To analyze the current and future landscape of technological strategies in EDs, a scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines [10]. Studies were retrieved from Scopus, PubMed, IEEE Xplore, and CINAHL in January 2025. The inclusion of CINAHL and PubMed ensures coverage of nursing and clinical perspectives that are highly relevant to patient care and workflow improvements, complementing the technical focus of IEEE Xplore and the multidisciplinary scope of Scopus. The keywords used in the search queries included technology, strategy, ED, communication, and access to information. The complete search strategy was as follows: (“Technolog*”) AND (“Strateg*” OR “Approach*” OR “Solution*” OR “Framework*” OR “System*” OR “Model*”) AND (“Emergency Department*” OR “Emergency Service, Hospital” OR “Emergency Room*” OR “Emergency Medical Service*”) AND (“Communication” OR “Access to Information”). The final database search queries for the period January 2018 to December 2024 are summarized in Multimedia Appendix 1.

To ensure the quality of the articles, only those that met the inclusion and exclusion criteria presented in Textbox 1 were considered in the review process. These criteria were chosen to focus on studies that specifically examine technological strategies designed for EDs and their impact on patient experience, particularly in the dimensions of communication and information accessibility. Three reviewers independently applied the criteria to refine the list of eligible articles. In cases of uncertainty, the decision was made collectively after discussion.

A 3-step filtering process was implemented to refine the selection of studies relevant to our RQ:

CADIMA was used for both the first and second filtering stages. CADIMA is an open-access online tool developed by the Julius Kühn-Institut during the EU-funded Global Response Against Child Exploitation project to support the conduct of systematic reviews [11].

The data charting process for the studies included in this review was structured into three rigorous rounds to explore the categories of technological strategies in EDs comprehensively. In the first round, we extracted fundamental attributes from each study, such as the authors, publication year, journal, and keywords. This process allowed us to understand the distribution of research over time and identify key categories within the field. A standardized data charting form was jointly developed in Microsoft Excel by three reviewers and piloted on a subset of studies to ensure consistency and clarity before full data extraction.

In the second round, we delved deeper into technological strategies applied in the studies. The charting form included variables such as the affected dimension (communication or access to information), technology and infrastructure used, impact on patient experience, measurement tools for usability or satisfaction, preferred information by patients, implementation details (approach, settings, challenges), and implementation outcomes.

Finally, in the third round, each paper was independently reviewed by three reviewers to ensure consistency and reduce bias in the analytical process. Any discrepancies were discussed and resolved by consensus. The charting process was iterative, and adjustments were made to the Excel form when new variables or categories emerged.

Each selected paper underwent a quality appraisal conducted independently by two reviewers using the Crowe Critical Appraisal Tool version 1.4 (CCAT) [12]. This step was undertaken to assess the methodological rigor and credibility of the included evidence, supporting a more reliable interpretation of the findings in relation to our research questions. The CCAT is a widely used instrument recognized for its high reliability in evaluating research papers [13]. This instrument is organized into 8 categories comprising 22 items. Each category is scored on a 6-point scale ranging from 0 (lowest) to 5 (highest). The overall score is calculated as a percentage, and we arbitrarily considered acceptable a score above 60%. Prior to the appraisal, both reviewers were familiarized with the CCAT manual to ensure consistent interpretation of criteria. In cases of discrepancies between the reviewers’ assessments, consensus was reached through discussion of the arguments and evidence.

We grouped the studies by technological strategy category and summarized their associated challenges, as well as related patient experience outcomes and impacts. The strategy categories were defined using a content-based grouping approach: we reviewed all included studies, examined the technologies and their stated purposes, and clustered similar technologies based on their primary function and orientation toward improving ED patient experience. The synthesis mapped the relationship between each strategy and its impact on communication and access to information, highlighting key outcomes, impacts, and challenges. Technologies and IT infrastructures were tabulated by strategy category, while patients’ preferred information and satisfaction improvements were synthesized narratively.

The scoping review process is detailed in the flow diagram shown in Figure 1, presenting the stepwise filtering and the number of studies included at each step. In the identification step, 976 papers were identified and selected. Papers were imported into the CADIMA, where duplicates were removed, resulting in 923 papers. These papers were screened, applying the defined inclusion and exclusion criteria, where 21 papers were classified as eligible. Finally, after full-text reading, 16 papers were selected for further analysis; 5 articles did not contribute to the RQ.

The set of 16 studies, published between 2018 and 2024 in journals such as Journal of Medical Internet Research and Applied Clinical Informatics, examines a range of technological strategies designed to improve patient experience in EDs. These studies address key aspects, including the design and implementation of solutions, the technological and infrastructural components that support them, patients’ preferences for information delivery, system usability, and the assessment of their impact on patient satisfaction and overall experience. Methodologically, the articles include qualitative evaluations, observational pilot studies, and mixed methods research, reflecting a diversity of approaches (see Multimedia Appendix 2).

