From Internet to Artificial Intelligence (Al) Bots: Symbiotic Evolutions of Digital Technologies and e-Patients

This paper will view the rise of the e-patient, who is "equipped, enabled, empowered, and engaged" through the lens of the evolution of successive digital technology innovations, each building on its predecessors, creating new tools for patient empowerment. We begin with the dawn of the web and the proliferation of health websites and discuss the use of digital communication tools. We then discuss the adoption of electronic health records, which enabled the rise of patient portals. This digitization of health data, along with the rapid adoption of mobile internet access and the proliferation of health-related smartphone apps, in turn, provided a platform for patients to coproduce health care by contributing their own health data to their self-care and health care. The exchange of health information between patients and providers has also been facilitated by telehealth or telemedicine technology, which enables direct care delivery. The use of social networks in health, in use since the early days of the web, has expanded since COVID-19, when public health authorities worldwide, as well as patients, sought the use of social media channels to get connected and share information. Most recently, artificial intelligence and large language models have emerged with yet untapped potential to provide patients with the information that could improve their understanding of their conditions and treatment options. We conclude that innovations in digital health technology have symbiotically evolved with the ascendance of the e-patient, enabling improved communication, collaboration, and coordination between patients and clinicians and forging a health care system that is safer and more responsive to patient needs.