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Table 4 Suggested modifications – experts panel

From: Enhancing patient-doctor-computer communication in primary care: towards measurement construction

Original item number

Item

Suggested modification

2

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

Discard item

4

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

Keep item

8

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

Discard – similar to item 7

9

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

Keep and add: if needed

10

Discuss antecedent treatments while browsing the computerized record

Keep item

12

Reposition the screen so that it is closer to the patient

Keep and add: or in view of the patient

14

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

Discard – similar to item 11

15

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

Modify item into: Read back what you have written and add item: Type-in and document information provided by the patient

16

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

Discard – similar to items 25, 26 (verbal and non-verbal communication skills)

17

Encourage patient participation in building their charts

Keep item: Item is important as it offers the patient the opportunity to correct errors in his record and/or approve certain information in his chart.

19

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

The issue of patient literacy is extremely important especially while using the computer for patient education purposes

24

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

Discard – does not refer specifically to EMR use and is similar to 25, 26.