Frontiers in digital health最新文献

{"title":"Accuracy of ChatGPT-3.5, ChatGPT-4o, Copilot, Gemini, Claude, and Perplexity in advising on lumbosacral radicular pain against clinical practice guidelines: cross-sectional study.","authors":"Giacomo Rossettini, Silvia Bargeri, Chad Cook, Stefania Guida, Alvisa Palese, Lia Rodeghiero, Paolo Pillastrini, Andrea Turolla, Greta Castellini, Silvia Gianola","doi":"10.3389/fdgth.2025.1574287","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1574287","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial Intelligence (AI) chatbots, which generate human-like responses based on extensive data, are becoming important tools in healthcare by providing information on health conditions, treatments, and preventive measures, acting as virtual assistants. However, their performance in aligning with clinical practice guidelines (CPGs) for providing answers to complex clinical questions on lumbosacral radicular pain is still unclear. We aim to evaluate AI chatbots' performance against CPG recommendations for diagnosing and treating lumbosacral radicular pain.</p><p><strong>Methods: </strong>We performed a cross-sectional study to assess AI chatbots' responses against CPGs recommendations for diagnosing and treating lumbosacral radicular pain. Clinical questions based on these CPGs were posed to the latest versions (updated in 2024) of six AI chatbots: ChatGPT-3.5, ChatGPT-4o, Microsoft Copilot, Google Gemini, Claude, and Perplexity. The chatbots' responses were evaluated for (a) consistency of text responses using Plagiarism Checker X, (b) intra- and inter-rater reliability using Fleiss' Kappa, and (c) match rate with CPGs. Statistical analyses were performed with STATA/MP 16.1.</p><p><strong>Results: </strong>We found high variability in the text consistency of AI chatbot responses (median range 26%-68%). Intra-rater reliability ranged from \"almost perfect\" to \"substantial,\" while inter-rater reliability varied from \"almost perfect\" to \"moderate.\" Perplexity had the highest match rate at 67%, followed by Google Gemini at 63%, and Microsoft Copilot at 44%. ChatGPT-3.5, ChatGPT-4o, and Claude showed the lowest performance, each with a 33% match rate.</p><p><strong>Conclusions: </strong>Despite the variability in internal consistency and good intra- and inter-rater reliability, the AI Chatbots' recommendations often did not align with CPGs recommendations for diagnosing and treating lumbosacral radicular pain. Clinicians and patients should exercise caution when relying on these AI models, since one to two-thirds of the recommendations provided may be inappropriate or misleading according to specific chatbots.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1574287"},"PeriodicalIF":3.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Master protocols in vocal biomarker development to reduce variability and advance clinical precision: a narrative review.","authors":"Ayush Kalia, Micah Boyer, Guy Fagherazzi, Jean-Christophe Bélisle-Pipon, Yael Bensoussan","doi":"10.3389/fdgth.2025.1619183","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1619183","url":null,"abstract":"<p><strong>Introduction: </strong>Vocal biomarkers, defined as acoustic or linguistic features extracted from voice samples, are an emerging innovation in medical diagnostics. Utilizing artificial intelligence, machine learning, or traditional acoustic analysis, vocal biomarkers have shown promise in detecting and monitoring conditions such as respiratory disorders and cognitive impairments. Despite their potential, the lack of standardized protocols for data collection and analysis has limited their clinical applicability.</p><p><strong>Objectives: </strong>This review assesses the current state of research on developing a master protocol for vocal biomarkers, identifying key aspects essential for reducing variability across studies. It also explores insights from digital biomarker research to inform the creation of a standardized framework for vocal biomarker development.</p><p><strong>Methods: </strong>A narrative review was conducted by searching PubMed for literature on vocal and digital biomarker development. Articles were evaluated based on their proposed frameworks and recommendations for addressing methodological inconsistencies.</p><p><strong>Results: </strong>Twenty-one relevant articles were identified, including 12 focused on vocal biomarkers and 9 addressing broader digital biomarkers. Vocal biomarker literature emphasized the lack of existing master protocols and the need for standardization. In contrast, digital biomarker research from organizations like the Digital Medicine Society offered structured frameworks applicable to voice research.</p><p><strong>Conclusion: </strong>There is currently no established master protocol for vocal biomarker development. This review highlights foundational elements necessary for future standardization efforts to support the clinical integration of vocal biomarkers in healthcare.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1619183"},"PeriodicalIF":3.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and digital health in the health systems of developing countries: the challenges and vision of integration in the primary health care setting.","authors":"Manoochehr Karami, Hayder Madlool","doi":"10.3389/fdgth.2025.1532361","DOIUrl":"10.3389/fdgth.2025.1532361","url":null,"abstract":"","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1532361"},"PeriodicalIF":3.