Impact of Electronic Health Services on Patient Satisfaction in Primary Care: A Systematic Review

Electronic health services (EHS) integrate telecommunications, electronic patient data, and computerized medical knowledge. The growing implementation of EHS in primary care underscores the necessity to comprehend its effect on patient satisfaction and highlight areas for improvement. This systematic review study aims to evaluate the impact of EHS on patient experiences in a primary care setting. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A series of searches was conducted until November 2024 in the following databases: PubMed, Science Direct, and the Cochrane Library. Two independent reviewers extracted the data from eligible studies using a standardized extraction sheet. The inclusion criteria encompassed randomized controlled trials (RCTs), observational studies involving adult patients who employed EHS interventions, including electronic health records (EHRs), telemedicine, patient portals, or online appointment systems. The Cochrane Risk-of-Bias tool and Newcastle-Ottawa Scale have been used to assess the risk of bias of included studies. Ten studies involving participants ranging from 52 to 203,903 were included. It was seen that increased provider focus on EHR use, including prolonged silence and gaze at the screen, negatively influenced patient-centered communication and involvement. Nonetheless, in a variety of contexts, the use of EMRs enhanced patient satisfaction with clinical consultations, services, and overall healthcare experiences. Effective prescription and referral procedures, improved communication, and reduced wait times were among the improvements. Patient portals and EHS demonstrated increased satisfaction with healthcare quality, particularly among patients with long-term provider relationships. Socioeconomic factors, such as age, education, and income, influenced preferences for communication modes like portals, phone calls, and text messages. This systematic review demonstrates the transformative potential of EHS in enhancing patient satisfaction within primary care. EHR/electronic medical record (EMR) systems were associated with better service efficiency and patient satisfaction, despite challenges in balancing provider interaction with technology use. By improving access, communication, and efficiency, EHS can play a pivotal role in advancing patient-centered care. However, challenges related to provider communication, interoperability, and health equity highlight the need for thoughtful implementation and continuous refinement of these tools.