| Aims and Background--The sound of typing is no longer unfamiliar to most patients who visit their primary care physicians as computers have become ubiquitous in patients’ rooms. While physicians in the United States are trained to use medical software they are not trained on the new subtleties of medical interviewing with a computer as a partner in the room. This project provides a description of the dynamics of medical interviews that involve using a computer while interacting with patients.Methods--Patients are recruited from a local primary care center. Utilizing rooms equipped with audiovisual recording materials, encounters between patients and their physicians are videotaped and then transcribed. Conversation Analysis [1,2,3] provide much of the foundation for the analysis.Results--This study shows that the human computer interface in doctors’ consultations is of critical importance. Patients’ and doctors’ turn taking is guided by attempts to co-ordinate with the computers’ needs at the expense of conversational coherence. The computer shapes the design of the interview and affects conversation flow and turn-taking. The computer distracts the physician from eye contact, body language and non-verbal cues that make communication effective. Summary--The description of the dynamics of the medical interviews enabled through a computer elucidates the impact of using computers in general practice. We provide a model for the doctor-patient-computer interface to improve the medical interview while continuing to take advantage of the intelligence offered by information technology. |
