Computer-based documentation: effects on parent-provider communication during pediatric health maintenance encounters.

Johnson KB, Serwint JR, Fagan LA, Thompson RE, Wilson ME, Roter D
Pediatrics. 2008 122 (3): 590-8

PMID: 18762530 · DOI:10.1542/peds.2007-3005

OBJECTIVE - The goal was to investigate the impact of a computer-based documentation tool on parent-health care provider communication during a pediatric health maintenance encounter.

METHODS - We used a quasiexperimental study design to compare communication dynamics between clinicians and parents/children in health maintenance visits before and after implementation of the ClicTate system. Before ClicTate use, paper forms were used to create visit notes. The children examined were
RESULTS - Computer-based documentation visits were slightly longer than control visits (32 vs 27 minutes). With controlling for visit length, the amounts of conversation were similar during control and computer-based documentation visits. Computer-based documentation visits were associated with a greater proportion of open-ended questions (28% vs 21%), more use of partnership strategies, greater proportions of social and positive talk, and a more patient-centered interaction style but fewer orienting and transition phrases.

CONCLUSIONS - The introduction of ClicTate into the health maintenance encounter positively affected several aspects of parent-clinician communication in a pediatric clinic setting. These results support the integration of computer-based documentation into primary care pediatric visits.

MeSH Terms (14)

Adolescent Child Child, Preschool Communication Documentation Female Health Maintenance Organizations Health Personnel Humans Infant Infant, Newborn Male Medical Records Systems, Computerized Physician-Patient Relations

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