Studies reported that heath information technology could affect the provider-patient dynamic. When designing the layout of an exam room, the computer monitor placement was shown to affect the interaction between provider and patient [77]. Analysis showed that during an interview, when providers turned away from patients to enter clinical data into the system, a natural conversation breakpoint occurred. Interestingly, the study suggested that this breakpoint allowed the patient time to think about the interview and add detail to it enhancing the transfer of information between patient and provider [37 77]. The study observed physicians showing patients their patient record to reinforce physician comments [77]. Physicians who stopped talking when entering data used more gestures to communicate with patients, than those physicians who continued to talk while entering data [77]. Patients did show any signs of boredom or frustration while physicians attended to the EMR[77]. One study acknowledged that systems occupy space within the exam room and advised implementers to provide appropriate physical space for system [67]. No studies were found that compared how provider-patient interactions in interviews were effected were effected when providers used electronic health information system as opposed to the paper equivalent.