title: Patient-centered communication in the era of electronic health records: What does the evidence say?
abstract: Patient-physician communication is essential for patient-centered health care. Physicians are concerned that electronic health records (EHRs) negatively affect communication with patients. This study identified a framework for understanding communication functions that influence patient outcomes. We then conducted a systematic review of the literature and organized it within the framework to better understand what is known.
  
  
  
  A comprehensive search of three databases (CINAHL, Medline, PsycINFO) yielded 41 articles for analysis.
  
  
  
  Results indicated that EHR use improves capture and sharing of certain biomedical information. However, it may interfere with collection of psychosocial and emotional information, and therefore may interfere with development of supportive, healing relationships. Patient access to the EHR and messaging functions may improve communication, patient empowerment, engagement, and self-management.
  
  
  
  More rigorous examination of EHR impacts on communication functions and their influences on patient outcomes is imperative for achieving patient-centered care. By focusing on the role of communication functions on patient outcomes, future EHRs can be developed to facilitate care.
  
  
  
  Training alone is likely to be insufficient to address disruptions to communication processes. Processes must be improved, and EHRs must be developed to capture useful data without interfering with physicians' and patients' abilities to effectively communicate.
authors.affiliation: Department of Health Administration, 1008 East Clay St. P.O. Box 980203, Virginia Commonwealth University, Richmond, VA 23298-0203, United States. Electronic address: crathert@vcu.edu.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Rathert
authors.affiliation: Department of Health Administration, 1008 East Clay St. P.O. Box 980203, Virginia Commonwealth University, Richmond, VA 23298-0203, United States. Electronic address: jnmittler@vcu.edu.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Mittler
authors.affiliation: Department of Health Administration, 1008 East Clay St. P.O. Box 980203, Virginia Commonwealth University, Richmond, VA 23298-0203, United States. Electronic address: banerjees3@mymail.vcu.edu.
authors.forename: Sudeep
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: Tompkins-McCaw Library for the Health Sciences, 509 North 12th Street, P.O. Box 980582, Virginia Commonwealth University, Richmond, VA 23298-0582, United States. Electronic address: jamcdaniel@vcu.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McDaniel
mesh_terms: D003142:Communication; D057286:Electronic Health Records; D006801:Humans; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care
keywords: Electronic health records; Electronic medical records; Patient-physician communication; Patient-physician relations