PhotoIt's a fairly common experience these days: you're sitting there in front of your doctor, perhaps wearing one of those charming paper gowns, while your doctor's eyes remain fixated on her computer screen.

Healthcare professionals were slow to adopt computers in the exam room but they're making up for lost time now, so much so that a new study finds they may be overlooking nonverbal cues that could help them better understand and diagnose their patients' problems.

“When doctors spend that much time looking at the computer, it can be difficult for patients to get their attention,” said Enid Montague, an assistant proessor at Northwestern University's medical school. “It’s likely that the ability to listen, problem-solve and think creatively is not optimal when physicians’ eyes are glued to the screen.”

Eye-gaze patterns

Using video cameras, Northwestern scientists recorded 100 doctor-patient visits in which doctors used computers to access electronic health records. The videos were used to analyze eye-gaze patterns and how they affected communication behavior between patients and clinicians.

Published online in the International Journal of Medical Informatics, the study found that doctors who use electronic health records in the exam room spend about a third of their visits looking at a computer screen.

“We found that physician–patient eye-gaze patterns are different during a visit in which electronic health records versus a paper-chart visit are used,” Montague said. “Not only does the doctor spend less time looking at the patient, the patient also almost always looks at the computer screen, whether or not the patient can see or understand what is on the screen.”

Understanding physicians’ eye-gaze patterns and their effects on patients can contribute to more effective training guidelines and better-designed technology. Future systems, for example, could include more interactive screen sharing between physicians and patients, Montague said.

“The purpose of electronic health records is to enable health care workers to provide more effective, efficient, coordinated care,” Montague said. “By understanding the dynamic nature of eye-gaze patterns and how technology impacts these patterns, we can contribute to future designs that foster more effective doctor–patient interaction.”

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