Enter Health Information Technology: Expanding Theories of the Doctor–Patient Relationship for the Twenty-First Century Health Care Delivery System

Abstract

Since the publication of the Institute of Medicine’s landmark report To Err is Human (1999), health care industry leaders and policymakers have emphasized the central importance of improving the quality of care and reducing the number of medical errors. More recently, various health information technologies (HIT) have been identified by many as essential quality improvement tools. Indeed, over the past two decades, HIT has expanded dramatically. While originally viewed as a hospital-based resource, HIT is increasingly entering the exam rooms of both primary care and specialty providers. The enthusiasm for HIT is undeniable, yet the impact of the expanded use of HIT on the care delivery process, especially the impact on the doctor–patient relationship, is still unclear. Available research highlights an emerging paradox. On the one hand, the strength and quality of the doctor–patient relationship have been shown to have important implications for understanding both the quality and outcome of care provided. At the same time, a growing body of literature suggests that physicians’ utilization of HIT during consultations may be changing the nature of their relationships with patients. This chapter reviews the literature on the expansion of HIT in primary care settings and explores the sociological implications of this emerging trend for the social dynamics of doctor–patient interaction.