O'Malley Ann S, Cohen Genna R, Grossman Joy M
Issue Brief Cent Stud Health Syst Change. 2010 Apr(131):1--4.
Commercial electronic medical records (EMRs) both help and hinder physician interpersonal communication--real-time, face-to-face or phone conversations--with patients and other clinicians, according to a new Center for Studying Health System Change (HSC) study based on in-depth interviews with clinicians in 26 physician practices. EMRs assist real-time communication with patients during office visits, primarily through immediate access to patient information, allowing clinicians to talk with patients rather than search for information from paper records. For some clinicians, however, aspects of EMRs pose a distraction during visits. Moreover, some indicated that clinicians may rely on EMRs for information gathering and transfer at the expense of real-time communication with patients and other clinicians. Given time pressures already present in many physician practices, EMR and office-work flow modifications could help ensure that EMRs advance care without compromising interpersonal communication. In particular, policies promoting EMR adoption should consider incorporating communication-skills training for medical trainees and clinicians using EMRs.
根据医疗系统变革研究中心（HSC）的一项新研究，该研究基于对26家医师诊所的临床医生进行的深入访谈，商业电子病历（EMR）对医生与患者及其他临床医生之间的人际沟通——实时、面对面或电话交谈——既有帮助也有阻碍。电子病历有助于在门诊期间与患者进行实时沟通，主要是通过即时获取患者信息，使临床医生能够与患者交谈，而不必从纸质记录中查找信息。然而，对于一些临床医生来说，电子病历的某些方面在门诊期间会造成干扰。此外，一些人指出，临床医生可能依赖电子病历进行信息收集和传递，而牺牲了与患者及其他临床医生的实时沟通。鉴于许多医师诊所已经存在时间压力，电子病历和办公流程的改进有助于确保电子病历在不损害人际沟通的情况下推进医疗服务。特别是，促进采用电子病历的政策应考虑为使用电子病历的医学实习生和临床医生纳入沟通技能培训。
