“Patient-centered care” and “information technology” are both fast-growing trends in outpatient care delivery. Yet, studies on how to optimize the physical environments considering these fast-growing trends are scares. This study focuses on the design of the physical exam room environment to support patient-physician interactions and physician-computer interactions. We conducted a secondary analysis on the role of exam room design on physicians’ musculoskeletal burden and patient engagement. We analyzed video data from 22 patient visits in 5 exam rooms with 3 primary care physicians. Our analysis showed that physicians’ repetitive upper body motions and patient eye contact duration changed by based on the placement of the EHR and patient exam table. From the three room configurations resulting in a narrow angle, moderate angle, and a wide angle between the EHR and the patient exam table, the physician who delivered care in the room with moderate angle had longest patient eye contact and lowest number of upper body repetitive motions. The finding, however, did not reach statistical significance potentially due to the small sample size or other limitations. We recommend future research with a larger sample size and randomization of physician, room assignment. Design recommendations on the placement of EHR in an exam room, the use of proper furniture, and system engineering functional requirements for consideration in design and renovation are provided.