Mesko Bertalan, deBronkart Dave, Dhunnoo Pranavsingh, Arvai Nora, Katonai Gellért, Riggare Sara
The Medical Futurist Institute, Budapest, Hungary.
e-Patient Dave, LLC, Nashua, NH, United States.
J Med Internet Res. 2025 May 1;27:e60562. doi: 10.2196/60562.
In the 21st century, health care has been going through a paradigm shift called digital health. Due to major advances and breakthroughs in information technologies, most recently artificial intelligence, the patriarchy of the doctor-patient relationship has started evolving toward an equal-level partnership with initial signs of patient autonomy. Being an underused resource for centuries, patients have started to contribute to their care with information, data, insights, preferences, and knowledge. It is important to recognize that at its core, digital health represents a cultural transformation, where patient empowerment has likely played the most significant role in driving these changes. This viewpoint paper traces the remarkable journey of patient empowerment from its nascent stages to its current prominence in shaping health care's future. Spanning over two and a half decades, we explore pivotal moments and technological advancements that have revolutionized the patient's role in health care. We dive into a few historical milestones, mainly in the United States, that have challenged and redefined societal norms around agency, drawing parallels between patient empowerment and broader social movements, such as the women's suffrage and civil rights movements. Through these lenses, we argue that patient empowerment is not solely a function of knowledge or technology but requires a fundamental shift in societal attitudes, policies, health care culture, and practices. As we look to the future, we posit that the continued empowerment of patients will play a pivotal role in the development of more equitable, effective, and personalized health care systems. This paper calls for an ongoing commitment to fostering environments that support patient agency, access to resources, and the realization of patient potential in navigating and contributing to their health outcomes with an emphasis on the emerging significance of patient design.
在21世纪，医疗保健正在经历一场被称为数字健康的范式转变。由于信息技术，尤其是最近人工智能的重大进展和突破，医患关系的家长制开始朝着平等的伙伴关系发展，出现了患者自主的初步迹象。几个世纪以来一直未得到充分利用的患者，开始通过信息、数据、见解、偏好和知识为自己的护理做出贡献。必须认识到，数字健康的核心是一种文化变革，患者赋权在推动这些变革中可能发挥了最重要的作用。这篇观点论文追溯了患者赋权从萌芽阶段到其在塑造医疗保健未来中目前的突出地位的非凡历程。跨越二十五年多的时间，我们探索了彻底改变患者在医疗保健中角色的关键时刻和技术进步。我们深入研究了一些主要发生在美国的历史里程碑，这些里程碑挑战并重新定义了围绕能动性的社会规范，将患者赋权与更广泛的社会运动，如妇女选举权运动和民权运动进行了比较。通过这些视角，我们认为患者赋权不仅仅是知识或技术的作用，而是需要社会态度、政策、医疗保健文化和实践的根本转变。展望未来，我们认为患者的持续赋权将在更公平、有效和个性化的医疗保健系统的发展中发挥关键作用。本文呼吁持续致力于营造支持患者能动性、获取资源以及实现患者在掌控自身健康结果并为之做出贡献方面的潜力的环境，同时强调患者设计的新重要性。