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"iACT4IBD: a randomised controlled trial of a brief online intervention based on acceptance and commitment therapy to improve wellbeing for adults with inflammatory bowel disease.","authors":"Karen Lin, Alana Cavadino, Maggie Ow, Meihana Douglas, Anna Serlachius","doi":"10.3389/fdgth.2025.1587765","DOIUrl":"10.3389/fdgth.2025.1587765","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory bowel disease (IBD) is associated with high rates of depression and anxiety. Acceptance and Commitment Therapy (ACT) has demonstrated utility across different chronic health conditions, and online ACT interventions may potentially improve access to mental health support.</p><p><strong>Methods: </strong>This study was a parallel two-arm randomised controlled trial that investigated the effects a brief seven-day online ACT intervention (iACT4IBD) on psychological and physical health outcomes. We examined whether iACT4IBD could reduce depressive symptoms in adults with IBD compared to a waitlist control group at 4-weeks follow-up. Effects of iACT4IBD on levels of anxiety, stress, wellbeing, quality of life, and IBD activity were also explored. Seventy adults with IBD (Crohn's disease and ulcerative colitis) were randomly allocated to either the iACT4IBD intervention or a waitlist control group. Psychological and physical health outcomes were collected at baseline, 4-weeks and 8-weeks after baseline. Outcome measures were assessed at baseline and 4-weeks follow-up using mixed ANOVAs.</p><p><strong>Results: </strong>No between-group differences in psychological outcomes were found from baseline to 4-weeks follow-up. Crohn's disease activity scores in the intervention group were significantly lower after 4-weeks compared to the waitlist control group. Qualitative feedback suggested that the intervention was acceptable and beneficial.</p><p><strong>Discussion: </strong>There were no improvements to mental wellbeing; however, findings provided some support for the intervention improving physical health in people with Crohn's disease. Further research is needed.</p><p><strong>Clinical trial registration: </strong>Australian New Zealand Clinical Trials Registry (U1111-1282-2334).</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1587765"},"PeriodicalIF":3.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cricket, commerce, and public health: promotion of tobacco, alcohol, and high in fat, sugar, and salt products.","authors":"Prashant Kumar Singh, Rupal Jain, Vandana Tamrakar, Sanchita Roy Pradhan, Sagarika Rout, Chandresh Pragya Verma, Amit Yadav, Upendra Bhojani, Yatan Pal Singh Balhara, Shalini Singh","doi":"10.3389/fdgth.2025.1503680","DOIUrl":"10.3389/fdgth.2025.1503680","url":null,"abstract":"<p><strong>Background: </strong>Increasing incidences of non-communicable diseases globally present a major public health challenge, with tobacco, alcohol, and ultra processed food products high in fat, sugar, and salt (HFSS) contributing significantly to this epidemic. Despite regulatory efforts, loopholes persist, allowing companies to promote such products through surrogate advertisements and new media platforms. This study investigates advertisements aired during the Men's Cricket World Cup 2023 on the Over-the-Top (OTT) platform.</p><p><strong>Methods: </strong>A comprehensive analysis of advertisements aired during the World Cup matches on OTT platform during October-November 2023 was undertaken to assess the extent and type of advertising of alcohol, tobacco and HFSS products. A standardized observation protocol was followed, documenting the frequency, type, and celebrity featured in each advertisement. The observed advertisements were categorized into six segments including surrogate tobacco and alcohol, soft drinks, energy drinks, edible products commonly consumed by children, and other edibles/beverages.</p><p><strong>Results: </strong>Observations show that 80.9% (<i>n</i> = 1,769) of total advertisements promoted tobacco, alcohol and HFSS products. Notably, surrogate tobacco advertisements were predominantly displayed during matches involving the Indian team, accounting for 86.7% of the total surrogate tobacco advertisements. Edible products commonly consumed by children comprised 60.6% of unhealthy advertisements during over-breaks. Celebrity endorsements, particularly by Bollywood actors and Indian cricketers were common.</p><p><strong>Conclusion: </strong>Observations reveal a concerning prevalence of advertisements promoting tobacco, alcohol, and HFSS products. Children emerged as a particularly vulnerable target for advertisement-induced consumption behaviors. These findings highlight the need for stricter regulations and effective enforcement to curb the promotion of unhealthy products.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1503680"},"PeriodicalIF":3.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility, acceptability, patient experience, and preliminary efficacy of a virtual reality guided imagery intervention for chronic pain.","authors":"Lauren Doan, Marc Recasens, Jessica Lake, Ian Miller, Elise Vierra, Steven Richeimer, Iris Yao, Doerte U Junghaenel, Faye Weinstein","doi":"10.3389/fdgth.2025.1505861","DOIUrl":"10.3389/fdgth.2025.1505861","url":null,"abstract":"<p><strong>Objectives: </strong>Guided imagery is a strategy utilized in chronic pain management by patients. Benefits are cumulative via ongoing application. Engagement via Virtual Reality (VR) is becoming more accessible as a strategy to enhance adherence, use and benefit of guided imagery. We conducted a preliminary investigation of the feasibility, acceptability, patient experience, and efficacy of the use of VR for patients with chronic pain to use at home.