the international council on medical & care compunetics


December, 2014

physician patient relationship

Giving Patients Granular Control of Personal Health Information: Using an Ethics ‘Points to Consider’ to Inform Informatics System Designers

There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this.

We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to Consider” (P2C) document, and convened a national expert panel to review and critique the P2C.
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11 September 2013 | No Comments »
Categories: Bibliography, Journal Article, Patients, RA Research | Keyword(s): , , , , , , , , ,

Enhancing patient-centered communication and collaboration by using the electronic health record in the examination room

White A et Danis M. JAMA, 309(22)

As widespread adoption of the electronic health record (EHR) takes place in US medical practice, many health care experts have emphasized the promising capabilities of the EHR to foster patient activation, which is a characteristic of patients who view themselves as active collaborators in their own health care management. The use of EHRs has the potential to facilitate patient-physician communication via electronic messaging.
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20 June 2013 | No Comments »
Categories: Bibliography, Journal Article, RA News, Record Access | Keyword(s): , ,

Inviting patients to read their doctors’ notes: a quasi-experimental study and a look ahead

Delbanco T et al, Annals of internal medicine, 157(7)

Little information exists about what primary care physicians (PCPs) and patients experience if patients are invited to read their doctors’ office notes.

To evaluate the effect on doctors and patients of facilitating patient access to visit notes over secure Internet
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15 January 2013 | No Comments »
Categories: Bibliography, Journal Article, RA Research, Record Access | Keyword(s): , , , , , , , ,

The Cost of Technology

Toll E. JAMA, 307(23)

No one was more surprised than the physician himself. The drawing was unmistakable. It showed the artist—a 7-year-old girl—on the examining table. Her older sister was seated nearby in a chair, as was her mother, cradling her baby sister. The doctor sat staring at the computer, his back to the patient—and everyone else.
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13 July 2012 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): , ,

The Patient-Doctor Relationship and Online Social Networks: Results of a National Survey

Bosslet GT et al, Journal of General Internal Medicine, 2011

The use of online social networks (OSNs) among physicians and physicians-in-training, the extent of patient-doctor interactions within OSNs, and attitudes among these groups toward use of OSNs is not well described.

To quantify the use of OSNs, patient interactions within OSNs, and attitudes toward OSNs among medical students (MS), resident physicians (RP), and practicing physicians (PP) in the United States.
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27 September 2011 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): , , , ,

Patient Expectations in the Digital World

Bos L. Future Visions on Biomedicine and Bioinformatics 1, 2011

This chapter is based on my keynote during the Estonian e-Health Conference in Tallinn, october 2010.
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4 September 2011 | No Comments »
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Secure web messaging in a pediatric chronic care clinic: a slow takeoff of “kids’ airmail”

Hsiao AL et al, Pediatrics, 127(2)

Although e-mail may be an efficient clinician-patient communication tool, standard e-mail is not adequately secure to meet Health Insurance Portability and Accountability Act (HIPAA) guidelines. For this reason, firewall-secured electronic messaging systems have been developed for use in health care. Impact and usability of these secure systems have not been broadly assessed.

To evaluate the impact of a secure electronic messaging system implemented for a pediatric subspecialty clinic.
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28 July 2011 | No Comments »
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How adolescents use SMS (short message service) to micro-coordinate contact with youth mental health outreach services

Furber GV et al, The Journal of Adolescent Health, 48(1)

Mobile phones play a central role in the lives of young people and are being increasingly recognized as valuable tools in health care. However, there is a paucity of studies exploring the use of mobile phones in youth outreach mental health services. Our outreach team’s experience is that enabling youth to access their therapist directly through mobile phone improves engagement and retention, and short message service (SMS) in particular, is a useful tool for coordinating appointments. The purpose of this study was to audit the content of SMS exchanges between therapists and clients and to investigate the extent of inappropriate SMS use.
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24 July 2011 | No Comments »
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Trust and Sources of Health Information

Hesse BW et al, Archives of Internal Medicine, 165(22)

The context in which patients consume health information has changed dramatically with diffusion of the Internet, advances in telemedicine, and changes in media health coverage. The objective of this study was to provide nationally representative estimates for health-related uses of the Internet, level of trust in health information sources, and preferences for cancer information sources.

Data from the Health Information National Trends Survey were used. A total of 6369 persons 18 years or older were studied. The main outcome measures were online health activities, levels of trust, and source preference.
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4 July 2011 | No Comments »
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The Use of Physician-Patient Email: A Follow-up Examination of Adoption and Best-Practice Adherence 2005-2008

Menachemi N et al, J Med Internet Res, 13(1)

Improved communication from physician- patient emailing is an important element of patient centeredness. Physician-patient email use has been low; and previous data from Florida suggest that physicians who email with patients rarely implement best-practice guidelines designed to protect physicians and patients.

