Digital communication increasingly mediates clinical relationships through patient portals, secure messaging, telemedicine, electronic health records (EHRs), conversational agents, and artificial intelligence (AI). These technologies change not only access to information but also how attention, trust, participation, emotional presence, privacy, and professional roles are negotiated. This scoping review mapped evidence on how digitally mediated communication is associated with the patient-clinician relationship, with particular attention to trust, engagement, accessibility, human interaction, control, and equity. Evidence published from 2017 through 2026 was identified through broad and targeted searches of web-accessible bibliographic and journal interfaces, followed by DOI, journal, and relevance verification. Evidence was charted by technology, design, setting, relational construct, contextual modifiers, and interpretive limits. The archived search trail permitted reconstruction of the final inclusion endpoint but not every earlier identification-stage denominator. Thirty-two substantive evidence sources entered the review synthesis. Two additional sources were retained only for methodological or theoretical support, yielding a 34-reference evidence base. Across technologies, relational consequences were heterogeneous. Benefits in convenience, informational access, and continuity coexisted with risks involving transactional communication, attentional fragmentation, unequal access, reduced agency, privacy concerns, and uncertain AI-mediated trust. Digital technologies do not uniformly strengthen or weaken patient relationships. Their relational consequences depend on how technological functions interact with communication practices, patient capability, continuity, organizational arrangements, accessibility, and opportunities for meaningful human participation.
