Cancer patients’ perceptions of physicians who use an integrated electronic health record (EHR) approach during clinic visits: A double-blinded randomized clinical trial (RCT).

Abstract

e24201 Background: Our previous RCT found that cancer patients prefer and positively perceive physicians who communicate face-to-face as compared to using the EHR. However, the use of EHR in the examination room remains a practical necessity. Based on the existing literature, our team developed a simple and very short intervention to integrate the EHR into the encounter, which includes optimal positioning of the computer, a proper introduction to the computer, effective time management for data-entry while maintaining patient-physician interaction and use of the EHR as a tool to enhance patient education. Methods: In this double-blind, crossover RCT, 120 patients with advanced cancer were enrolled between April 1, 2019, and September 15, 2019. Our objectives were to compare patients’ perceptions of physicians’ compassion, communication skills, professionalism, and patients’ overall physician preference after watching 2 standardized scripted-video vignettes of physicians: one portraying the use of a standard EHR approach and the other portraying use of an integrated EHR approach. Both actors and patients were blinded to the purpose of the study. Investigators were blinded to the sequence of videos watched by the patients. After viewing each video, patients completed validated questionnaires rating their perception of the physician’s compassion (0 = best, 50 = worst), communication skills (0 = poor, 70 = excellent) and professionalism (0 = poor, 20 = very good). Patients were also asked to rate their overall physician preference. Results: After watching the first video, the integrated EHR, compared to the standard EHR, resulted in better scores for physician compassion (median [interquartile range], (5[0-10] vs 12[4-25]; P = .0009), communication skills (69[63-70] vs 61[50-69]; P = .0026) and professionalism (20[18-20] vs 18[14-20]; P = .0058). The majority of cancer patients preferred an integrated EHR physician as their provider (70[58%] vs 21[18%], P < 0.0001). Patients with college or an advanced degree had a 5 times higher chance of preferring an integrated EHR physician ( P < 0.0171). Conclusions: Cancer patients perceived physicians who used an integrated EHR approach as more compassionate, professional, and with better communication skills. Moreover, they preferred an integrated EHR physician to be their provider. Integrated EHR has the potential to improve communication in oncological settings. Clinical trial information: NCT03856060 .