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Qualitative Health Research, Vol. 16, No. 3, 353-376 (2006)
DOI: 10.1177/1049732305282396

What Does the Use of a Computerized Checklist Mean for Patient-Centered Care? The Example of a Routine Diabetes Review

Penny Rhodes

Mark Langdon

Emma Rowley

John Wright

Bradford Teaching Hospitals NHS Trust, United Kingdom.

Neil Small

School of Health Studies, University of Bradford, United Kingdom.

The authors examine the interaction between nurses and patients with type 2 diabetes during routine consultations in primary care settings in the United Kingdom. Through preconsultation interviews, the authors identified the patients’ expectations. The article draws on videotaped consultations with 25 patients with type 2 diabetes. Using conversation analysis, the authors examine the use of a rigid agenda, imposed via a computerized checklist, and consider how far this is able to suppress the patient's agenda. They consider the potential impact for the patient and the factors that might encourage the clinician, and the nurse specifically, to adopt a narrowly task-based approach to the consultation. They identify two potentially conflicting strands within contemporary diabetes care, patient-centered practice and an emphasis on biomedical audit, and suggest that achievement of the former might be compromised by the demands of the latter.

Key Words: diabetes mellitus • patient-centered medicine • nurse-patient communication • electronic medical records


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P. Rhodes, N. Small, E. Rowley, M. Langdon, S. Ariss, and J. Wright
Electronic Medical Records in Diabetes Consultations: Participants' Gaze as an Interactional Resource
Qual Health Res, September 1, 2008; 18(9): 1247 - 1263.
[Abstract] [PDF]