The Digitally Enabled Care Framework: Leveraging Technology to Enhance the Physician–Patient Relationship

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Clinical medicine is transitioning from in-person care to digitally enabled care (DEC), a framework in which consumer-behavior research and technology are used to fully support patients in their care journey. The Covid-19 pandemic saw a rapid transformation from in-person to virtual care models, including televisiting and email messaging, but the urgency of the pandemic response limited the full development of these care models. The result has been a workflow crisis for physicians, who are juggling packed schedules with increased electronic documentation and an abundance of messages from patients in their inboxes. In this paper, the authors describe the features necessary for the successful implementation of a fully realized DEC framework. This framework has the potential to improve the value of health services for patients through DEC and extends beyond virtual visits, envisioning a comprehensive set of patient-directed services that are enabled by technology. The DEC framework considers the previsit, visit, and postvisit periods as having discrete sets of objectives and opportunities for the development and integration of new digital tools and strategies to help patients achieve their goals. In the previsit period, there are opportunities to foster active preparation, to improve condition-specific health literacy, and to reduce stress. During visits, there are opportunities to build engagement, reach agreement on care plans, and coordinate care in partnership with the patient. In the postvisit period, there are opportunities to reinforce the decisions reached during a visit, build patient engagement and activation, and facilitate the logistics of care. The authors discuss how the payment model for clinical services must evolve to support this new care paradigm.