Digital Records and E-Check-Ups Win Strong Patient Support at a Bangladeshi Hospital

Patients at one of Bangladesh's largest tertiary care hospitals are voicing strong support for electronic health tools, even as they report deep dissatisfaction with the way doctors currently communicate with them. A descriptive cross-sectional study conducted at Dhaka Medical College Hospital between December 2024 and February 2025 surveyed 208 adult patients drawn systematically from four outpatient departments: Medicine, Eye, Ear, Nose, and Throat (ENT), and Orthopedic Surgery. The findings, published in BMC Health Services Research, paint a picture of a health system in which basic record-keeping is almost entirely absent from electronic systems, yet patients are overwhelmingly ready to embrace digital alternatives.

The scale of the documentation gap was striking. According to the patients' statements, reported unanimously across the sample, detailed clinical histories, investigation records, and follow-up histories were not documented electronically at all. Communication failures extended well beyond record-keeping.

Nearly half of the respondents, 47.1 percent, said they felt ignored because of the attitude of the physician's secretary, pointing to administrative staff as a significant barrier between patients and their doctors. Dissatisfaction with physicians themselves was also substantial: 39.9 percent of patients disagreed that their physicians were sympathetic, and 45.7 percent strongly disagreed that doctors listened carefully to them. These figures suggest that the problems patients face are not only logistical but relational, rooted in how much attention and empathy they perceive during consultations.

Logistical barriers were equally prominent in the survey data. Missed follow-up appointments were reported by 78.8 percent of participants, and the reasons behind those missed visits were varied. The demographic profile of the surveyed patients helps explain why these barriers weigh so heavily.

The median participant age was 36 years, 58.2 percent were male, and 68.3 percent lived in rural areas. Educational attainment was low across the sample: 36.5 percent of participants could only sign their names, and 33.7 percent reported very low income. Despite these constraints, patients expressed remarkable enthusiasm for the e-health measures proposed to them.

71.6 percent strongly agreed that secure messaging could facilitate follow-up schedules, and an even larger share, 81.3 percent, strongly agreed that e-check-ups could improve healthcare access. The study's statistical analysis revealed patterns in who embraced these recommendations most readily. Communication barrier scores differed significantly across demographic groups, with p values below 0.001.

In an unexpected reversal, males and urban residents reported greater communication barriers than females and rural participants. Yet when it came to acceptance of e-health recommendations, males and urban residents showed higher acceptance than females, while rural participants were less accepting, a difference that reached statistical significance at p = 0.005. Acceptance of e-health recommendations did not differ significantly between males and females overall, with a p value of 0.519.

Occupation emerged as another powerful predictor of attitudes toward digital health tools. Businesspersons and day labourers showed the strongest acceptance of the e-health recommendations, a difference significant at p < 0.001. In the study's multiple regression model, occupation and residence remained statistically significant at p < 0.01 alongside the measured communication barriers and e-health recommendations, indicating that these socioeconomic factors carry independent weight in shaping patient responses rather than simply reflecting other characteristics.

The authors conclude that communication barriers are firmly present in the outpatient departments of Bangladesh's tertiary care hospitals, particularly concerning physician empathy, careful listening, and administrative weaknesses. Their findings position residential context and occupational status as significant influences on how patients respond to proposed e-health solutions. As an observational, single-centre study of 208 patients using an interviewer-administered Bangla questionnaire, the research captures patient perceptions at one institution during a three-month window rather than measuring the actual performance of any deployed technology.

Nevertheless, the study offers a clear signal for health planners in Bangladesh and comparable settings: patients are not waiting to be convinced about digital health.

Subject of Research: Patient-reported communication barriers and acceptance of e-health technology at a Bangladeshi tertiary care hospital

Article Title: E-Health technology as a catalyst for enhancing clinical communication: observational insights into overcoming doctor–patient barriers

Article References: Latif, W. B., Yasin, I. M., Amin, M. B., Nusrat, F., Rahaman, M. A., & Oláh, J. (2026). E-Health technology as a catalyst for enhancing clinical communication: observational insights into overcoming doctor–patient barriers. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15419-9

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15419-9

Keywords: e-health, doctor-patient communication, Bangladesh, Dhaka Medical College Hospital, cross-sectional study, electronic health records, follow-up adherence, healthcare access, tertiary care, patient satisfaction, telemedicine, health services research