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

Abstract

Effective doctor–patient communication is essential for building trust and improving health care outcomes. The specific dynamics of communication within E-Health are limited, while it is known to enhance satisfaction and treatment adherence. This study aimed to assess the patients’ response on recommended E-Health technology to remove the communication barriers between doctors and patients. A descriptive cross-sectional study was conducted among 208 adult patients at Dhaka Medical College Hospital between December 2024 and February 2025. Participants were systematically selected from four outpatient departments of Medicine, Eye, Ear, Nose, and Throat (ENT), and Orthopedic Surgery. An interviewer-administered Bangla questionnaire was used to assess communication barriers and patients’ response on recommended E-Health technology. Data were analyzed using SPSS version 25 with descriptive statistics, Kruskal–Wallis tests, and multiple regression analyses. The median participant age was 36 years; 58.2% were male, and 68.3% lived in rural areas. A substantial proportion (36.5%) could only sign their names, and 33.7% reported very low income. Missed follow-ups (78.8%) were primarily due to distance (40.1%), followed by transport costs (17.3%) and long waiting times (41.8%). Nearly half of the respondents (47.1%) felt ignored due to the physician's secretary's attitude. According to the patients' statement (100.0%), detailed clinical history, investigation records, and follow-up history were not documented electronically. Dissatisfaction with communication was high: 39.9% disagreed that physicians were sympathetic, and 45.7% strongly disagreed that doctors listened carefully. Nevertheless, strong support was reported for E-Health recommendations; 71.6% strongly agreed that secure messaging could facilitate follow-up schedules, and 81.3% strongly agreed that e-check-ups could improve healthcare access. Significant differences were observed in communication barrier scores across demographics (p < 0.001), with males and urban residents (p = 0.002) reporting greater barriers than females and rural participants, for E-Health recommendations, males and urban residents accepted more than females (p = 0.519), and rural participants (p = 0.005), respectively. Businesspersons and day labourers showed the strongest acceptance (p < 0.001). Occupation and residence were also found to be statistically significant (p<0.01) in a multiple regression model alongside communication barriers and E-Health recommendations. Communication barriers exist in Bangladesh's tertiary care hospital outpatient departments, particularly regarding physician empathy, careful listening, and administrative weaknesses. Residential context and occupational status significantly influenced patients' acceptance of E-Health recommendations.