Our objective was to examine whether email use with patients has changed over time (2005-2008) by using two surveys of Florida physicians, and to determine whether physicians have more readily embraced the best-practice guidelines in 2008 versus 2005. Lastly, we explored the 2008 factors associated with email use with patients and determined whether these factors changed relative to 2005.
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2 May 2011 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): , ,

Personal Health Records (PHR) and the Future of the Physician-patient Relationship

Baird A et al, Proceedings of the 2011 iConference, 2011

We provide early evidence that healthcare consumers plan to play a more active role in their healthcare through the use of a patientcentric information tool—the Personal Health Record (PHR). We assess consumer attitudes, values, and beliefs of PHRs through the use of a focus group and further analyze the intention to adopt a PHR through the use of a survey based on the adoption of innovations model by Rogers [38]. We find that while barriers to PHR adoption exist—such as concerns about privacy, security and the lack of visible use of PHRs by others within immediate social groups—intention to use PHRs are high within our sample. This suggests that active consumer involvement in healthcare may be on the rise and, more importantly, that information may become a key mediator in the physician-patient relationship. While our findings are based on pilot studies consisting of relatively small sample sizes and subject to limited generalizability, these results do suggest that consumer empowerment has the potential to fundamentally alter traditional physician-patient paradigms.

27 February 2011 | No Comments »
Categories: Bibliography, Book Article | Keyword(s): , , ,

Patient attitudes toward physician use of tablet computers in the exam room

Strayer SM et al, Family Medicine, 42(9)

Previous research has examined patients’ attitudes toward use of exam room computers by physicians. Our objective was to determine patient attitudes toward physicians’ exam room use of new tablet computers.
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10 February 2011 | No Comments »
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The patient and the computer in the primary care consultation

Pearce C et al, J Am Med Inform Assoc, 2011

Studies of the doctor-patient relationship have focused on the elaboration of power and/or authority using a range of techniques to study the encounter between doctor and patient. The widespread adoption of computers by doctors brings a third party into the consultation. While there has been some research into the way doctors view and manage this new relationship, the behavior of patients in response to the computer is rarely studied. In this paper, the authors use Goffman’s dramaturgy to explore patients’ approaches to the doctor’s computer in the consultation, and its influence on the patient-doctor relationship.
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29 January 2011 | No Comments »
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Facebook activity of residents and fellows and its impact on the doctor-patient relationship

Moubarak G et al, Journal of Medical Ethics, 37(2)

Facebook is an increasingly popular online social networking site. The purpose of this study was to describe the Facebook activity of residents and fellows and their opinions regarding the impact of Facebook on the doctor-patient relationship.

An anonymous questionnaire was emailed to 405 residents and fellows at the Rouen University Hospital, France, in October 2009.
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17 December 2010 | 1 Comment »
Categories: Bibliography, Journal Article | Keyword(s): , , ,

How will e-health affect patient participation in the clinic? A review of e-health studies and the current evidence for changes in the relationship between medical professionals and patients

Dedding C et al, Social Science & Medicine, 72(1)

In this report we discuss the consequences of e-health for patient-clinician encounters. On the basis of an analysis of the literature, we propose an analytical framework, composed of five different themes, regarding the impact of e-health on the relationship between patients and their health professionals. Internet health sites can: be or come to be a replacement for face-to-face consultations; supplement existing forms of care; create favorable circumstances for strengthening patient participation; disturb relations; and/or force or demand more intense patient participation.
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8 November 2010 | No Comments »
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Physicians Slow to E-mail Routinely with Patients

Boukus E et al, Center for Studying Health System Change, Issue Brief No. 134

Some experts view e-mail between physicians and patients as a potential tool to improve physician-patient communication and, ultimately, patient care. Despite indications that many patients want to e-mail their physicians, physician adoption and use of e-mail with patients remains uncommon—only 6.7 percent of office-based physicians routinely e-mailed patients in 2008, according to a new national study from the Center for Studying Health System Change (HSC). Overall, about one-third of office-based physicians reported that information technology (IT) was available in their practice for e-mailing patients about clinical issues.
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7 October 2010 | No Comments »
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HIV patients’ willingness to share personal health information electronically

Teixeira PA et al, Patient Education and Counseling, 2010

To assess the attitudes of persons living with HIV/AIDS (PLWH) towards having their personal health information (PHI) stored and shared electronically.
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18 August 2010 | No Comments »
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The Role of the Internet on Patient Knowledge Management, Education, and Decision-Making

Ilic D. Telemedicine and e-Health, 16(6)

E-health encompasses a broad range of health disciplines that use the Internet and associated technologies to deliver information and health services. Traditionally, patients have relied on the healthcare professional to provide relevant medical information to inform decision making on diagnosis and therapy. Patient education in the past has consisted of independently collated health information, disseminated predominantly in written and video formats.
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8 August 2010 | No Comments »
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Gradual electronic health record implementation: new insights on physician and patient adaptation

Shield RR et al, Annals of Family Medicine, 8(4)

Although there is significant interest in implementation of electronic health records (EHRs), limited data have been published in the United States about how physicians, staff, and patients adapt to this implementation process. The purpose of this research was to examine the effects of EHR implementation, especially regarding physician-patient communication and behaviors and patients’ responses.
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21 July 2010 | No Comments »
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Open Notes: Doctors and Patients Signing On

Delbanco T et al, Annals of Internal Medicine, 153(2)

Few patients read their doctors’ notes, despite having the legal right to do so. As information technology makes medical records more accessible and society calls for greater transparency, patients’ interest in reading their doctors’ notes may increase. Inviting patients to review these notes could improve understanding of their health, foster productive communication, stimulate shared decision making, and ultimately lead to better outcomes. Yet, easy access to doctors’ notes could have negative consequences, such as confusing or worrying patients and complicating rather than improving patient–doctor communication.
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20 July 2010 | No Comments »
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