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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.