Aboumoussa Tagried H, Hassan Amna, Almarzooqi Eman Ali
Department of Family Medicine, Dubai Health, Dubai, ARE.
Cureus. 2025 May 12;17(5):e83949. doi: 10.7759/cureus.83949. eCollection 2025 May.
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.
电子健康服务（EHS）整合了电信、电子患者数据和计算机化医学知识。EHS在初级保健中的日益普及凸显了理解其对患者满意度的影响并突出改进领域的必要性。这项系统评价研究旨在评估EHS对初级保健环境中患者体验的影响。本评价按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行。截至2024年11月，在以下数据库中进行了一系列检索：PubMed、Science Direct和Cochrane图书馆。两名独立评审员使用标准化提取表从符合条件的研究中提取数据。纳入标准包括随机对照试验（RCT）、涉及使用EHS干预措施（包括电子健康记录（EHR）、远程医疗、患者门户网站或在线预约系统）的成年患者的观察性研究。Cochrane偏倚风险工具和纽卡斯尔-渥太华量表已用于评估纳入研究的偏倚风险。纳入了10项研究，参与者人数从52人到203,903人不等。可以看出，提供者对EHR使用的关注度增加，包括长时间沉默和盯着屏幕，对以患者为中心的沟通和参与产生了负面影响。尽管如此，在各种情况下，EMR的使用提高了患者对临床咨询、服务和整体医疗体验的满意度。改进措施包括有效的处方和转诊程序、改善沟通以及减少等待时间。患者门户网站和EHS显示出对医疗质量的满意度提高，特别是在与提供者建立长期关系的患者中。年龄、教育程度和收入等社会经济因素影响了对门户网站、电话和短信等沟通方式的偏好。这项系统评价证明了EHS在提高初级保健患者满意度方面的变革潜力。EHR/电子病历（EMR）系统与更好的服务效率和患者满意度相关，尽管在平衡提供者与技术使用之间的互动方面存在挑战。通过改善获取、沟通和效率，EHS可以在推进以患者为中心的护理方面发挥关键作用。然而，与提供者沟通、互操作性和健康公平性相关的挑战凸显了对这些工具进行深思熟虑的实施和持续改进的必要性。
