Study: Digital tools lead to patient dissatisfaction

The pull-down menus, alerts and point-of-care information contained in computerized clinical decision-support systems can distract physicians from their face-to-face encounters and leave patients feeling ignored and dissatisfied with their care. That's the conclusion of a study from the University of Missouri at Columbia, which assessed patients' perceptions of physicians who use digital diagnostic tools.

Led by Victoria Shaffer, an assistant professor in the university's health sciences department, researchers provided participants with a number of different hypothetical physician-patient scenarios, including one in which a physician used unaided judgment, one in which a physician used a computerized clinical decision-support system and another in which a physician sought the advice of an expert colleague.

Physicians who made unaided diagnoses were rated more positively and were perceived as more thorough, able and professional than their peers who used aids, according to the study, which appeared in the journal Medical Decision Making. But physicians who sought help from a colleague were much better perceived than physicians who relied on technology.

On the other hand, when physicians worked to humanize technological tools and included patients in the use of decision-support tools, satisfaction levels increased. Physicians “can use the aids as teaching tools to explain their diagnoses using pictures or graphs, which make the patients' experiences much more interactive and educational,” Shaffer said in a news release.

Better approaches to the use of decision-support tools are pressing, especially as the federal government proceeds with its electronic health-record incentive program, the authors said, adding that their research “may help to guide education efforts for patients not ready to make” the transition to computer-based aids.

“In addition, clinicians may use this information to tailor how information is presented to individual patients,” they wrote in the study.