title: Electronic Health Record's Effects on the Outpatient Office Visit and Clinical Education.
abstract: During an office visit, the provider has the important cognitive task of attending to the patient while actively using the electronic health record (EHR).  Prior literature suggests that EHR may have a positive effect on simple tasks, but a negative effect on tasks that require complex cognitive processes.  No study has examined the provider's perception of EHR on multiple distinct aspects of the office visit.
  
  
  
  We surveyed providers/preceptors regarding their perception of EHR on multiple aspects of the office visit.  We summarized their EHR utilization history and their perceptions of the EHR during the visit using descriptive statistics.  We tested for associations between time spent using the EHR and distinct aspects of the visit using Chi-square tests of association.
  
  
  
  In total, 83 providers/preceptors reported use of EHR (response rate 52%). Provider/preceptors reported an overall negative effect of EHR on the patient-provider connection, but an overall positive effect on the review of medications/medical records, communication between providers, review of results with patients and review of follow-up to testing results with patients. The effect of EHR on history taking and teaching students was neutral.  We observed no correlation between the provider's time spent using the EHR and their perception of its effectiveness.
  
  
  
  Providers reported a positive perception of EHR on aspects of the office visit that involved a single cognitive task.  However, providers reported a negative perception of EHR on patient-provider connection, which involves a high degree of cognitive processing.
authors.affiliation: University of Vermont Medical School. marie.sandoval@UVMHealth.org.
authors.forename: Marie B
authors.initials: MB
authors.lastname: Sandoval
authors.affiliation: University of Vermont College of Nursing and Health Science. mpalumbo@uvm.edu.
authors.forename: Mary Val
authors.initials: MV
authors.lastname: Palumbo
authors.affiliation: Office of Health Promotion Research at the University of Vermont, College of Medicine. victoria.mclaughlin@uvm.edu.
authors.forename: Vicki
authors.initials: V
authors.lastname: Hart
mesh_terms: D000554:Ambulatory Care Facilities; D003142:Communication; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D009819:Office Visits; D010045:Outpatients; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
keywords: electronic health record effects, outpatient office visit, patient-provider connection, student education, EHR specific communication skills