THE IMPACT OF DIGITALIZATION AND ARTIFICIAL INTELLIGENCE ON THE PATIENT–FAMILY–PHYSICIAN RELATIONSHIP: A SYSTEMATIC REVIEW

Abstract

Background: The integration of digital technologies and artificial intelligence (AI) is reshaping the foundations of trust and communication within the patient–family–physician relationship. Understanding these changes is critical to maintaining relational quality in digitally mediated healthcare.

Objective: This systematic review aims to synthesize evidence on how digitalization and AI influence trust, communication, satisfaction, and engagement between patients, families, and physicians.

Methods: Following PRISMA 2020 guidelines, a comprehensive search of PubMed, Scopus, Web of Science, Embase, and Google Scholar was conducted for English-language studies published between 2020 and 2025. Empirical studies evaluating telemedicine, AI-assisted systems, digital family engagement, and eHealth literacy in primary or secondary care were included. Data were extracted on study characteristics, interventions, outcomes, and relational effects. Quality assessment employed the Newcastle–Ottawa Scale for quantitative studies and the CASP checklist for qualitative designs. Narrative synthesis was applied due to heterogeneity in study designs and outcome measures.

Results: Ten studies met inclusion criteria. Telemedicine and eHealth literacy generally improved satisfaction and accessibility, particularly among younger and digitally literate patients. AI-assisted decision-making enhanced technical efficiency but sometimes reduced perceived physician competence or interpersonal trust, moderated by baseline technology confidence. Digital family engagement and health apps facilitated empowerment and relational dialogue but highlighted disparities in digital literacy. Psychological empowerment emerged as a key mediator of satisfaction and trust. Cultural, gender, and age-related differences influenced adoption and relational perceptions.

Conclusion: Digitalization and AI are reshaping relational dynamics in healthcare. Strategies integrating human empathy, technological literacy, and ethical transparency are essential to preserve trust, satisfaction, and family engagement in the evolving digital ecosystem.