The purpose of this study is to understand the potential relationship between the ways primary care doctors interact with electronic health records (EHRs) and the eye gaze patterns of doctors and patients during primary care visits. Forty primary care encounters where doctors used two different EHR interaction styles were analyzed. This study used a lag analysis method to analyze the eye-gaze patterns between doctor and patient for each style. Differences and similarities in eye gaze behavior patterns were found between the two styles. The results of this study may inform guidelines for EHR design and implementation and inform EHR interaction training.
Get full access to this article
View all access options for this article.
References
1.
BakemanR.GottmanJ. (1997). Observing interaction: An introduction to sequential analysis: Cambridge University Press.
2.
BakemanR.McArthurD.QueraV. (1996). Detecting group differences in sequential association using sampled permutations: Log odds, kappa, and phi compared. Behavior Research Methods Instruments and Computers, 28, 446–457.
3.
BeckR.DaughtridgeR.SloaneP. (2002). Physician-patient communication in the primary care office: a systematic review. The Journal of the American Board of Family Medicine, 15(1), 25.
4.
BensingJ. (1991). Doctor–patient communication and the quality of care. Social Science & Medicine, 32, 1301–1310.
5.
BensingJ. M.KerssensJ. J.van der PaschM. (1995). Patient-directed gaze as a tool for discovering andhandling psychosocial problems in general practice. Journal of Nonverbal Behavior, 19(4), 223–242.
6.
ClarkH. H.BrennanS. E. (1991). Grounding in communication. In ResnickL. B.LevineJ. M.TeasleyS. D. (Eds.), Perspectives on socially shared cognition (pp. 127–149). Washington, DC: American Psychological Association.
7.
HallJ.HarriganJ.RosenthalR. (1996). Nonverbal behavior in clinician–patient interaction. Applied and Preventive Psychology, 4(1), 21–37.
8.
Gorawara-BhatR.CookM. A. (2011). Eye contact in patient-centered communication. Patient Education and Counseling, 82(3), 442–447.
9.
KieslerD. J.AuerbachS. M. (2003). Integrating measurement of control and affiliation in studies of physician-patient interaction: the interpersonal circumplex. Social Science & Medicine, 57(9), 1707–1722.
10.
MakoulG.CurryR. H.TangP. C. (2001). The use of electronic medical records. Journal of the American Medical Informatics Association, 8(6), 610.
11.
MargalitR. S.RoterD.DunevantM. A.LarsonS.ReisS. (2006). Electronic medical record use and physician-patient communication: an observational study of Israeli primary care encounters. Patient education and counseling, 61(1), 134–141.
12.
MastM. S. (2007). On the importance of nonverbal communication in the physician-patient interaction. Patient Education and Counseling, 67(3), 315–318.
13.
MilesM. B.HubbermanA. M. (1994). Data management and analysis methods. In DenzinN. K.LincolnY. S. (Eds.), Qualitative data analysis: An expanded sourcebook (2nd ed., pp. 428–444). CA: Thousand Oaks.
14.
MontagueE.XuJ.ChenP.AsanO.BarrettB. P.ChewningB. (2011). Modeling Eye Gaze Patterns in Clinician–Patient Interaction with Lag Sequential Analysis. Human Factors: The Journal of the Human Factors and Ergonomics Society, 53(5), 502–516. doi: 10.1177/0018720811405986
15.
NoordmanJ.VerhaakP.van BeljouwI.van DulmenS. (2010). Consulting room computers and their effect on general practitioner–patient communication. Family practice, 27(6), 644.
16.
OngL.De HaesJ.HoosA.LammesF. (1995). Doctor-patient communication: a review of the literature. Social Science & Medicine, 40(7), 903–918.
17.
ShachakA.ReisS. (2009). The impact of electronic medical records on patient–doctor communication during consultation: a narrative literature review. Journal of Evaluation in Clinical Practice, 15(4), 641–649.
18.
SilvermanJ.KinnersleyP. (2010). Doctors’ non-verbal behaviour in consultations: look at the patient before you look at the computer. The British Journal of General Practice, 60(571), 76.
19.
XuJ.AsanO.MontagueE. (2011). A New Method to Evaluate Gaze Behavior Patterns in Doctor-Patient Interaction. Proceedings of the 2011 Human Factors and Ergonomics Society Annual Meeting, 55(1), 485–489.