</p><p><strong>Methods: </strong>36 patients with Complex Regional Pain Syndrome or Low Back Pain were randomly assigned to VR or audio only guided imagery groups. Feasibility, acceptability and patient experience were rated by participants. Outcomes assessed at baseline and post-intervention were pain, mental and physical health, and mood.</p><p><strong>Results: </strong>Results indicate that the intervention was feasible and found acceptable by participants. The intervention also demonstrated promising preliminary efficacy based on self-reported within-group decreases in pain, depressive symptoms, anxiety symptoms and improvements in physical and mental functioning.</p><p><strong>Conclusions: </strong>The use of VR shows promise for enhancing the application and experience of guided imagery training with people who have chronic pain.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1505861"},"PeriodicalIF":3.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retention and characteristics associated with remote questionnaire completion in a general population cohort study: the project baseline health study.","authors":"Megan K Carroll, Safa Faheem, Jean Bouteiller, Adrian Hernandez, Kenneth W Mahaffey, Jessica L Mega, Neha Pagidipati, Terry Schaack, Svati H Shah, Sumana Shashidhar, Susan Swope, Donna Williams, R Scooter Plowman, Edgar P Simard, Sarah A Short, Shannon S Sullivan","doi":"10.3389/fdgth.2025.1520132","DOIUrl":"10.3389/fdgth.2025.1520132","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate remote participant engagement in a clinical study over time, based on data from the Project Baseline Health Study (PBHS), a hybrid in-person and virtual study.</p><p><strong>Methods: </strong>The PBHS enrolled 2,502 adult US residents from March 3, 2017 to April 26, 2019, with a ≤5-year follow-up. We summarized 4-year retention and rates of longitudinal patient-reported outcome survey completion. We investigated participant characteristics for their associations with quarterly remote survey completion using regression models.</p><p><strong>Results: </strong>Of the total participants (<i>N</i> = 2,502), 94% remained enrolled after 4 years and 60% completed all annual visits; 2,490 participants stayed enrolled for at least one quarter. The median (IQR) number of remote electronic survey sets completed was 8 (3-12), of a possible 16. Age [odds ratio (OR), >70 vs. ≤30 years: 2.56; 95% CI: 2.24-2.94] and education (OR, advanced degree vs. ≤high school: 1.36; 95% CI: 1.22-1.52) were positively associated with remote survey completion. Participants with lower odds of completion were Black (OR vs. White: 0.73; 95% CI: 0.67-0.80), Hispanic (OR vs. non-Hispanic: 0.84; 95% CI: 0.77-0.93), or had at least mild symptoms of depression (OR vs. without: 0.90; 95% CI: 0.84-0.96) or anxiety (OR vs. without: 0.84; 95% CI: 0.78-0.90).</p><p><strong>Conclusions: </strong>Overall, 94% of PBHS participants remained enrolled after four years. Age, race, ethnicity, income, education, and symptomatic depression/anxiety were significantly associated with longitudinal remote questionnaire completion. These findings on engagement over time may inform future longitudinal study design.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov, identifier (NCT03154346).</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1520132"},"PeriodicalIF":3.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How equitable is digital rehabilitation for people after stroke? A systematic review using an equity approach.","authors":"Rachel C Stockley, Yasemin Hirst, Chantelle Hayes, Kimberley E Watkins, Peter C Goodwin","doi":"10.3389/fdgth.2025.1544754","DOIUrl":"10.3389/fdgth.2025.1544754","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke is the largest global cause of adult neuro-disability. Health inequities increase the risk of stroke and are likely to influence overall recovery. Rehabilitation after stroke seeks to restore function and independence and may utilise digital technologies to augment usual care. This study systematically investigates the reporting of equity factors in digital stroke rehabilitation research.</p><p><strong>Methods: </strong>This systematic review examined equity factors contained in the PROGRESS-Plus framework in a random sample of clinical trials of technologies used as part of stroke rehabilitation published in 2011-2021. Four reviewers double-screened titles and abstracts of 14,724 papers. A random selection was carried out across all potentially eligible papers (<i>n</i> = 821) and 135 papers were reviewed for data extraction. Each study was coded with 36-point PROGRESS-plus criteria for inclusion, exclusion, and baseline characteristics. ANOVA and multivariable linear regression were used to assess the variation in PROGRESS-Plus reporting by year of publication, location, type of technology used, intervention target, number of comparison groups and sample size.