The Electronic Health Record System May Destroy the Empathy

Aims: The use of the electronic health record systems has been developed in the health system, but it is still not known whether empathy is created in the visit of the patient despite this system. Therefore, this study was designed with the purpose of comparing patients’ perceptions about physicians’ empathy after the patient viewed standardized and scripted video vignettes of two physicians one uses the electronic health record system and the other one consults the patient without the electronic health record systems. Material and Methods: This is a double-blind, crossed-over quasi-experimental, only with post-test study that was held in Hematology-oncology ward and clinics of Omid hospital, in Isfahan, Iran.  120 patients selected using convenience sampling method and were randomized into two groups (each 60 patients) in a crossover study plan. In group 1, the first arm viewed standard scripted video of visit between standard patient and physician with using the electronic health record systems, and the second arm viewed standard scripted video of the visit without electronic health record systems, and in group 2 vice versa.  The perception of the patients about empathy between standard patient and physician in two videos were gathered by the Jefferson Scale of Patient Perceptions of Physician Empathy. The data was analyzed by the SAS (Institute Inc) version 9.4 using Chi-square test or the Fisher test, Wilcoxon rank-sum test, and generalized estimation equation. Finding: There were no significant differences between demography and clinical characteristics between two groups. The video of visit without electronic health record system resulted in significantly better empathy scores compared with the visit with electronic health record system in each arm of the participants (P<0.05).  Conclusion: In this study; Cancer patients perceived more empathy in physicians who did not use the EHR during visits and considered this strategy more empathetic. It is recommended that doctors pay attention to empathy in the visit with electronic health record system.