EPRs in the consultation room: A discussion of the literature on effects on doctor-patient relationships |
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Authors: | Irma van der Ploeg Brit Ross Winthereik Roland Bal |
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Institution: | 1. Institute for Healthcare Management & Policy, Erasmus University Medical Centre, P.O. box 1738, 3000 DR, Rotterdam, The Netherlands 2. School of Dentistry, University of Copenhagen, N?rre Alle 20, 2200, K?benhavn N, Denmark
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Abstract: | In this paper we discuss expected and reported effects on care provider-patient relations of the introduction of electronic
patient records (EPRs) in consultation settings by reviewing exemplary studies and literature on the subject from the past
decade. We argue that in order for such assessments to be meaningful, talk of effects of “the” EPR needs to be replaced by
an “unpacking” of EPR systems into their constituent parts and functionalities, the effects of which need to be assessed individually.
Following from this principle, the paper discusses EPR systems ranging from simple data entry and retrieval systems to more
sophisticated multi-user and multifunctional on-line systems. On a second level, our analysis of the literature is informed
by the question which model of ideal patienthood underlies the assessment of effects of EPRs. To this end, we identify three
“models of patienthood” implicit in writing about benefits and drawbacks of EPRs for patients: the autonomy, the consumer,
and the holistic models, and argue that assumptions concerning these models need to be reflected upon more critically to improve
understanding of what exactly EPR use does to the doctor-patient relationship. |
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Keywords: | doctor-patient relations electronic patient records models of patienthood patient-centeredness |
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