Odenheimer Sandra, Goyal Deepika, Jones Veena Goel, Rosenblum Ruth, Ho Lam, Chan Albert S
Palo Alto Medical Foundation, Sunnyvale, CA, United States.
The Valley Foundation School of Nursing, San Jose State University, San Jose, CA, United States.
J Med Internet Res. 2018 Jun 21;20(6):e10762. doi: 10.2196/10762.
The ubiquitous use of electronic health records (EHRs) during medical office visits using a computer monitor and keyboard can be distracting and can disrupt patient-health care provider (HCP) nonverbal eye contact cues, which are integral to effective communication. Provider use of a remote medical scribe with face-mounted technology (FMT), such as Google Glass, may preserve patient-HCP communication dynamics in health care settings by allowing providers to maintain direct eye contact with their patients while still having access to the patient's relevant EHR information. The medical scribe is able to chart patient encounters in real-time working in an offsite location, document the visit directly into EHR, and free HCP to focus only on the patient.
The purpose of this study was to examine patient perceptions of their interactions with an HCP who used FMT with a remote medical scribe during office visits. This includes an examination of any association between patient privacy and trust in their HCP when FMT is used in the medical office setting.
For this descriptive, cross-sectional study, a convenience sample of patients was recruited from an outpatient dermatology clinic in Northern California. Participants provided demographic data and completed a 12-item questionnaire to assess their familiarity, comfort, privacy, and perceptions following routine office visits with an HCP where FMT was used to document the clinical encounter. Data were analyzed using appropriate descriptive and inferential statistics.
Over half of the 170 study participants were female (102/170, 59.4%), 60.0% were Caucasian (102/170), 24.1% were Asian (41/170), and 88.8% were college-educated (151/170). Age ranged between 18 and 90 years (mean 50.5, SD 17.4). The majority of participants (118/170, 69.4%) were familiar with FMT, not concerned with privacy issues (132/170, 77.6%), and stated that the use of FMT did not affect their trust in their HCP (139/170, 81.8%). Moreover, participants comfortable with the use of FMT were less likely to be concerned about privacy (P<.001) and participants who trusted their HCP were less likely to be concerned about their HCP using Google Glass (P<.009). Almost one-third of them self-identified as early technology adopters (49/170, 28.8%) and 87% (148/170) preferred their HCP using FMT if it delivered better care.
Our study findings support the patient acceptance of Google Glass use for outpatient dermatology visits. Future research should explore the use of FMT in other areas of health care and strive to include a socioeconomically diverse patient population in study samples.
在医疗门诊中普遍使用电子健康记录（EHRs）时，通过电脑显示器和键盘操作可能会分散注意力，并打断患者与医疗服务提供者（HCP）之间的非语言眼神交流线索，而这种眼神交流对于有效沟通至关重要。医疗服务提供者使用带有面部安装技术（FMT）的远程医疗抄写员，如谷歌眼镜，可能会通过让提供者在仍能访问患者相关电子健康记录信息的同时与患者保持直接眼神接触，从而在医疗环境中保持患者与HCP之间的沟通动态。医疗抄写员能够在异地实时记录患者诊疗过程，将诊疗记录直接录入电子健康记录，并使HCP能够专注于患者。
本研究的目的是调查患者对在门诊就诊时与使用FMT和远程医疗抄写员的HCP互动的看法。这包括考察在医疗门诊环境中使用FMT时患者隐私与对其HCP信任之间的任何关联。
对于这项描述性横断面研究，从北加利福尼亚的一家门诊皮肤科诊所招募了一个便利样本的患者。参与者提供了人口统计学数据，并完成了一份12项问卷，以评估他们在与使用FMT记录临床诊疗过程的HCP进行常规门诊后的熟悉程度、舒适度、隐私情况和看法。使用适当的描述性和推断性统计方法对数据进行分析。
170名研究参与者中超过一半为女性（102/170，59.4%），60.0%为白种人（102/170），24.1%为亚洲人（41/170），88.8%受过大学教育（151/170）。年龄在18至90岁之间（平均50.5岁，标准差17.4）。大多数参与者（118/170，69.4%）熟悉FMT，不担心隐私问题（132/170，77.6%），并表示使用FMT不会影响他们对HCP的信任（139/170，81.8%）。此外，对使用FMT感到舒适的参与者不太可能担心隐私问题（P<.001），而信任其HCP的参与者不太可能担心HCP使用谷歌眼镜（P<.009）。其中近三分之一的人自认为是早期技术采用者（49/170，28.8%），87%（148/170）的人如果使用FMT能提供更好的护理，则更喜欢他们的HCP使用FMT。
我们的研究结果支持患者接受在门诊皮肤科就诊时使用谷歌眼镜。未来的研究应探索FMT在其他医疗保健领域的应用，并努力在研究样本中纳入社会经济背景多样化的患者群体。
