Computers in the consulting room: a case study of clinician and patient perspectives.

Few clinicians in the United States use computers during patient encounters and many still worry that computers will depersonalize their interactions with patients. This case study describes patient and clinician reactions to a computer-based health appraisal system. Findings showed no difference in any aspect of patient satisfaction between computer and non-computer groups. Use of a computer in the consulting room neither depersonalized nor enhanced patient satisfaction. Clinicians (in this case, nurse practitioners and physician assistants) were willing to use the system, which they perceived as having benefits for patient care, but were concerned about the increased time required for exams, effort required to learn the system while still interacting appropriately with the patient, increased monitoring of their performance, and other organizational issues. Clinicians who used the system showed a higher tolerance for uncertainty and communicated more frequently with each other and with others throughout the department. Implementation was slowed by the need to demonstrate the monetary value of the system.