The use of electronic health records in the studies reviewed. Among the selected newspaper articles, four issues examined concerned the use of an electronic device during the visit. The level of use was reviewed in two selected studies because one involved high computer use and the other low use. In the high-usage study, the physician was observed using the computer for more than 40% of the visit. The time at which data entry occurred varied between the two studies. Sometimes the insertion was carried out in the presence of the patient, other times it was carried out after the conclusion of the patient's visit. In one case, the information collected by the doctor was transcribed by a staff member at the doctor's office. Studies have shown that physician data entry was seen as a cost-saving measure for the medical practice (Booth, Robinson, Kohannejad, 2004)(Ventres, Kooienga, Marlin, Vuckovic, Stewart, 2005)( Margalit et al, 2006)( Ventres et al, 2006). One of the included studies found that computers were also used by the doctor to manage the pace and direction of communication during the visit. This has been done in several ways. The computer was used by the doctor in one of the included studies to interrupt communication with the patient in order to collect his thoughts on a particular topic (Ventres et al, 2005). In some studies, when the use of the EMR was extremely new, the computerized system was used to reinforce important points and give credence to claims (Als, 1997). None of the articles selected for this review had similar findings. This may be because attitudes towards computer use have changed since the time of this previous study. The effects of EMR use on doctor-patient communication...... half of the paper ......g used as a tool for the doctor to communicate with the patient instead of as a device to create distance between them ( Ventres et al, 2006) (Frankel et al, 2005). A surprising finding was that physicians surveyed about EMR use did not believe that doctor-patient communication would be affected by using mobile computing options to view the EMR instead of desktop computers (Ventres et al, 2006) (Frankel et al, 2005) (Bullard, Meurer, Colman, Holroyd, Rowe, 2004). Doctors who used the electronic medical record as a checklist and verified information with the patient as they recorded it were more likely to be considered good communicators by their patients. One of the articles reviewed described the development of a transcription methodology to enable the clinician to make more efficient use of time with the patient (Gibson, Jenkings, Wilson, Purves, 2005).