title: Capturing the patients' voices: Planning for patient-centered electronic health record use.
abstract: To understand (1) the perceptions of patients regarding use of EHR during clinic visits, (2) the impact of the presence of EHR on patient interactions with physicians, and (3) the ways in which EHR usage might increase patient engagement.
  
  
  
  We conducted semi-structured interviews of a convenience sample of patients of internal medicine resident doctors from three primary care clinics. Interviews were audio-recorded and transcribed verbatim. We used thematic analysis to identify themes from the transcripts. Informed consent was obtained from each participant.
  
  
  
  We interviewed 32 patients; 37.5% male. Our analysis revealed three primary themes: (1) the views and beliefs of patients on the use of EHR in clinics, (2) patients' perception of the communication skills of residents, and (3) patients' perceptions about information sharing, patient engagement, and health education related to the EHR. An invitation to patients to view the screen as the physician interprets its content increases patient satisfaction and understanding. Residents' possessed skills in communication is not impeded when using EHR.
  
  
  
  Patients generally express a positive or neutral perception of EHR use during clinic visits. Using information voiced by patients, we can teach health providers EHR strategies that are likely to engage patients in the visit and engender their trust.
authors.affiliation: Center for Patient Care and Outcomes Research, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States. Electronic address: oasan@mcw.edu.
authors.forename: Onur
authors.initials: O
authors.lastname: Asan
authors.affiliation: Center for Patient Care and Outcomes Research, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Tyszka
authors.affiliation: Center for Patient Care and Outcomes Research, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States; Clement J. Zablocki VA Medical Center, 5000 West National Avenue, Milwaukee, WI 83295, United States.
authors.forename: Kathlyn E
authors.initials: KE
authors.lastname: Fletcher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000554:Ambulatory Care Facilities; D003142:Communication; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000592:standards*; D010817:Physician-Patient Relations; D010820:Physicians; D014743:Videotape Recording; D055815:Young Adult
keywords: Doctor-patient relationships; Electronic health records; Health communication; Patient education; Patient engagement