First the relationship, then the technology: Healthcare professionals' perceptions on how digital health solutions impact the interaction with patients.

Objectives: Previous research has explored barriers and facilitators to digital health solutions (DHS) implementation, yet less is known on how DHS should be implemented to maintain patient interaction, and accommodate shifting responsibilities. This study explores health care professionals' (HCP) perspectives on patient-HCP interactions in DHS including video consultations, remote monitoring, and digital care platforms. Methods: Semi-structured interviews were conducted with twenty-six HCPs. Interviews were transcribed verbatim and thematically analysed by two researchers. Results: Analysis revealed three overarching themes (the impact of DHS on the relationship, responsibility and anxiety), and ten subthemes. HCPs noted that DHS changed patient-HCP interactions, hindering relationship building. In regard to video consultations, interactional etiquette shifted, with the patient-HCP interaction transitioning towards more informal contact. Remote monitoring and digital care platforms increase patient responsibility, which can hinder communication, particularly when patients access medical results prior to consultations. Most HCPs emphasized that a trusting relationship should be established before introducing DHS to ensure responsible and effective use. Conclusion and innovation: This study shifts the focus from how DHS can be implemented to how they should be implemented to sustain meaningful patient-HCP interactions. The findings challenge the assumption that DHS can readily replace or supplement traditional care, emphasizing that face-to-face encounters remain essential for patient engagement, relational continuity, and professional fulfilment of HCPs. DHS implementation should therefore follow the establishment of trust and be guided by a tailored, human-centered approach that accounts for individual differences in patients' health status and digital literacy.