Promoting Quality Face-to-Face Communication during Ophthalmology Encounters in the Electronic Health Record Era

Area of Science:

• Ophthalmology
• Health Informatics
• Quality Improvement

Background:

• Electronic Health Records (EHR) implementation can impact physician-patient communication time.
• Optimizing EHR use is crucial for maintaining patient-centered care in high-volume settings.

Purpose of the Study:

• To evaluate informatics-enabled quality improvement (QI) strategies for enhancing face-to-face communication between ophthalmologists and patients.
• To assess the impact of EHR implementation on communication time and documentation efficiency.

Main Methods:

• A prospective study in an academic ophthalmology department during EHR implementation.
• QI strategies included single sign-on, mobile applications, EHR personalization, team-based orders, and problem-based charting.
• Data collected on communication, documentation, and examination time during 648 outpatient encounters.

Main Results:

• Face-to-face communication time initially decreased but returned to baseline levels within 6 months post-EHR implementation.
• Ophthalmologists using QI strategies outperformed national averages in documentation time, personalization, team-based orders, and note efficiency.
• No EHR redesign, scribes, or excessive after-hours work were required.

Conclusions:

• Informatics-enabled QI interventions effectively promote patient-centeredness and communication in ophthalmology.
• Strategies can preserve face-to-face physician-patient interaction time without compromising documentation efficiency.
• These interventions may help mitigate physician burnout by optimizing EHR workflows.