BACKGROUND: The growing demand for primary health care necessitates more efficient use of resources. Digital health solutions, such as online platforms for patient-provider communication, are seen as promising tools to enhance service delivery efficiency. However, adoption in Swedish primary health care remains limited. Understanding the factors that influence patients' choices regarding digital health services is essential to realizing potential efficiency gains as these services scale. OBJECTIVE: This study aims to explore patients' experiences using the digital platform 1177-direkt for chat-based consultations in Swedish primary health care, with a focus on understanding their concerns when accessing services digitally. METHODS: We conducted 23 semistructured interviews between March 2024 and December 2024 with patients from 3 health care regions in southeastern Sweden, focusing on their use of 1177-direkt to contact their primary health care center (PHCC). Thematic analysis was performed using an inductive approach. Additionally, a sentiment analysis was conducted, categorizing statements as positive, negative, or neutral. The unified theory of acceptance and use of technology (UTAUT) framework was applied to interpret the findings, given its widespread use in predicting technology acceptance in consumer contexts. RESULTS: Three main themes emerged: (1) digital technology's impact on access to services, (2) perceived digital platform functionality and usability, and (3) shifts in the patient-provider dynamic through digital communication. In addition, there were 9 subthemes. Patients expected quicker access to their PHCC via the platform, but this was often offset by delays later in the process. Most found the platform easy to navigate, though uncertainty remained about appropriate use cases. Concerns were raised about the automated symptom checker, which was seen as either too broad or too narrow and often failed to interpret or contextualize patient input-leaving users to draw their own conclusions. Patients, especially returning users, expressed a desire for more personalized interactions and perceived a tension between digital contact and relational continuity. Sentiment analysis revealed that infrequent users of health care responded more negatively than frequent users. CONCLUSIONS: This study highlights a wide range of user experiences, with most participants encountering both benefits and challenges. The sentiment analysis offered novel insights not commonly reported in similar research. To enhance the efficiency of digital platforms in primary care, key areas to address include ease of access, time-saving potential, and a more personalized user experience. Neglecting the needs of returning patients may hinder broader adoption of digital primary care services.