Abstract:

Digital tools are now part of everyday primary care, yet their uptake is far from uniform. This narrative review asks what drives and what blocks the adoption of health information systems (HIS) in primary care networks. It draws on full-text studies that passed screening for relevance, and it discusses a representative set of 47 of them. These include systematic and scoping reviews, hybrid effectiveness and implementation trials, surveys of providers and patients, and qualitative evaluations. The findings are grouped into five areas. The first is telehealth and virtual consultations. The second is electronic health records, clinical decision support, and information exchange. The third is patient portals and mobile health. The fourth is the factors that shape uptake among providers, patients, and organisations. The fifth is the frameworks that explain whether systems last. The COVID-19 pandemic was the main accelerant across all five areas. The main barriers were also consistent. They include disrupted workflows, weak interoperability, uncertain funding, limited digital skills, and unequal access to devices and connectivity. Adoption is therefore a social and technical task, not a purely technical one. The review argues that equity, provider engagement, and system integration decide whether HIS help the patients who need them most.