Ventres William, Kooienga Sarah, Marlin Ryan, Vuckovic Nancy, Stewart Valerie
Multnomah County Health Department, Mid-County Health Center, Portland, OR 97236, USA.
Fam Med. 2005 Apr;37(4):276-81.
The use of computers in medical examination rooms is growing. Advocates of this technology suggest that all family physicians should have and use examination room computers (ERCs) within the near future. This study explored how family physicians incorporate the use of ERCs in their interactions with patients.
This qualitative study involved five family physicians, one family nurse practitioner, and a convenience sample of 29 patients. Data included videotaped visits, clinician interviews, and videotape reviews. The setting was an urban family practice with a 7-year history of viewing electronic medical records. The main outcome measures were themes emergent from videotaped data.
We identified three distinct practice styles that shaped the use of the ERC: informational, interpersonal, and managerial styles. Clinicians with an informational style are guided by their attention to gathering data as prompted by the computer screen. Clinicians with an interpersonal style focus their attention and body language on patients. Clinicians with a managerial style bridge informational and interpersonal styles by alternating their attention in defined intervals between patients and the computer.
Family physicians have varying practice styles that affect the way they use examination room computers during visits with patients.
计算机在医疗检查室中的使用正在增加。这项技术的支持者建议，所有家庭医生应在不久的将来配备并使用检查室计算机（ERC）。本研究探讨了家庭医生在与患者互动中如何融入ERC的使用。
这项定性研究涉及五位家庭医生、一位家庭执业护士以及29名患者的便利样本。数据包括就诊录像、临床医生访谈和录像回顾。研究场景是一家具有7年查看电子病历历史的城市家庭诊所。主要结局指标是录像数据中出现的主题。
我们确定了三种不同的实践风格，它们影响着ERC的使用：信息风格、人际风格和管理风格。具有信息风格的临床医生会根据计算机屏幕提示，专注于收集数据。具有人际风格的临床医生将注意力和肢体语言集中在患者身上。具有管理风格的临床医生通过在特定时间间隔内交替关注患者和计算机，将信息风格和人际风格联系起来。
家庭医生有不同的实践风格，这会影响他们在与患者就诊时使用检查室计算机的方式。
