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Objectives This systematic review examines how patient-centered care (PCC) is conceptualized when mediated by artificial intelligence (AI), identifies governance mechanisms shaping AI-enabled PCC, and assesses implications for health equity at health system and population levels. Methods Following PRISMA 2020 guidelines, a theory-driven systematic review was conducted using Scopus and PubMed/Medline. Peer-reviewed studies published between 2020 and 2025 were screened based on relevance to AI-enabled PCC, governance, and equity. Thirty-two studies met the inclusion criteria and were synthesized through a theory-driven narrative approach integrating AI mediation, governance structures, and equity mechanisms. Results Findings indicate a shift in PCC from interpersonal clinical interactions toward a system-level capability embedded in digital infrastructures, algorithms, and organizational arrangements. Governance mechanisms, including regulatory oversight, accountability frameworks, and participatory design, emerged as mediators between AI technologies and patient-centered outcomes. Evidence suggests AI-enabled PCC may generate uneven equity effects, potentially mitigating or exacerbating disparities depending on governance capacity and system design. Conclusion AI reshapes PCC as a governance and equity challenge rather than a technological innovation, underscoring the need for stronger governance to ensure equitable, system-wide patient-centered outcomes.
Binsar et al. (2026) studied this question.