Evaluating patient satisfaction in the pediatric ophthalmology and strabismus clinic during the transition to electronic medical records

BACKGROUND Doctors may struggle to identify patient agendas during consultations. Patients who fail to discuss their agenda with their doctor feel dissatisfied. Therefore, an online patient agenda tool (the Values in Shared Interactions Tool- VISIT) was developed which allowed patients to enter their agenda items pre-consultation for doctors to view on their electronic medical records (EMR). OBJECTIVE To measure the impact of an EMR-integrated patient agenda website on patient satisfaction, number of agenda items discussed and consultation time. METHODS An unblinded cluster randomized controlled trial was conducted in a university-based primary care clinic between June-October 2019. Twenty-five family medicine trainees were randomized into using the VISIT tool (intervention) and usual care (control). 236 chronic patients were recruited when they came for their follow-up appointments. Descriptive statistics were used to analyze the control and trial arms. There were significant differences between trial and control arms for age, occupation and mobile device proficiency scores. These were entered as covariates in the trial analyzes. Primary outcome was mean self-reported patient satisfaction score using the Healthcare Provider-Patient Communication (HCPPC) questionnaire, secondary outcomes were average agenda items per consultation and consultation time. RESULTS The intervention arm had 12 doctors and 98 patients, while the control arm had 13 doctors and 129 patients. The participation rate was 25.5% for intervention vs 53.6% for control. There was no difference between arms for HCPPC patient satisfaction scores (134.0 +1.32 in intervention, 134.2 +1.14 in control, P=.917) and consultation duration (15.13 + 6.418 minutes in intervention, 14.96 + 6.074 minutes in control, P=.791). The only significant outcome was for mean number of agenda items discussed (2.25 + 0.098 items in intervention; 1.95 + 0.085 in control, P<.05). Consultation time showed no significant difference between arms. CONCLUSIONS Integrating patient agendas into the EMR did not affect patient satisfaction compared to usual care but was associated with an increased number of agenda items without an increase in consultation time. This shows it may be useful for a busy primary care setting with multiple comorbidities and short consultation times. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (Registration number: ACTRN12619000499189)

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Disciplined Doctors

Selling Our Souls ◽

10.23943/princeton/9780691160405.003.0008 ◽

2014 ◽

Author(s):

Adam D. Reich

Keyword(s):

Health Care ◽

Patient Satisfaction ◽

Electronic Medical Records ◽

Medical Records ◽

Health Care Quality ◽

Well Being ◽

Care Quality ◽

Delivery Of Care ◽

Satisfaction Surveys

This chapter examines GroupCare Hospital's disciplinary program for its doctors. Just as GroupCare worked to convince patients that each member's well-being was consistent with the optimization of the membership's health, so it sought to convince physicians that their submission to the organization's disciplinary authority was in the interests both of patients and of physicians themselves and that an efficient, rationalized delivery of care was synonymous with health care quality. Doctors were encouraged to treat individuals while at the same time keeping an eye on the interests of the membership in the aggregate. The chapter first considers doctors' understandings of their work at GroupCare, with particular emphasis on the notion of autonomy, before discussing two technologies through which GroupCare sought to bring doctors into line with the prerogatives of the organization as a whole: electronic medical records and patient satisfaction surveys.

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