• Onur Asan, Kenneth Kushner, and Enid Montague.
• Center for Patient Care and Outcomes Research, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin.
• Fam Med. 2015 Oct 1; 47 (9): 722-6.

ObjectivesOur objective was to explore and compare residents' interaction with electronic health records during primary care encounters and whether those behaviors differ by residency year level.MethodsA field study was conducted in which 38 patient visits with 12 family medicine resident physicians were observed and video recorded in two primary care clinics under the umbrella of a university-based department of family medicine. Videos were then coded for gaze behaviors in which patients' and physicians' gazes at electronic health records and at each other were coded using a pre-established objective coding scheme.ResultsThird-year residents spent the greatest percentage of visit time looking at EHR screens when compared to first- and second-year residents. Third-year residents also spent significantly more time typing or inputting information into the records during the clinical visit when compared to first- and second-year residents.ConclusionsThis study illustrated that patterns for using the EHR and interacting with patients may change over time for residents. These changes may be due to increased EHR proficiency or increased workload that incentivizes using the EHR to retrieve information and to complete charting in front of the patient.

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