The digital healthcare paradigm heralds a transformation in the entities within the healthcare industry [1]. In particular, patients—once viewed as passive consumers of healthcare services—are now emerging as “Smart Patients,” a new type of healthcare actor who takes a proactive, leading role in managing their own health, driven by advances in the information society and digital technology [2]. However, despite its importance, discussions about this emerging population remain scarce. This paper explores the evolution, role, and key capabilities of the smart patient and examines ways to enhance them.

In the 1960s and 1970s, despite innovations in computer technology and electronic medical records, the limited availability of personal technology and the absence of a patient-centered care philosophy restricted patients’ access to their health information, which was primarily held by professionals. Subsequently, the development of personal computers and the Internet gave rise to the “e-patient”—an individual who manages their health by accessing and learning about health information [3,4]. However, during this period, the prefix “smart” was paradoxically used to position patients as objects of smart systems and devices rather than as active agents of intelligence.

In the 2000s, mobile devices enabled patients to monitor their health in real time, analyze health data, and communicate with healthcare professionals. Coinciding with the emergence of a patient-participatory paradigm in healthcare, which emphasizes precision, prediction, and disease prevention, these developments laid the groundwork for patients to become more empowered in managing their health by actively engaging in care planning, a shift further recognized with the advancement of participatory medicine.

Since the 2010s, big data and artificial intelligence technologies have further transformed healthcare. In particular, advances in data science techniques and digital healthcare infrastructure have created an environment that facilitates the launch of patient-tailored healthcare services and greater patient participation, thereby demanding increased “smartness” from patients.

The emerging term “smart patient” describes patients who become active subjects in managing their health as they acquire more information about themselves through advances in health technology [5]. These empowered patients influence healthcare by sharing information and forming communities [6], thereby becoming stakeholders in the healthcare system alongside traditional providers. Because digital technologies serve as connectors between patients’ bodies, devices, and mediated services in the digital realm, smart patients also collaborate with healthcare professionals and digital tools [7].

However, these technologies also introduce risks and ethical uncertainties. Patients should advocate for patient-centeredness by participating in decision-making processes regarding technology assessment and target setting [8]. They also function as innovators or lead users—driving technology adoption in its early stages—and as co-creator who shape innovations based on their experiences and the perceived value of new technologies [9,10].

The smart patient has evolved alongside digital healthcare, repositioning themselves as active participants in self-health management, health communication, and co-creation within digital healthcare. However, they cannot exist in isolation. Their success requires collaborative efforts from all stakeholders—including competency assessment, education, information sharing, participation, and empowerment—to build a patient-centered health system that leverages opportunities while addressing technological challenges. These considerations should be integrated into a holistic framework that promotes patient empowerment [13,19], consistent with the World Health Organization’s 2020 framework, which identifies patient “empowerment” as key to achieving better outcomes [20]. While this paper provides an overview of the smart patient, future research involving stakeholders should further refine the definition of the smart patient in digital health diffusion.