Ab1594-HPR Physician Interaction With an Electronic Health Record During Consultations and Its Association With the Quality of Patient-Physician Communication: An Observational Study Using an Eye-Tracker Device in Daily Clinical Care

Background: Increased interaction with electronic health records (EHRs) during consultations may influence patient-physician communication. Studies show both positive effects and negative effects of EHR usage. While previous studies used videotaping to investigate eye-gaze during consultations, use of mobile eye-tracker glasses has been shown to be more accurate. Objectives: The aim of this study was to investigate the influence of physician-computer interaction on perceived quality of patient-physician communication, using eye-tracking technology. Methods: This observational study included a convenience sample of 6 physicians and 68 patients. Physicians' eye gaze was measured during the consultation with mobile Tobii Pro III eye tracking glasses (Figure 1). Following each consultation, patients filled in the Communication Assessment Tool (CAT). A top-box score was calculated as the percentage of patients that gave the highest score on the CAT. The results of the CAT scores were associated to the face gaze duration ratio and the face gaze frequency ratio using generalized estimating equations and Spearman's correlation coefficient. Results: The physicians spent on average 33.7% (SD 11.8) of the time looking at the patient's face and 36.0% (SD 15.3) looking at the computer. Of the total fixation count, the mean amount of time the physician looked at the patient's face was 28.9% (SD 11.6) and the mean percentage of the fixation count of the computer was 47.3% (SD 15.8). The remaining time, the physicians spent gazing outside the areas of interest, such as the desk, the clock or the body of the patient (Table 1). The CAT top-box scores ranged from 35.7% to 100%. The median CAT top-box score was 100% and the mean top-box score was 78.1% (SD 34.0). The median top-box score per physician ranged from 92.1% to 100%. A top-box score of 100% was seen in 35 patients (51.5%). There was no significant association between face gaze duration and CAT scores (p = 0.115) or between face gaze frequency ratio and CAT scores (p= 0.119). Conclusion: During consultations, most physicians were found to spent equal or more time looking at the computer than looking at the patient's face, but this physician-computer interaction was not significantly associated with perceived quality of patient-physician communication. While this is in line with previous studies, the relatively small sample size, established patient-physician relationship and overall high CAT scores may have influenced results. REFERENCES: [1] Jongerius C, van den Boorn HG, Callemein T, Boeske NT, Romijn JA, Smets EM, et al. Eye-tracking analyses of physician face gaze patterns in consultations. Scientific Reports. 2021;11(1). doi:10.1038/s41598-021-99068-4. Acknowledgements: NIL. Disclosure of Interests: Angelique Wortelboer: None declared, Floris Wender: None declared, Vanity Steneker: None declared, Mirjam Hegeman: None declared, Demy Gerritsen: None declared, Peter Slijkhuis: None declared, Peter ten Klooster: None declared, Harald E. Vonkeman AbbVie, Novartis, Pfizer, UCB, Johnson and Johnson, Galapagos, Boehringer Ingelheim.