201716 How physicians' use of information technology is related to patient relationship and quality care?

Tuesday, November 10, 2009

Jong-Deuk Baek, PH D , Health Services Administration, San Diego State University, San Diego, CA
Carleen H. Stoskopf, ScD , Graduate School of Public Health, San Diego State University, San Diego, CA
(1) Background

Physician/patient relationship and interaction during the delivery of healthcare affects quality of care. Use of information technology (IT) is believed to increase clinical effectiveness but mixed results on the relationship between IT use and physician/patient relationship has been reported.

(2) Objective

To see how use of IT for clinical activities affect physicians' subjective evaluation on the relationship between patient interaction and quality of care.

(3) Methods

Secondary data analysis based on 2004-05 CTS physician survey (n=6,068). Quality of care, the dependent variable, is based on physicians' subjective evaluation; two variables for physician/patient relationship (continuing relationship with patients and spend adequate time). Four binary variables for IT activities (generating reminders, accessing patient notes/problem lists/medication lists, writing prescriptions, and exchanging clinical data) were used and interaction terms between the two physician/patient relationship variables and the four IT activity variables were created. Physicians' demographic variables were controlled in a multiple regression.

(4) Results

After controlling for physicians demographic variables, the two physician/patient relationship variables are positively associated with quality of care but no direct impact from IT use on quality of car is found. Use of IT to generate reminder was found to enhance the impact of having continuing relationship with patients on quality of care (β=0.06, p=0.03) but more IT activities for accessing patient notes decreased the impact of physicians/patient relationship on quality of care (β=-0.05, p=0.03). More use of IT for generating reminders reduced the time spending with patients that is negatively associated with quality of care (β=-0.05, p=0.01).

(5) Discussion/Conclusion

IT must be used in a coordinated way to improve physician/patient relationships that is a direct determinant of delivering quality care. However, study results indicated that IT use may prevent physicians from making a good relationship with their patients and, consequently, from improving quality of care provided. The lack of general conclusion about the relationship between IT for the physician/patient relationship could be attributed to healthcare organizations contextual factors. Physicians' personal preferences and organizational contexts may make a difference in the ways physicians interact with information technologies and their patients. Developing strategies to best coordinate IT interaction for better patient interaction is required, if quality of care is to improve.

Learning Objectives:
By the end of the session, the participant will be able to; 1) Evaluate the importance of physician/patient relationship and its implication for higher quality of care; 2) Discuss how IT use can hinder or improve the physician/patient relationship, and quality of care; and 3) Discuss how physicians can coordinate IT interactions toward better physician/patient relationship and improving quality of care.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: It is an individual research to contribute to the body of knowledge on which I have studied.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.