Digital Patient Care: Bridging Technology and Clinical Practice

Background/Objectives: Home-based telemedicine requires patients to perform technical tasks independently, whereas assisted public health center (PHC)-based telemedicine transfers some of these tasks to on-site personnel. This study describes model-specific perceptions and estimates the difference in intention to use between the two scenarios among relatively digitally capable, community-dwelling older adults. Methods: A cross-sectional, fixed-order, scenario-based online survey was completed by 300 adults aged 65 years or older in South Korea. Home-based barriers and PHC-based facilitators were analyzed as non-equivalent descriptive domains. The primary paired comparison used three conceptually matched intention items. Internal consistency, exploratory factor evidence, 95% confidence intervals (CIs), Pearson and Spearman correlations, and multivariable linear regressions with HC3 robust standard errors were reported. Results: The seven-item home-based barrier score was 2.80 (SD 0.76; 95% CI 2.71–2.89), and the seven-item PHC facilitator score was 3.58 (SD 0.58; 95% CI 3.52–3.65). Intention scores were 3.91 (SD 0.64) for home-based and 3.88 (SD 0.66) for PHC-based telemedicine. The paired mean difference (PHC minus home) was −0.030 (95% CI −0.107 to 0.047; p = 0.441; Cohen’s dz = −0.045, bootstrap 95% CI −0.155 to 0.071). Preferences were home-based 42.7% (95% CI 37.2–48.3%), PHC-based 41.3% (95% CI 35.9–47.0%), and unsure 16.0% (95% CI 12.3–20.6%). After adjustment, digital literacy remained positively associated with both intention outcomes. Conclusions: No statistically detectable difference in intention to use was observed between the two hypothetical scenarios; this finding does not establish equivalence. The item-level results generate a hypothesis that staff-supported PHC delivery may be useful for some older adults, but actual uptake, effectiveness, accessibility, and equity require evaluation in real-world studies that include less digitally capable and more vulnerable populations. Full article

Background/Objectives: Single-retainer Maryland adhesive restorations provide a minimally invasive fixed option for replacing missing anterior teeth in young patients. When congenital absence of a maxillary lateral incisor is associated with a contralateral conoid lateral incisor, the clinical problem extends beyond tooth replacement to bilateral symmetry management. This case report describes a digital-restorative workflow combining a single-retainer lithium disilicate Maryland adhesive restoration with a pontic-derived stamp technique for contralateral symmetry correction. Methods: A medically healthy 13-year-old patient presented with congenital absence of the maxillary left lateral incisor (FDI 22; Universal 10) after orthodontic treatment and had been wearing a removable appliance to replace the single missing tooth. The contralateral maxillary right lateral incisor (FDI 12; Universal 7) presented with conoid morphology, further compromising anterior symmetry. Clinical assessment confirmed ideal mesiodistal space at FDI 22, a vital and unrestored FDI 21 with intact enamel and healthy periodontal support, and the absence of abnormal overjet, overbite, or excursive contact pattern. Based on the findings, a single-retainer Maryland adhesive restoration was fabricated from lithium disilicate (IPS e.max CAD) and bonded to the maxillary left central incisor (FDI 21; Universal 9) using an enamel-only preparation and adhesive cementation protocol. The fixed restoration was combined with a pontic-derived stamp workflow to guide direct composite reshaping of the contralateral conoid lateral incisor. Results: At 1-year follow-up, no debonding, sensitivity, marginal discoloration, or soft-tissue inflammation was observed. The contralateral composite reshaping remained clinically stable, and the patient and guardian reported improved comfort and esthetic satisfaction compared with the previous removable appliance. Conclusions: This case suggests the short-term clinical feasibility of combining a single-retainer lithium disilicate Maryland adhesive restoration with a pontic-derived stamp workflow to achieve minimally invasive tooth replacement and contralateral symmetry correction. Longer follow-up and broader case series are required to confirm the long-term predictability and reproducibility of this approach. Full article

