Exploring Residents' Interactions With Electronic Health Records in Primary Care Encounters

OBJECTIVES: Our objective was to explore and compare residents' interaction with electronic health records during primary care encounters and whether those behaviors differ by residency year level. METHODS: A field study was conducted in which 38 patient visits with 12 family medicine resident physicians were observed and video recorded in two primary care clinics under the umbrella of a university-based department of family medicine. Videos were then coded for gaze behaviors in which patients' and physicians' gazes at electronic health records and at each other were coded using a pre-established objective coding scheme. RESULTS: Third-year residents spent the greatest percentage of visit time looking at EHR screens when compared to first- and second-year residents. Third-year residents also spent significantly more time typing or inputting information into the records during the clinical visit when compared to first- and second-year residents. CONCLUSIONS: This study illustrated that patterns for using the EHR and interacting with patients may change over time for residents. These changes may be due to increased EHR proficiency or increased workload that incentivizes using the EHR to retrieve information and to complete charting in front of the patient.