title: The use of electronic health records in the exam room and patient satisfaction: a systematic review.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculty of Health Sciences and the Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon. jihad.irani@balamand.edu.lb
authors.forename: Jihad S
authors.initials: JS
authors.lastname: Irani
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Middleton
authors.forename: Ruta
authors.initials: R
authors.lastname: Marfatia
authors.forename: Evelyn T
authors.initials: ET
authors.lastname: Omana
authors.forename: Frank
authors.initials: F
authors.lastname: D'Amico
mesh_terms: D000368:Aged; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010808:Physical Examination; D011320:Primary Health Care