Table 2 Frequencies of item ratings (N=48)

1.

Arrange the room to allow both patient and physician to see the screen

50

3.63

.841

2.

Preview the EMR before entering or having the patient enter the room

60.4

3.69

1.055

3.

Introduce yourself before turning to the computer

93.7

4.71

.874

4.

Introduce the computer and its role to the patient, while identifying the patient in the EMR

33.3*

3.15

1.010

5.

Begin the encounter with your patient’s concerns

95.9

4.60

.574

6.

Summarize and briefly touch-type the visit’s agenda

77.1

4.13

.866

7.

Do not interrupt the patient while he is talking due to computer guided questions/prompts

83.3

4.33

.753

8.

Establish reason for visit primarily based on the patient’s needs rather than computer prompts

85.5

4.29

.713

9.

Describe the security and confidentiality of the patient’s electronic record information

37.5*

3.06

1.262

10.

Discuss antecedent treatments while browsing the computerized record

48*

3.54

.898

11.

Tell the patient what you are doing as you turn to the computer

81.2

3.98

.729

12.

Reposition the screen so that it is closer to the patient

29.2*

3.15

.945

13.

Point to relevant areas on the screen

54.2

3.56

.920

14.

Signal shifts toward the computer, let the patient know that you are still attending to his or her needs

83.4

4.10

.660

15.

Read back what you have written followed by looking at your patient

60.4

3.71

.922

16.

Use transition statements to the computer, signpost, use real-time typing, read-back

47.9*

3.52

.772

17.

Encourage patient participation in building their charts

31.3*

2.92

1.007

18.

Demonstrate sufficient typing skills

64.6

3.67

.996

19.

Verify patient literacy, primary language, and visual acuity to optimize computer use

41.7*

3.19

1.142

20.

Print out or share: care plans, medication lists, office notes, information, follow up appointments

62.5

3.69

1.133

21.

Discuss medical issues and prevention strategies while using computer resources

54.2

3.54

1.031

22.

Initiate/acknowledge patient requests for on-line information (data, screen sharing)

62.5

3.73

.939

23.

Teach the patient about his own body and situation by providing feedback from tests, diagnosis, showing test results on the screen or print out

70.9

3.94

.954

24.

Use verbal and non-verbal cues: eye gaze, affirmative head nodding while patient is talking

89.6

4.46

.743

25.

While typing on the computer, use verbal skills that demonstrate active listening: continuers (uh-huh, go on, I see), echoing statements (back channeling), short requests (tell me more), and short summarizing statements

85.4

4.21

.683

26.

When the patient is talking or when information is provided to him, face the patient: head, eyes, and torso toward the patient, remove hands from the keyboard or mouse, push the monitor away, and give the patient her undivided attention

77.1

4.21

.798

27.

Provide patient handouts (or Web site references) and information about community support services, medication side effects, and follow-up appointments

60.4

3.75

.978