Patient-centered communication in the era of electronic health records: What does the evidence say?

•EHR use appears to improve capture of patient biomedical information.•EHR use may interfere with nonverbal engagement between patients and physicians.•EHR use may interfere with capture of psychosocial and emotional information.•Patient access and use of EHR may increase engagement and self-management.

ObjectivePatient-physician communication is essential for patient-centered health care. Physicians are concerned that electronic health records (EHRs) negatively affect communication with patients. This study identified a framework for understanding communication functions that influence patient outcomes. We then conducted a systematic review of the literature and organized it within the framework to better understand what is known.MethodA comprehensive search of three databases (CINAHL, Medline, PsycINFO) yielded 41 articles for analysis.ResultsResults indicated that EHR use improves capture and sharing of certain biomedical information. However, it may interfere with collection of psychosocial and emotional information, and therefore may interfere with development of supportive, healing relationships. Patient access to the EHR and messaging functions may improve communication, patient empowerment, engagement, and self-management.ConclusionMore rigorous examination of EHR impacts on communication functions and their influences on patient outcomes is imperative for achieving patient-centered care. By focusing on the role of communication functions on patient outcomes, future EHRs can be developed to facilitate care.Practice implicationsTraining alone is likely to be insufficient to address disruptions to communication processes. Processes must be improved, and EHRs must be developed to capture useful data without interfering with physicians' and patients' abilities to effectively communicate.