Recent research highlights the nuanced relationship between digital health engagement and distress, underscoring this need.

A large cross-sectional study published in JAMA Open Network in 2026, for example, found that higher digital health engagement with clinical care systems was, overall, associated with higher psychological distress. According to the study, distress may be more likely depending on how patients engage with digital health. More active digital health engagement, like communicating electronically with care providers, was more strongly associated with distress than more passive engagement, like accessing an online portal.

Which patients are engaging and why also seems to matter. In a 2026 report published in Healthcare, researchers emphasized this “paradox of monitoring,” in which the continuous monitoring that digital health tools allow—meant to reduce uncertainty and provide reassurance—can ultimately backfire for some. Pregnant patients with preexisting psychological vulnerabilities were more likely to engage more frequently with digital health monitoring and to experience higher distress. Another 2026 study in Journal of Medical Internet Research established that patients who were previously diagnosed with obsessive-compulsive disorder were more likely to experience compulsive checking and reassurance-seeking with the use of digital health tools. These behaviors were particularly reinforced by the constant notification and instant information provision that health apps provided.

Caglar Onal, PhD, Senior Research Data Analyst at Northwestern University and Sezen O Onal, PhD, Assistant Professor in the department of health policy and management at the State University of New York Downstate Health Sciences University, coauthors of the 2026 JAMA Open Network study, shared a joint statement over email on the results. “Psychological distress may lead some patients to engage more with digital health tools, but it is also possible that certain forms of engagement contribute to distress, or that the relationship operates in both directions.” They went on to add, “Our findings suggest that digital engagement may provide an additional behavioral signal about a patient’s psychological context.”

While a causal relationship between digital health engagement and psychological distress hasn’t been established, the research does suggest that distressed patients may engage more heavily with digital tools because they are seeking information or reassurance. This information may present a useful clinical opportunity: by flagging the patients who engage most frequently with their digital health care, clinicians could implement early monitoring systems to identify patients most at risk for anxiety and other mental health concerns.

It may also present a fruitful design opportunity. The issue isn’t that patients should have less access to their health information; rather, designers and clinicians need to consider how that information is likely to be viewed by the patient and how to distinguish, account for, and design for productive engagement.

For example, productive engagement might include checking a result when prompted or using a monitoring device as clinically recommended, while potentially concerning patterns could include repeated checking or excessive messaging for reassurance or difficulty disengaging from health information. Beyond frequency, patient context, motivation, behavior patterns, and psychological state must be interpreted in context.

Cooper points out the distinction between access to information and the ability to interpret it and suggests key changes to the design and function of health apps. “Design for state of mind, [meaning] don’t assume everyone using this is balanced, able, or in a ‘normal state,’” he says. “How does [the app] work in stress, in anxiety, in panic, in a happy day. Is it simple, is it clear, is it too much? The important question is: what life is this person living when they open the app?...Think about their life and their situation.” He suggests different interfaces for patients versus clinicians or simplified readouts that offer explanations of readouts that laypeople may not understand. Modifications such as these support patient-centered design and may help to mitigate digitally induced health distress.

Information-seeking can become a cycle between reassurance and certainty, and increased digital health engagement is not inherently a positive outcome. Unusually high engagement could prompt clinicians to screen patients for mental health conditions and consider whether a patient needs a clearer explanation, reassurance, or additional education about when and how often to monitor.

In the interim, Martin recommends that patients adjust how and when they check their digital health tools, for example “...setting specific windows to look at a portal or send a message, rather than checking or messaging on impulse.” While pulling back on repeated checks can be challenging for a patient in distress or one who may not have the clinical knowledge to interpret their health data, creating boundaries rather than endlessly refreshing a screen may help to establish a more controlled baseline.

The same tool can increase patient autonomy while also creating uncertainty. Patterns of digital engagement may provide another window into patient well-being, and effective digital health should not only deliver more information and access; it should help patients understand what that information means and how they and their health care team can best respond.