The reviewed literature reveals an interdisciplinary orientation, with collaborations among computer scientists, clinicians, designers, and data analysts. Notably, studies originate from diverse regions, including the United States [14-19], the United Kingdom [20], Italy [21], Israel [22,23], Denmark [5], Australia [24], Thailand [25], Malaysia [26], South Korea [27], and Greece [28]. Finally, the quality appraisal of the 16 studies revealed that 87.5% (n=14) were of high quality and 12.5% (n=2) of medium quality (see Multimedia Appendix 2).

The selected studies displayed a wide variety of topics that patients preferred on their journey through the ED. Specifically, patients preferred detailed information on their medical status and progress updates [18,26], including triage status [15,28], treatment, and discharge instructions [17,19,24]. Additionally, patients valued comprehensive medical information related to their vital signs [18,25,28], laboratory results [27] and medical orders [16,18], nursing care plans [15,25,28], and the nurse and physician responsible for care [5,16]. Patients also appreciated personalized medical information and updates on procedures, associated waiting times [5,21], as well as current and upcoming stages of their ED stay [16,22]. They also favored precise tracking of their location in the ED [26,27], safety, and disposition information [16]. These preferences highlight a significant trend toward personalized health care information, underscoring the need for technological strategies to focus on delivering precise, individualized health data and highlighting the importance of accuracy and clarity in the patient communication tools of the ED.

Usability evaluations are essential in health care technology to identify design flaws early and prevent ineffective implementations [24]. Among reviewed studies, the System Usability Scale (SUS) was the most frequently used instrument [5,18,24,27]. SUS is a 10-item Likert questionnaire that generates a score from 0 to 100, interpreted using a grading scheme (eg, >90: “A” [excellent]; <60: “F” [poor]). To illustrate, the PETS mobile discharge tool scored 94/100 (A grade—Excellent), indicating superior design and strong patient acceptance [24]. Similarly, the CCL patient information system achieved near-excellent usability with a mean SUS score of 83.6/100 (B+ grade—Acceptable) [5]. In contrast, NFC-integrated mobile EMR and REDCap eConsent interfaces scored 71.9/100 and 78/100 (B grade—acceptable), reflecting moderate usability and less direct impact on patient experience [24,27]. The electronic health record display for ED patient health status and care plan progress received a mean SUS score of 69.6 out of 100 (C grade—marginally acceptable) [18], suggesting limited effectiveness in improving patient experience.

While SUS provides a standardized measure, complementary approaches are often necessary to capture user perceptions more comprehensively. Likert-scale satisfaction surveys (typically 5- or 10-point) are commonly used to assess design quality, content relevance, and overall user-friendliness [16,25,26]. For example, the web application for emergency trauma patients, using a 10-point Likert scale, reported a mean usability score of 4.09 (SD 0.74) [25]. Similarly, the TrackMe patient-tracking system, using a 5-point Likert scale, reported a mean usability score of 4.0 (SD 1.2) and a mean satisfaction score of 4.4 (SD 1.0), indicating a generally positive user experience during ED waiting periods [26]. These findings reinforce that usability and satisfaction are interrelated but distinct constructs, underscoring the need for multidimensional assessment.

Patient experience and satisfaction are closely linked to usability, which strongly influences technology acceptance in clinical settings. In ED environments, these areas are typically assessed using mixed methods that combine SUS scores, Likert-scale measures, and validated instruments such as Hospital Consumer Assessment of Health Care Providers and Systems (CAHPS) and ED-CAHPS [16,17], complemented by semistructured interviews for contextual insights into patient perceptions [5,22,24]. For example, semistructured interviews in the MyED study showed that patients who used the solution demonstrated significantly better understanding of their ED journey compared with nonusers (F_8,299=2.519; P=.01) [22]. Using satisfaction surveys, the digital whiteboards intervention improved patient-reported communication about delays (1.96 vs 2.48; P=.03) and clarity of post-discharge instructions (2.41 vs 2.83; P=.02), and users were more likely to recommend the facility (9.66 vs 9.22; P=.05) [16]. Operational benefits were also reported in the MyEDCare study: patients receiving digital discharge instructions had significantly fewer unscheduled ED returns at 72 hours and 30 days compared with those receiving standard paper-based discharge (P=.003 and P<.001) and higher ED-CAHPS scores in nursing communication domains (eg, “Nurses explain in a way you understand”: 86.5 vs 81.9; P=.03) [17].

Collectively, these findings underscore that usability is not merely a design metric but a critical driver of patient experience, satisfaction, and even clinical outcomes in ED technology implementations. In addition, the evidence shows that Interfaces and Information Systems—particularly mobile and web applications—provide the greatest added value for improving patient experience, primarily by enhancing communication, transparency, and comprehension.

