The Use of Electronic Health Records in the Exam Room and Patient Satisfaction: A Systematic Review

BACKGROUND: Physicians may hesitate to implement electronic health record (EHR) systems because they fear a decrease in patient satisfaction. We conducted a systematic review to determine whether physician EHR use in the patient room affects patient satisfaction. METHODS: We searched the literature using MEDLINE (Ovid), EMBASE, CINAHL, Cochrane Library, PsycINFO, Proceedings First, and ProQuest Digital Dissertations. Our inclusion criteria were a description of physician EHR use in the examination room, EHR use in an outpatient setting, setting in the United States, publication year no earlier than 2000, and measurement of patient satisfaction. We included both qualitative and quantitative research. We included 7 articles in the final analysis: 3 cross-sectional, and 4 pre-design and post-design. RESULTS: Several studies had methodological concerns. Six studies found that physician EHR use had either a positive or neutral effect on patient satisfaction. One study found a negative effect on the physicians' perception of patient satisfaction. The reported statistical results from these studies were not homogenous enough for meta-analysis. CONCLUSION: Studies examining physician EHR use have found mostly neutral or positive effects on patient satisfaction, but primary care researchers need to conduct further research for a more definitive answer.