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Do electronic health records affect the patient-psychiatrist relationship? A before & after study of psychiatric outpatients | Stewart et al. BMC Psychiatry 2010 10 3 http www.biomedcentral.eom 1471-244X 10 3 BMC Psychiatry RESEARCH ARTICLE Open Access Do electronic health records affect the patient-psychiatrist relationship A before after study of psychiatric outpatients Randall F Stewart1 Philip J Kroth1 Mark Schuyler3 Robert Bailey2 Abstract Background A growing body of literature shows that patients accept the use of computers in clinical care. Nonetheless studies have shown that computers unequivocally change both verbal and non-verbal communication style and increase patients concerns about the privacy of their records. We found no studies which evaluated the use of Electronic Health Records EHRs specifically on psychiatric patient satisfaction nor any that took place exclusively in a psychiatric treatment setting. Due to the special reliance on communication for psychiatric diagnosis and evaluation and the emphasis on confidentiality of psychiatric records the results of previous studies may not apply equally to psychiatric patients. Method We examined the association between EHR use and changes to the patient-psychiatrist relationship. A patient satisfaction survey was administered to psychiatric patient volunteers prior to and following implementation of an EHR. All subjects were adult outpatients with chronic mental illness. Results Survey responses were grouped into categories of Overall Technical Interpersonal Communication Education Time Confidentiality Anxiety and Computer Use. Multiple unpaired two-tailed t-tests comparing pre- and post-implementation groups showed no significant differences at the 0.05 level to any questionnaire category for all subjects combined or when subjects were stratified by primary diagnosis category. Conclusions While many barriers to the adoption of electronic health records do exist concerns about disruption to the patient-psychiatrist relationship need not be a prominent focus. Attention to communication style interpersonal manner and computer .