The integration of advanced digital technologies in EDs represents a rapidly evolving but still unstructured field. Among the 16 studies included in this review, 9 reported interventions that achieved measurable improvements in communication, patient satisfaction, or reductions in service fragmentation [5,16-18,22,24-27]. Despite the promising results (see subsection Measuring Usability, Patient Experience, and Satisfaction Improvement), the absence of standardized frameworks, definitions, and evaluation models limits comparability and scalability across settings [29]. Developing a shared conceptual and operational framework is essential to ensure consistency in research and guide technology implementation within ED systems.

Patient-facing technologies such as mobile apps, real-time dashboards, and web-based platforms have enabled patients to access individualized health information, often in real time, enhancing their sense of involvement in emergency care [22]. Some tools demonstrated significant benefits—for example, MyEDCare improved patient comprehension and experience (86.5 vs 81.9; P=.03) [17], and digital whiteboards reduced perceived uncertainty (2.41 vs 2.83; P=.02) [16]. However, implementation challenges were common. The MyED system faced difficulties synchronizing live data from hospital databases, and short ED visits limited patient engagement [22]. Usability issues were also reported among older adults, who requested simplified functions [5]. These findings underscore the need for participatory design approaches that incorporate patient perspectives prior to implementation [30]. Ultimately, usability remains a critical determinant of successful adoption and effective use [31].

Technological impact extends beyond patient interaction to clinical workflows. Real-time data systems and mobile-based discharge tools require adjustments in routines, new training protocols, and additional coordination. While these tools can enhance communication and data accuracy, they often introduce extra responsibilities, increasing cognitive and operational burden on health care professionals [24]. This tension—between intended benefits such as efficiency and the reality of added workload—has been documented in multiple studies [32,33]. Understanding nursing staff perceptions and acceptance is therefore essential for successful adoption [34]. Policymakers and ED managers must consider these trade-offs when planning technological strategies to avoid overburdening staff while pursuing efficiency goals [16].

Additionally, the integration of wearable devices (eg, TrackMe, IntelTriage) and patient-facing platforms (eg, CCL, MyED) is reshaping care dynamics by fostering patient autonomy [5] and involvement in decision-making [20,23]. Although these innovations hold promise for improved outcomes and satisfaction [16,17,23], they raise concerns regarding workflow implications (eg, TrackMe increased nurses’ workload [26]; fears of delays with MyED [22]), digital literacy barriers (eg, limited access to Open Notes among non-English speakers [23]; usability issues for older users of CCL [5]), and communication norms (eg, risks of patients viewing information before staff [22]; potential reduction in nurse/physician time) [5]). These factors must be addressed to ensure equitable and safe implementation.

Finally, the economic cost required for the investment, implementation, and maintenance of advanced technologies in EDs must be carefully considered. These expenses may include infrastructure upgrades, software development, technical support, and training for health care personnel [19]. Given the potential financial implications, future studies should explore the cost-benefit relationship of these technological strategies, assessing their feasibility, sustainability, and overall value in diverse health care settings [17].

A key strength of this study is its multidimensional approach, which provides a holistic view by examining various facets of ED care, including communication and information accessibility. This comprehensive perspective was achieved by focusing on emerging technologies, such as AI and IoT, which represent the forefront of operational efficiency and diagnostic accuracy in EDs. The recent literature (2018‐2024) grounds the study’s findings in current technological trends, ensuring relevance. However, limitations include a focus on English articles, which may have excluded relevant studies in other languages, potentially restricting generalization. Furthermore, since many technologies analyzed are relatively new (eg, IoMT, AI), few studies directly address their long-term impacts. Variability in environments where these technologies are implemented can also affect reproducibility, especially in resource-limited settings. The recent temporal range may not capture emerging trends or long-term effects, highlighting the need for ongoing research to understand their sustained impact.

This scoping review synthesized current technological strategies designed to enhance patient experiences in EDs, primarily through improved communication and access to information. The limited number of studies identified (n=16, published between 2018 and 2024) underscores the nascent and fragmented nature of this research area. Existing evidence suggests that patient-facing tools—such as mobile apps, real-time dashboards, and web-based platforms—can improve information transparency and engagement, while clinical workflow solutions, including digital whiteboards and mobile discharge systems, support communication accuracy and care coordination. Emerging innovations like IoT-wearable monitoring devices further demonstrate potential for promoting patient autonomy and continuous observation. However, these benefits are tempered by persistent implementation challenges. Usability barriers among older adults, technical integration issues, and increased workload for health care professionals remain significant obstacles. Equity concerns related to digital literacy and language accessibility further complicate adoption, raising questions about inclusiveness and fairness in technology-driven care. Importantly, none of the reviewed studies conducted systematic evaluations of long-term outcomes or cost-effectiveness across diverse ED contexts, limiting the evidence base for sustainable integration. Future research should move beyond descriptive assessments toward rigorous, standardized evaluation frameworks that capture clinical, economic, and experiential outcomes. Participatory and inclusive design approaches are essential to address usability and equity gaps, while comprehensive cost-effectiveness analyses will inform scalability and resource allocation. Advancing this agenda is critical to ensure that technological innovations in EDs are not only effective but also equitable, sustainable, and adaptable across varied health care settings.