanying editorial, Uplifting Primary Care Through the Electronic Health Record, Anthony Sunjaya notes that health care is rapidly becoming digital, helping to increase patient engagement in their own care, and improve primary care research. "However, we need to be able to measure these benefits through fit-for-purpose metrics in order to motivate practices to adopt them," he writes. Best practice goals for these metrics can then be developed and their integration linked to reimbursement, as well as other rewards for the benefit of clinicians, patients, and health systems.

Use of the Electronic Health Record During Clinical Encounters: An Experience Survey
Ellen C. Meltzer et al.

Communication Gaps Persist Between Primary Care and Specialist Physicians
Lori Timmins et al.

Impact of Home Blood Pressure Data Visualization on Hypertension Medical Decision Making in Primary Care
Deborah J. Cohen et al.

Designing and Implementing an Electronic Health Record–Embedded Card Study in Primary Care: Methods and Considerations
Arwen Bunce et al.

Uplifting Primary Care Through the Electronic Health Record
Anthony Paulo Sunjaya

SOURCE Annals of Family Medicine