Physicians’ use of digital technologies and the impact on the physician-patient relationship: a Scoping Review (Preprint)

BACKGROUND Physician-patient relationships are important for patients’ health outcomes. The rapid introduction of new technologies has brought complex dimensions into this relationship. OBJECTIVE The main objective of this scoping review is to explore empirical research on the use of digital health technologies and how these affect the physician-patient relationship. METHODS PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used for this scoping review, and 50 studies were included. The data were summarized through a narrative synthesis of the findings. RESULTS We found that physicians perceived digital health software as time-consuming and intrusive. Their lack of trust and concern with the technology resulted in increased inefficiency and workload and in reduced quality of health care delivery. Physicians accepted technology when it resulted in benefits. Patients felt that digital health technology shifted the power balance in their favor. This finding was biased toward young, literate, financially secure patients. The use of digital technology did not reduce the number of patient consultations. Instead, patients who felt more intimate with their physicians would communicate more with them online. This resulted in increased patient loyalty, which in some cases could resemble a customer relationship. CONCLUSIONS The review highlights the understanding that, in the search for better and more effective health care services, patients are seen as consumers, and the focus is on technology that increases patient access to the physician. This process is without regard for the physician and negatively affects them. The physician-patient relationship is strengthened when technology is used to improve mutual understanding, sharing, and communication. If focus is placed on digital technology that can help improve the physician-patient relationship, we believe that better health outcomes and efficiency will be happy by-products. Based on this scoping review, we would like to see further research on technology that can strengthen the relational bond between the physician and patient. CLINICALTRIAL The review protocol is registered at the Center for Open Science’s Open Science Framework.