Trustworthy AI in Telehealth: Navigating Challenges, Ethical Considerations, and Future Opportunities for Equitable Healthcare Delivery

Trustworthy artificial intelligence (TAI) will transform telehealth by providing safe, transparent, and ethically compliant systems that enhance clinician decision-making and patient relationships. This systematic review examines how TAI and large language models (LLMs), including large language model meta ai (LLaMA), can be integrated into telehealth systems, their role in optimizing e-consultation workflows, and their capacity to support personalized care through data collected by wearable biosensors and biological microelectromechanical systems (BioMEMS). These devices monitor physiological and behavioral data, such as heart rate, blood pressure, and emotional state. TAI enables effective diagnostics and targeted treatment by combining various information sources, including biosensor readings, patient history, and cognitive data. Firmware integrity plays a crucial role in ensuring security, reliability, and continuous data encryption. This review analyses 135 papers (October 2020-March 2025) from databases like IEEE Xplore, PubMed, and Scopus to demonstrate TAI's potential to enhance resource use and patient engagement. However, widespread adoption depends on overcoming technical challenges, improving firmware reliability, strengthening data security, and addressing ethical concerns. This review offers valuable guidance for engineers, system architects, and healthcare providers to create a sensitive and effective telehealth ecosystem.