Background/Objectives: Artificial intelligence (AI) is increasingly being integrated into dental diagnostics, promising improved detection, efficiency, and patient communication. While these developments offer potential clinical benefits, emerging commercial applications raise important ethical concerns. This study explores how providers of diagnostic AI systems frame their technologies in marketing materials, with particular attention to features designed to influence patient acceptance and increase revenue. Methods: An exploratory qualitative thematic analysis was conducted on publicly available promotional content from leading dental AI companies between September and October 2025. Materials were analyzed for recurring rhetorical strategies related to commercialization, persuasion, technological authority, and representations of objectivity. Ethical interpretation was guided by principlism, professional ethics, and virtue-based perspectives. Results: The findings show that AI is frequently marketed not only as a diagnostic aid but also as a tool for boosting case acceptance, return on investment, and practice expansion. Visualizations and performance metrics are used rhetorically to position AI as authoritative and objective, encouraging patient compliance while downplaying uncertainty and potential harm. These practices risk undermining patient autonomy, promoting diagnostic inflation and overtreatment, and compromising professional integrity by shifting attention from patient welfare toward commercial outcomes. Conclusion: Pervasive marketing of diagnostic AI amplifies existing tensions between professional integrity and commercial incentives in dentistry. Without appropriate safeguards, AI risks reinforcing a transactional model of care in which patients are treated as consumers and diagnostics become instruments of persuasion. To preserve trust and ethical practice, dentists and professional organizations must ensure that AI remains a supportive clinical tool rather than a commercial device, prioritizing transparency, informed consent, and patient-centered care. Full article

Background: Although early mobilization has been shown to improve clinical outcomes after intensive care unit (ICU)-acquired weakness, its implementation remains limited in routine clinical practice. This study aimed to evaluate the feasibility, safety, and preliminary clinical outcomes of a mobile application-based rehabilitation program in non-ambulatory patients during the early ward phase following ICU discharge. Methods: This prospective single-arm pilot trial included adult patients (≥19 years) who had received ICU care and demonstrated limited ambulatory function, defined as Functional Ambulatory Category (FAC) ≤3. Participants received an individualized, application-guided exercise program comprising two daily sessions over two weeks. Primary outcomes were programmatic feasibility, safety, and patient satisfaction. Rehabilitation compliance was quantified using application usage logs and categorized as high (≥50%) or low (<50%). Secondary functional outcomes, such as Medical Research Council Sum Score (MRC-SS), ICU Mobility Scale, FAC, muscle strength measures, health-related quality of life, and pain scores, were assessed at baseline, week 1, and week 2. Results: Of the 25 initially enrolled patients, 5 dropped out due to clinical status changes or transfers, yielding a retention rate of 80.0%. For the 20 analyzed patients (mean age 52.7 ± 13.9 years; 45% male), the overall mean rehabilitation compliance was 40.6%. No serious adverse events related to the intervention were reported, and overall patient satisfaction and application usability were high. Progressive increases in exercise intensity and training levels were observed throughout the intervention period. Significant improvements over time were found in MRC-SS, ICU Mobility Scale, FAC, grip strength, health-related quality of life, and pain scores (all p < 0.05). Although compliance-based recovery trajectories were confounded by small subgroup sizes and baseline clinical imbalance, exploratory analyses nonetheless identified statistically significant time × compliance interaction effects for MRC-SS and straight leg raise performance. Conclusions: This pilot study demonstrates that a mobile application-based rehabilitation program is a feasible and safe approach to implement in deconditioned patients after ICU discharge. These preliminary functional recovery trajectories provide encouraging signals, suggesting that this digital platform may serve as a potential adjunct to conventional care. Rigorous, randomized controlled trials are required to confirm its definitive clinical efficacy and scalability. Full article

Objectives: The transition from in-person to online formats for clinical case discussions has transformed the way medical professionals collaborate and share knowledge. The current pilot study investigates the potential impact of this shift by comparing the experiences of specialists and residents who had practiced both online and in-person pituitary tumor boards compared to the experiences of those who only experienced the online format. Methods: A cohort of 15 participants, including 10 specialists and 5 residents, provided insights through structured surveys and free-text responses. Results: The results indicate differences in the perception of the duration and participation dynamics in online pituitary tumor boards between both groups, with online boards facilitating the discussion of more cases. Overall participant engagement was mostly perceived as the same; a subset reported reduced perceived engagement, particularly among senior professionals. Conclusions: These findings highlight how prior experience can affect the perceived effectiveness, level of engagement and duration of online formats, providing valuable hypothesis-generating input for optimizing future medical board meetings. Full article

Background/Objectives: The study primarily examined whether an IoT-based medication assistance system enhances ART adherence relative to standard care, and secondarily evaluated device feasibility and error patterns over time. Methods: This prospective study was conducted between June 2022 and October 2023 at a tertiary hospital in South Korea. Adults (≥19 years) living with HIV and prescribed ART were included; those with comorbid hepatitis B or C were excluded. People living with HIV who agreed to use the IoT-based InPHRPILL system (Sofnet Inc., Seoul, Republic of Korea) were assigned to the intervention group, whereas those who declined were assigned to the control group. Viral suppression, CD4⁺ cell counts, and adherence rates were measured. Additional analyses evaluated 12-month longitudinal adherence using pill-count data in both groups, and device-measured adherence and device-associated error rates in the intervention group. Results: Thirty-five participants (12 in the intervention group and 23 in the control group) were included. The intervention group demonstrated marginally shorter durations since HIV diagnosis and ART initiation at study enrollment, as well as slightly higher baseline HIV-RNA levels; however, these differences did not reach statistical significance. The median pill-counting and IoT device adherence rates were 100% and 87.4%, respectively (median deviation error rate = 4.4%). Poisson regression revealed significantly reduced error rates over time (β = −0.06493, p < 0.01), suggesting improved device use proficiency. Conclusions: IoT-based medication assistance systems may provide objective, real-time monitoring of ART adherence and facilitate identification of discrepancies between clinical evaluations and actual adherence patterns. Larger studies targeting individuals with suboptimal adherence are warranted to determine whether such systems can enhance adherence outcomes. Full article