</p><p><strong>Results: </strong>87 studies were included with a mean PROGRESS-Plus score of 7.05 (<i>SD</i> <i>=</i> 2.06), minimum score of 0 and maximum score of 14. Despite their importance to health outcomes, education, social capital and socioeconomic status were reported by less than 5% of studies. The most commonly reported equity factors were age, disability and gender. There were no significant differences in reporting by technology used, target of the intervention (upper or lower limb), sample size, location, number of comparison groups and sample size. Variation in equity reporting was not explained through multiple linear regression factors. There was a small positive correlation between the year of publication and the PROGRESS-Plus score (<i>r</i> = .26, <i>n</i> = 87, <i>p</i> < 0.05).</p><p><strong>Discussion: </strong>Few studies of digital rehabilitation interventions considered several key equity factors, including those recognised to precipitate digital exclusion and influence health outcomes. An encouraging finding was that more recent work was slightly more likely to report equity factors, but future research should ensure complete reporting of equity factors to ensure their findings are applicable to clinical populations.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024504300, PROSPERO/identifier, CRD42024504300.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1544754"},"PeriodicalIF":3.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel personal identification system using doorknob lead electrocardiograms for unconscious authentication in unlocking doors.","authors":"Keisuke Kawamura, Masaki Kyoso","doi":"10.3389/fdgth.2025.1585431","DOIUrl":"10.3389/fdgth.2025.1585431","url":null,"abstract":"<p><strong>Introduction: </strong>In highly information-oriented society, personal authentication technology is essential. Biometric authentication is becoming popular as a method of personal authentication from the viewpoint of usability. In this research, in order to realize unconscious personal authentication during daily activities, we proposed a novel biometric authentication system using a doorknob-type electrocardiogram (ECG) measuring device. In our previous study, it was shown that ECG obtained with a contact-type electrode on doorknob and a capacitive-type electrode on the floor could be used for personal identification. However, identification performance is easily affected by noise from body movements and other factors, due to loose contact between electrodes and the body.</p><p><strong>Method: </strong>In this paper, we proposed to add two preprocessing techniques to the system. Synchronized averaging process was applied to the measured ECG waveforms. Then, data augmentation was applied to the machine learning training data.</p><p><strong>Results: </strong>It was found that synchronized averaging with 5 consecutive wave segment improved accuracy by 10%. It was also found that training data augmentation improved the performance even under limited amount of ECG data.</p><p><strong>Discussion: </strong>The results demonstrate that remarkable performance improvement can be achieved even with short term door-knob ECG by using synchronized averaging and data augmentation.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1585431"},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a COVID-19-focused mHealth system in a low-resource setting during the COVID-19 pandemic: challenges and opportunities.","authors":"Rosie Stenhouse, Wassie Gebbie Beshir, Demessie Girma, Gosaye Fida, Clara Calia, Godana Guto, Maria Klara Wolters","doi":"10.3389/fdgth.2025.1543828","DOIUrl":"10.3389/fdgth.2025.1543828","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately three-quarters of Ethiopia's population lives in rural areas, and access to healthcare is difficult with poor transport infrastructure and long travel times. Telemedicine has the potential to support healthcare access and minimise COVID-19 transmission through a reduced need to travel.</p><p><strong>Objectives: </strong>This Brief Research Report describes the analysis of qualitative data relating to the development of a mobile health (mHealth) system during the COVID-19 pandemic to support COVID-19 symptom management in the community in Oromia, Ethiopia.</p><p><strong>Methods: </strong>Data were collected from (1) meeting notes and WhatsApp group discussions, (2) a focus group with medical staff, and (3) an interview with a senior hospital leader. A framework method was used for the analysis.</p><p><strong>Results: </strong>Three themes were identified: (1) patient-physician relationship, (2) new ways of using everyday technology, and (3) infrastructure and digital access.</p><p><strong>Discussion: </strong>We discuss the challenges of developing an mHealth system during a pandemic alongside infrastructural challenges and the preparedness of medical staff and communities for the use of mHealth.</p><p><strong>Conclusions: </strong>There is a need for investment in information technology infrastructure and in access to digital networks, alongside a need to improve the digital and health literacy of populations for the successful implementation of a patient-facing mHealth system. Thus, whilst the policy aspirations are admirable, the potential for technological innovation is great, and the clinicians can see the benefit of using technologies to provide care to those who cannot reach clinics, there is a gap between what is possible given the current reality of infrastructure and patient preparedness and the requirements for a successful telemedicine intervention.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1543828"},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}