Reconfiguring patienthood through the digitalization of healthcare communication

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Abstract

A Book Review on

Healthcare and patient communication in the digital era: a pitenthood and patient perspective.

Torkkola, S., & Toset, A. S. (Eds.), Milton Park, United Kingdom: Routledge, 2025, 126 pages, ISBN: 978-1032857336

Digital technologies are rapidly transforming the communicative foundations of healthcare. From telemedicine platforms and wearable monitoring devices to online patient communities and AI-assisted medical systems, healthcare increasingly operates through digitally mediated infrastructures that transcend the traditional boundaries of clinical interaction. These developments accelerated during and after the COVID-19 pandemic, when digital technologies became central to healthcare delivery, public health communication, and patient self-management. As a result, healthcare communication no longer unfolds solely through face-to-face interactions between doctors and patients but across interconnected environments shaped by platforms, data systems, remote monitoring technologies, and algorithmic forms of care.

In Healthcare and Patient Communication in the Digital Era: A Patienthood and Patient Perspective, Sinikka Torkkola and Anna Sendra Toset offer a timely and theoretically ambitious contribution to contemporary health communication scholarship. The book’s central argument is not simply that digitalization changes healthcare technologies, but that it transforms healthcare communication itself across interpersonal, organizational, and societal levels. In doing so, it addresses a longstanding theoretical gap in health communication scholarship by providing a conceptual framework through which the communicative consequences of healthcare digitalization can be understood. Through these communicative transformations, digitalization ultimately reconfigures the sociocultural meaning of patienthood.

Healthcare Communication, Digitalization, and Patienthood

At the heart of the book is a theoretical framework that connects healthcare communication, patienthood, and digitalization. Drawing on Twaddle’s triadic distinction among illness, disease, and sickness, the authors examine healthcare communication from the perspectives of patients, healthcare professionals, and society simultaneously. Illness refers to the subjective experience of being unwell; disease denotes biomedical diagnosis and classification; and sickness concerns the social recognition and governance of ill health. Rather than treating these categories separately, the authors position patienthood at their intersection. Patienthood emerges not as a fixed identity but as a dynamic sociocultural condition shaped by expertise, medicalization, and health citizenship. Building on this central argument, the book develops a broader understanding of healthcare communication that extends beyond conventional doctor–patient interaction. Rather than limiting healthcare communication to interactions between doctors and patients, the authors define it as a communicative environment operating across interpersonal, organizational, and societal levels. Digitalization therefore affects not only consultations between care providers and care receivers but also institutional communication, public health messaging, professional practices, and platform-mediated interactions. In this respect, the book shifts the analytical focus from individual technologies to the broader communicative infrastructures through which healthcare is organized and experienced.

This perspective also helps explain the authors’ distinction between digitization and digitalization. Whereas digitization refers to the technical conversion of information into digital formats, digitalization refers to the ways digital media restructure healthcare communication and social relations. Electronic health records, telemedicine platforms, wearable devices, and mobile health applications matter not simply because they are digital technologies, but because they reshape how care providers, care receivers, and healthcare institutions communicate with one another. Consequently, the book’s central concern is not technological innovation per se, but the communicative transformations through which digitalization reconfigures patienthood.

Reconfiguring Patienthood through Illness, Disease, and Sickness

Chapter 2 develops this framework by positioning healthcare communication as a broad communicative environment that extends beyond the traditional patient–doctor dyad. Rather than focusing solely on interpersonal interactions, the authors conceptualize healthcare communication as operating simultaneously across interpersonal, organizational, and societal levels. This perspective provides the foundation for the book’s subsequent analysis of illness, disease, and sickness in digitally mediated healthcare environments.

Building on this framework, the remainder of the book examines how digitalization reshapes patienthood across the interconnected dimensions of illness, disease, and sickness. The analytical core of the book is therefore organized around three perspectives on digital healthcare communication: the patient perspective (illness), the healthcare professional perspective (disease), and the societal perspective (sickness). These perspectives correspond to different dimensions of ill health. Illness refers to the lived experience of being unwell and is therefore examined from the patient’s perspective. Disease concerns biomedical diagnosis and treatment and is consequently analyzed from the perspective of healthcare professionals. Sickness refers to the social organization and governance of ill health and is explored through the societal perspective. Together, these three domains enable the authors to examine how digitalization reshapes healthcare communication at personal, professional, and societal levels. Across all three dimensions, the authors emphasize that digitalization generates both opportunities and tensions. Expanded access to information, participation, and care coexist with risks of surveillance, exclusion, and inequality. These opportunities and tensions take different forms across the three domains. From the perspective of illness, digitalization enables greater access to informational and emotional support, the co-construction of experiential knowledge, and new forms of patient participation, while also generating challenges associated with misinformation and responsibilization. From the perspective of disease, digital technologies facilitate diagnosis, monitoring, and forms of joint expertise between patients and healthcare professionals, yet they may also increase the distance between disease and lived experience as bodily signs are translated into electronic data. From the perspective of sickness, digitalization expands opportunities for self-care and health promotion while simultaneously intensifying forms of self-discipline, social control, and digital health citizenship. This balanced perspective represents one of the book’s greatest strengths.

Digitalization of Illness: From Paternalism to Empowerment

Chapter 3, Digitalization of Illness: From Paternalism to Empowerment, focuses on the patient perspective. Here the authors explore how digital platforms, social media, and online patient communities transform the experience of illness. Digital environments provide opportunities for patients to obtain informational and emotional support, co-construct experiential knowledge, participate in health controversies, and share illness narratives beyond institutional medical settings. Particularly compelling is the discussion of online patient communities, which demonstrate how patients increasingly contribute to the production and circulation of health knowledge.

