Advancing relational primary healthcare: Four triadic components of the digital face-to-face professional service encounter

Primary healthcare service delivery prioritizes person-centricity and relational values such as equality and continuity. The emergence of technology has enabled digital face-to-face (D–F2F) service encounters between patients as end-users and physicians as professional care providers, which calls for a renewed understanding of relational approaches. To that end, the study investigated the perceptions of three groups of actors—patients, physicians, and first-line managers—of D–F2F service encounters in order to capture key aspects that can enhance relational primary healthcare in the era of digitalization. We adopted an interactive research design following a multi-actor approach and conducted conceptually and empirically informed concept mapping of the key actors in the primary healthcare service triad: patients with chronic, long-term needs, physicians, and first-line managers. From seven clusters capturing what D–F2F service encounters between patients and physicians mean, we derived four triadic perspectives that capture how relational primary healthcare can be advanced: “continuity,” “person-centered,” “interaction quality,” and “developability.” Despite high volumes and heterogeneity of end-users, primary healthcare requires a relational, person-centered perspective when it comes to healthcare delivery. Other sectors such as energy and automotive that are undergoing digital transformation and pursue an end-user's perspective can draw on the relational principles developed in our study. Our findings also raise questions about potential conflicts between end-users’ service co-creation and providers' professional boundaries. This paper presents a relational, multi-actor approach to the digitalization of a professional service encounter in primary healthcare. We propose a set of conditions conducive to taking a relational approach to D–F2F relationships. • Digitalization transforms traditional person-centered service encounters in primary healthcare. • Investigates perceptions of three key actors: patients, physicians, and first-line managers. • Relational service encounters advance through four triadic perspectives. • These are: 1) continuity, 2) person-centered, 3) interaction quality, and 4) developability.