Patients' and Healthcare Professionals' Experiences of Patient-Centeredness in Digital Care: A Qualitative Systematic Review.

TL;DR

A systematic review of 30 qualitative studies found that digital care can enhance patient-centeredness through greater patient autonomy and engagement, but it creates friction in the therapeutic relationship and requires intentional design to maintain continuity of care. Evidence is mixed on whether distance-based care preserves the human dimensions of healthcare.

What the Study Found

Patient-centeredness, the practice of organizing healthcare around patients' needs and preferences rather than institutional convenience, has become a stated priority across healthcare systems. Yet healthcare delivery is shifting rapidly toward digital platforms: telehealth visits, remote monitoring, patient portals, and asynchronous communication. The question becomes urgent: does this transition preserve or undermine patient-centered care? This systematic review synthesized findings from 30 qualitative studies examining how both patients and healthcare professionals experience patient-centeredness in digital care settings.

The research identified seven distinct dimensions along which digital care reshapes the patient-centeredness equation. The first three are generally favorable. Digital platforms can enhance patient ownership of their condition by giving patients direct access to their health data, educational resources, and asynchronous communication channels. This shifts the dynamic from patients passively receiving information to actively engaging with it on their own timeline. The studies found that patients appreciated this structure, particularly those managing chronic conditions who could review information without time pressure. Second, when designed well, digital care systems can support patients' sense of safety and continuity. This happens through consistent digital touchpoints, automated reminders, and the creation of a persistent record that patients control. However, this benefit appeared fragile, dependent on technical reliability and organizational follow-through. Third, digital care can rebuild the patient-professional relationship by redefining roles: professionals increasingly function as experts who enable patient autonomy rather than authorities who make unilateral decisions. Both patients and professionals reported this shift as potentially more collaborative, though it required new skills from both parties.

The remaining themes reveal genuine tensions. Digital care influences equality in ways that cut both directions. Access benefits appeared unevenly distributed: patients with digital literacy, reliable internet, and comfort with technology gained advantages, while others faced barriers that excluded them from the supposed benefits of the system. Patients and professionals reported that increasing professional versatility (learning new platforms, adapting communication styles, managing fragmented workflows across tools) was necessary but often under-resourced in practice. Most critically, physical distance and mediation through technology created observable strain on the therapeutic relationship. While some participants reported that asynchronous communication reduced pressure and allowed more thoughtful exchanges, others felt the absence of physical presence eroded trust and reduced opportunities for nonverbal communication that professionals traditionally use to assess safety, build rapport, and adjust their approach in real time.

What This Means for You

If you're navigating digital care platforms, the evidence suggests several practical considerations. First, patient autonomy and access to your own data are genuine advantages of digital systems: use them. Review your results, access educational materials, and participate actively in your care plan. Second, pay attention to continuity: whether you're receiving consistent follow-up, whether your concerns are being tracked over time, and whether your provider is demonstrating knowledge of your previous interactions. A system that simply replaces in-person visits with isolated video calls without integration into ongoing care loses this benefit. Third, recognize that digital care may obscure safety signals. If you feel your condition is being managed primarily through data rather than through a provider who knows how you actually function day-to-day, escalate to in-person assessment. For chronic conditions that benefit from distributed management (asynchronous support, self-monitoring, flexible scheduling), digital care can work well. For acute concerns, initial assessments, or situations where nonverbal communication matters (psychiatry, trauma-informed care, complex presentations), hybrid or in-person approaches remain preferable based on current evidence.

If you're a healthcare provider or organization implementing digital care, this review suggests that simply moving traditional care online without redesign creates the worst outcomes. The systems that worked were those that intentionally restructured the patient-professional interaction around digital affordances rather than trying to replicate in-person dynamics through a screen. This required training, time investment, and explicit attention to patients who experienced barriers to digital adoption.

Study Details

Sources

Scandinavan Journal of Caring Sciences - Patient-Centeredness in Digital Care PubMed: 42216667

Joanna Briggs Institute methodology for qualitative systematic reviews was used to structure the synthesis, ensuring consistency in how qualitative data were extracted, assessed for quality, and integrated into themes.