The example of long COVID illustrates this process effectively. Before long COVID gained widespread recognition within healthcare systems, patients used social media platforms and online communities to document symptoms, compare experiences, and collectively make sense of persistent post-viral conditions. Through these digital illness narratives, patients contributed to the social visibility and eventual medical recognition of the condition. In this sense, digitalization democratizes healthcare communication by expanding opportunities for participation and knowledge production. At the same time, however, the authors caution against romanticizing patient empowerment. Digital participation also creates risks associated with misinformation, unequal access to reliable information, and growing expectations that individuals actively manage their own health. Thus, empowerment becomes inseparable from responsibilization, a process through which healthcare responsibilities increasingly shift toward patients themselves.

From the Medical Gaze to the Digital Gaze

Chapter 4, From the Medical Gaze to the Digital Gaze, offers what is arguably the book’s most original theoretical contribution. Building on Michel Foucault’s concept of the medical gaze, which describes the authority of modern medicine to observe, classify, and interpret the patient’s body, the authors argue that digital healthcare increasingly replaces direct bodily observation with data-driven forms of visibility. Through wearable devices, telemedicine systems, electronic health records, and remote monitoring technologies, signs of disease become translated into electronic data streams. Healthcare professionals increasingly encounter patients through dashboards, metrics, and biometric indicators rather than through direct physical examination.

This transformation is conceptualized as a shift from the medical gaze to the digital gaze. The patient is no longer primarily observed as a body lying in a hospital bed but as a digitally represented body dispersed across data infrastructures. The discussion of wearable technologies is particularly illuminating. Devices such as smartwatches continuously generate information regarding heart rate, sleep quality, physical activity, and stress levels. These technologies expand possibilities for diagnosis and intervention while simultaneously transforming how disease itself is understood. Disease increasingly becomes data.

The chapter also offers one of the book’s most compelling discussions: the transformation of expertise itself. Digital healthcare challenges traditional assumptions that locate expertise exclusively within professional medicine. Through wearable technologies, online health resources, and patient-generated data, expertise becomes increasingly distributed between care providers and care receivers. The authors describe this shift as the emergence of “joint expertise.” While this argument effectively captures the participatory dynamics of digital healthcare, it also raises important questions regarding the growing role of algorithmic systems and AI-assisted decision-making, issues that remain largely outside the scope of the book.

Digitalization of Sickness and Health Citizenship

Chapter 5, Digitalization of Sickness: Renegotiating Health Citizenship, shifts attention to the societal dimension of health and illness. Here the authors explore how digital technologies reshape health citizenship and alter relationships among the individual, the state, and the market. The central argument is that digitalization intensifies both empowerment and self-discipline.

The discussion of health citizenship is especially persuasive when considered alongside the growing popularity of self-tracking technologies. Devices such as Fitbit and Apple Watch encourage users to monitor exercise, sleep, calorie expenditure, and other health indicators. While these technologies can promote healthier lifestyles, they also establish normative expectations regarding responsible citizenship and self-care. Individuals are increasingly expected to monitor, interpret, and optimize their own health data, transforming health management from a medical concern into a moral obligation.

The authors convincingly demonstrate that empowerment and surveillance are not opposing outcomes but often coexist within contemporary digital healthcare systems. Patients are encouraged to become active, informed, and autonomous participants in healthcare while simultaneously being subjected to new forms of monitoring and social control. This tension between participation and discipline constitutes one of the book’s most compelling insights and connects healthcare communication to broader debates surrounding datafication, self-tracking, and digital citizenship.

Strengths and Contributions

Another strength of the book is its interdisciplinary orientation. Torkkola and Sendra Toset successfully synthesize scholarship from health communication, media studies, sociology, digital health studies, and philosophy. Their approach enables them to bridge communication-focused analyses with broader sociotechnical understandings of healthcare transformation. Particularly valuable is their insistence that healthcare communication should be understood as a complex communicative environment involving institutions, media systems, platforms, healthcare professionals, and citizens rather than as a set of isolated interpersonal interactions.

Limitations

Nevertheless, the book leaves several important issues underdeveloped. While the authors acknowledge digital inequalities and differences in digital health literacy, questions concerning structural asymmetries in global healthcare infrastructures receive relatively limited attention. Similarly, although the book successfully highlights the tension between empowerment and self-discipline, it occasionally leans toward an optimistic account of patient participation. While patients are increasingly positioned as active participants in healthcare communication, not all individuals possess equal levels of digital literacy, technological access, or communicative resources. Consequently, the benefits of digital participation may be distributed unevenly, raising important questions about who is ultimately able to become the empowered digital patient envisioned throughout the book. .

Conclusion

Despite these limitations, Healthcare and Patient Communication in the Digital Era remains an important contribution to digital health communication scholarship. Its greatest achievement lies not in explaining digital health technologies themselves but in demonstrating how digitalization reconfigures patienthood across the intertwined domains of illness, disease, and sickness. In doing so, the book provides a valuable theoretical framework for understanding healthcare communication as a dynamic communicative environment rather than merely a series of interactions between doctors and patients. By foregrounding communication, power, and digital mediation, Torkkola and Sendra Toset offer a nuanced account of how healthcare is being transformed in digitally networked societies. At a time when care increasingly unfolds through platforms, data systems, and remote interactions, this book serves as a timely reminder that the future of healthcare is ultimately a question not only of technology, but also of communication, power, and patienthood.

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