Electronic health records may impede good doctor-patient relationships

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I was giving a talk today, and at the end, someone asked me about an application he has on his phone that monitors sleep (it’s called Sleep Cycle). It reminded me that there is ever-growing potential for individuals to be able to gather data on themselves and, if they want’ use that data to improve their situation. Blood pressure and blood glucose monitors are other examples. In general, I embrace this sort of technology as I believe, on the whole, it empowers people and makes them less reliant on doctors and the medical profession as a whole.

However, as with most things, technology can have a downside too. In medicine, there has been a move towards individuals’ health records being held electronically. What this means is that when a patient consults a doctor, the doctor is not consulting notes written on paper or card, but those appearing on a computer screen. A recent study assessed whether or not this changed the dynamic of the doctor-patient relationship [1].

Specifically, the researchers assessed how much time doctors spent looking at each other. It turns out that the use of electronic records was associated with significantly less time during which a doctor was actually looking at their patient. Also, there was a tendency for patients to spend quite a lot of the time staring at the screen too, irrespective of whether they could see what was on the screen or understand what was written.

These findings suggest that the use of electronic health records may represent an impediment to the doctor-patient relationship and the best medical care. After all, good communication, which is generally aided by eye-contact, is the bedrock of good medicine.

Reading this research, reminded me of the countless occasions I have heard patients complain about their experience with a doctor and they have used the words: “And all he/she seemed to be interested in was his/her computer screen.”

As I say, I embrace technology. However, when it comes to medical practice, I am a bit of a traditionalist, I think. Call me old-fashioned, but I think that during a medical consultation, it helps for the doctor and patient to be looking at one another.


1. Montague E, et al. Dynamic modeling of patient and physician eye gaze to understand the effects of electronic health records on doctor–patient communication and attention. International Journal of Medical Informatics 2014; 83(3): 225-234

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