Reimagining Patient Care in the Digital Health Era: A Systematic Literature Review and Analytical Synthesis
Keywords:
digital health; patient-centred care; telemedicine; artificial intelligence; electronic health records; health equity; health governance; systematic reviewAbstract
Background. Telemedicine, electronic health records (EHRs), mobile and wearable devices, and artificial intelligence (AI) are widely presented as instruments for transforming patient care. The evidence for them is fragmented across technologies, disciplines and settings.
Objective. To synthesise evidence on how digital health reshapes access, clinical decision-making, clinician workload, patient engagement, governance and equity, and to derive an integrative framework for reimagining patient care.
Methods. A systematic literature review reported in line with PRISMA 2020, combined with an analytical synthesis. Two evidence streams were screened. The first was an author-supplied corpus of 117 records, of which 27 were retained. The second was a purposively assembled external stream of 47 sources. Data were extracted, tabulated and analysed thematically across seven themes and six stakeholder perspectives.
Results. Seventy-four sources were synthesised. In a direct-observation study of US ambulatory practice, physicians spent 49.2% of the office day on EHR and desk work against 27.0% on face-to-face care. In same-sample imaging comparisons, deep-learning tools reached a pooled sensitivity of 87.0% against 86.4% for clinicians. A widely deployed sepsis-prediction model, however, achieved an external-validation AUC of only 0.63 and missed 67% of sepsis cases. Globally, 81% of urban residents but only 50% of rural residents used the Internet in 2023, and internet use was 93% in high-income countries against 27% in low-income countries. India's national digital mission had created 79.71 crore health accounts by July 2025.
Conclusions. Digital tools improve care when they are embedded in redesigned workflows, validated locally, governed transparently and deployed with equity safeguards. Otherwise they shift burden or reproduce disparities. We propose a five-layer Reimagined Care Framework (Access, Intelligence, Workflow, Trust, Learning) aligned with the Quintuple Aim.
