Historia clínica electrónica: evolución de la relación médico-paciente en la consulta de Atención Primaria / Electronic medical records: evolution of physician-patient relationship in the Primary Care clinic

Introducción. La historia clínica electrónica y los soportes informáticos en la consulta han modificado la relación médico-paciente. Este tipo de historia ofrece múltiples ventajas, aunque dudamos del protagonismo que ha adquirido el ordenador, que ha pasado de ser una herramienta de trabajo a ser el centro de nuestra atención durante la entrevista clínica, disminuyendo la interacción con el paciente. El objetivo del estudio fue estimar el tiempo empleado por el médico de familia en el manejo del soporte informático frente al dedicado a la comunicación interpersonal durante cada consulta y si se modifica en función de variables como la edad del médico o el motivo de consulta. Material y métodos. Realizamos un estudio observacional, descriptivo y transversal, donde participaron 2 centros de salud durante 10 semanas. El investigador asistió a todas las consultas, registrando la hora de entrada y salida del paciente de la consulta. Se cronometró cada vez que el médico fijaba su mirada en los soportes informáticos. Resultados. Se recogieron 436 consultas. Los médicos miraron los soportes informáticos una mediana del 38,33% de la duración total de una consulta. Los mayores de 45 años dedicaron más tiempo a fijar su vista en los soportes informáticos (p<0,05). Conclusión. Los médicos de familia utilizaron casi un 40% del tiempo de la consulta en mirar los soportes informáticos, variando según edad del médico, número de motivos de consulta y pacientes citados (AU)

Introduction. The introduction of electronic medical records and computer media in clinics, has influenced the physician-patient relationship. These modifications have many advantages, but there is concern that the computer has become too important, going from a working tool to the centre of our attention during the clinical interview, decreasing doctor interaction with the patient. The objective of the study was to estimate the percentage of time that family physicians spend on computer media compared to interpersonal communication with the patient, and whether this time is modified depending on different variables such as, doctor's age or reason for the consultation. Material and methods. An observational and descriptive study was conducted for 10 weeks, with 2 healthcare centres involved. The researchers attended all doctor- patient interviews, recording the patient time in and out of the consultation. Each time the doctor fixed his gaze on computer media the time was clocked. Results. A total of 436 consultations were collected. The doctors looked at the computer support a median 38.33% of the total duration of an interview. Doctors of 45 years and older spent more time fixing their eyes on computer media (P<.05). Conclusions. Family physicians used almost 40% of the consultation time looking at computer media, and depends on age of physician, number of queries, and number of medical appointments (AU)

[Electronic medical records: Evolution of physician-patient relationship in the Primary Care clinic]. / Historia clínica electrónica: evolución de la relación médico-paciente en la consulta de Atención Primaria.

INTRODUCTION: The introduction of electronic medical records and computer media in clinics, has influenced the physician-patient relationship. These modifications have many advantages, but there is concern that the computer has become too important, going from a working tool to the centre of our attention during the clinical interview, decreasing doctor interaction with the patient. The objective of the study was to estimate the percentage of time that family physicians spend on computer media compared to interpersonal communication with the patient, and whether this time is modified depending on different variables such as, doctor's age or reason for the consultation. MATERIAL AND METHODS: An observational and descriptive study was conducted for 10 weeks, with 2 healthcare centres involved. The researchers attended all doctor- patient interviews, recording the patient time in and out of the consultation. Each time the doctor fixed his gaze on computer media the time was clocked. RESULTS: A total of 436 consultations were collected. The doctors looked at the computer support a median 38.33% of the total duration of an interview. Doctors of 45 years and older spent more time fixing their eyes on computer media (P<.05). CONCLUSIONS: Family physicians used almost 40% of the consultation time looking at computer media, and depends on age of physician, number of queries, and number of medical appointments.