• Elaine C Khoong, Roy Cherian, George Y Matta, Courtney R Lyles, Dean Schillinger, and Neda Ratanawongsa.
• Division of General Internal Medicine, Department of Medicine at Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, United States.
• J. Med. Internet Res. 2019 May 22; 21 (5): e13131.

BackgroundSafety-net systems serve patients with limited health literacy and limited English proficiency (LEP) who face communication barriers. However, little is known about how diverse safety-net patients feel about increasing clinician electronic health record (EHR) use.ObjectiveThe aim of this study was to better understand how safety-net patients, including those with LEP, view clinician EHR use.MethodsWe conducted focus groups in English, Spanish, and Cantonese (N=37) to elicit patient perspectives on how clinicians use EHRs during clinic visits. Using a grounded theory approach, we coded transcripts to identify key themes.ResultsAcross multiple language groups, participants accepted multitasking and silent clinician EHR use if focused on their care. However, participants desired more screen share and eye contact, especially when demonstrating physical concerns. All participants, including LEP participants, wanted clinicians to include them in EHR use.ConclusionsLinguistically diverse patients accept the value of EHR use during outpatient visits but desire more eye contact, verbal warnings before EHR use, and screen-sharing. Safety-net health systems should support clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients.©Elaine C Khoong, Roy Cherian, George Y Matta, Courtney R Lyles, Dean Schillinger, Neda Ratanawongsa. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.05.2019.

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