A Review of Digital Age Transformation in the Past 25 Years (1999-2024): Enhancing Patient-Physician Health Communication Model through Patient Empowerment for Effective Shared Decision-making (Preprint)

Abstract

BACKGROUND The evolution of patient-physician communication has changed since the emergence of the World Wide Web. The internet has become an influential tool empowering patients with access to a breadth of health information. While such information has greatly facilitated communication between patients and physicians, it has also led to information overload and the opportunity to propagate misinformation. This could potentially result in suboptimal healthcare outcomes for patients. In the digital age, the integration of health IT, patient empowerment, strong patient-physician relationships, and shared decision-making could be increasingly important for effective health communication. OBJECTIVE This review aimed to identify key factors in health communication and demonstrate how health IT, patient empowerment, shared decision-making, and other essential elements can be utilized to optimize patient-physician healthcare communication and, ultimately, improve patient outcomes. METHODS Databases (PubMed, Web of Science, Scopus, PsycINFO, and IEEE Xplore) were searched using keywords related to patient empowerment, health IT, shared decision-making, and health communication for literature published between 1999 and Feb 2024. The data were limited with modified query using multi-database search strategy. The screening process was assisted by the web-based software tool Rayyan. The review methodology followed established protocols such as the PRISMA checklist to provide a comprehensive summary of existing research. Specifically, we explored key topics and essential elements useful for facilitating effective health communication. Topic modeling, trend analysis, and synthesis were applied to identify and assess topics, trends, evolutions, and gaps in health communication. RESULTS Our results elucidate the evolving dynamics within health communication through a detailed examination of data selection, topic modeling, and trend analysis. From a total of 397 selected studies published over the last 25 years, our analysis identified three topics: (1) Patient-physician Relationship and Shared Decision-making, (2) Patient Empowerment and Education Strategies, and (3) Healthcare Systems and Implementations. Trend analysis further indicated their intricate associations and the impact of health IT on enhancing patient-physician interactions. Our synthesis on the evolving association of health IT with changes in health communication models underscores its pivotal role in shaping patient-centered healthcare frameworks. CONCLUSIONS This review has highlighted the significant contributions of health IT to health communication in the digital age, particularly in promoting shared decision-making and patient empowerment. However, challenges such as usability, privacy concerns, and digital literacy hinder effective integration within health communication models. Additionally, there are gaps in understanding the critical role of trust, both in patient-physician relationships and between humans and machines. Future research should focus on addressing these challenges by refining health IT integration strategies and deepening our understanding of trust dynamics in digital health contexts. Additionally, exploring how emerging technologies like AI might further support these goals could also be valuable.