Does Sharing the Electronic Health Record in the Consultation Enhance Patient Involvement? A Mixed-methods Study Using Multichannel Video Recording and In-depth Interviews in Primary Care

Overview

Journal Health Expect

Publisher Wiley

Specialty Public Health

Date 2014 Dec 20

PMID 25523361

Citations 8

Authors

Heather Milne

Guro Huby

Susan Buckingham

James Hayward

Aziz Sheikh

Kathrin Cresswell

Hilary Pinnock

Affiliations

Soon will be listed here.

Abstract

Background: Sharing the electronic health-care record (EHR) during consultations has the potential to facilitate patient involvement in their health care, but research about this practice is limited.

Methods: We used multichannel video recordings to identify examples and examine the practice of screen-sharing within 114 primary care consultations. A subset of 16 consultations was viewed by the general practitioner and/or patient in 26 reflexive interviews. Screen-sharing emerged as a significant theme and was explored further in seven additional patient interviews. Final analysis involved refining themes from interviews and observation of videos to understand how screen-sharing occurred, and its significance to patients and professionals.

Results: Eighteen (16%) of 114 videoed consultations involved instances of screen-sharing. Screen-sharing occurred in six of the subset of 16 consultations with interviews and was a significant theme in 19 of 26 interviews. The screen was shared in three ways: 'convincing' the patient of a diagnosis or treatment; 'translating' between medical and lay understandings of disease/medication; and by patients 'verifying' the accuracy of the EHR. However, patients and most GPs perceived the screen as the doctor's domain, not to be routinely viewed by the patient.

Conclusions: Screen-sharing can facilitate patient involvement in the consultation, depending on the way in which sharing comes about, but the perception that the record belongs to the doctor is a barrier. To exploit the potential of sharing the screen to promote patient involvement, there is a need to reconceptualise and redesign the EHR.

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