Background: Cancer patients admitted to the bone marrow transplant (BMT) unit face life-threatening medical conditions. Consequently, their family members experience uncertainty, resulting in high levels of anxiety and depression (AD). Limited updates and communication from medical staff exacerbate these emotional burdens. To address these challenges, we developed a mobile health (mHealth) intervention, FamCarePlus, and evaluated its feasibility, usability, and efficacy. We hypothesized that the FamCarePlus application would demonstrate a high degree of feasibility and usability and would reduce AD compared to a control group relying solely on traditional communication through the nurses’ station. Methods: We employed a quasi-experimental pretest/posttest non-randomized, non-blinded self-report design over 3 weeks, with an experimental group (n = 10) using FamCarePlus and a control group (n = 9). We selected participants via convenience sampling using the electronic medical record to identify eligible patients and families, guided by inclusion and exclusion criteria. We used descriptive statistics and the Hospital Anxiety and Depression Scale (HADS) guidelines to analyze the data. Feasibility was defined by a retention rate > 80%, with usability testing using the System Usability Scale (SUS) and NASA Task Load Index (NASA-TLX) surveys. The HADS measured AD, comparing baseline to Week 3. Results: We met our feasibility criteria of >80%. All SUS and NASA scores were in the higher index, suggesting a significant degree of usability and low workload demand on participants. For efficacy, we compared baseline mean scores, with the experimental group reporting lower AD levels at Week 1 (41.9% and 27.8%, respectively) than the control group (55.2% and 34.2%, respectively). From Week 1 to Week 3, the percentage change showed an 8.6% decrease in anxiety in the experimental group, compared to a 12.8% decrease in anxiety in the control group. These results were consistent when analyzed according to HADS guidelines. Conclusions: The findings of this study provide preliminary evidence that the FamCarePlus intervention is feasible and usable, while also demonstrating that its use may be associated with a sustained reduction in AD levels among family members of patients admitted to the BMT unit. These outcomes underscore the potential of digital interventions to address disparities in patient health information access and psychosocial support. Full article

Background/Objectives: Mobile health (mHealth) technologies are increasingly used to support preventive oral care and patient self-management. CarieCheck is a Portuguese app intended to improve oral health literacy and support caries-risk self-assessment. This prospective pilot study focused on users’ perceived app quality and usability, assessed with uMARS-PT. Methods: Thirty participants from the academic community of Egas Moniz School of Health and Science used the app for 30 days and completed the uMARS-PT questionnaire. Descriptive statistics were used to calculate mean scores for Engagement, Functionality, Aesthetics, Information Quality, Subjective Quality, and Perceived Impact. Results: The overall mean uMARS-PT score was 4.22, indicating excellent perceived quality. The highest domain scores were Functionality (4.51), Aesthetics (4.45), and Information Quality (4.22). Engagement (3.71) and Subjective Quality (3.05) were moderate. Perceived Impact (3.85) reflected self-reported perception of increased awareness and motivation regarding oral health behaviors. Conclusions: CarieCheck was rated highly in usability, aesthetics, and information quality. These findings suggest that CarieCheck may be considered as a digital tool for preventive education and user-supported caries-risk self-assessment. Larger, longer-term studies in diverse populations using objective behavioral and clinical outcomes are warranted. Full article

Background: Digital technologies can contribute to healthcare democratization in an ethical, safe, and sustainable context. The remote monitoring of implantable cardiac devices enables the follow-up of patients from a distance. Patients with anti-bradycardia pacemakers represent the largest group and have the least access to this technology due to the controversial cost–benefit ratio and barriers to its widespread implementation, such as equipment costs and organizational challenges. In contrast, reimbursed transportation in Portugal reached approximately 82 million euros in 2024. Objectives: The aim of the present study was to assess the financial viability of remote pacemaker follow-up in a Portuguese district hospital, comparing the non-urgent transportation costs and the investment in remote monitoring equipment while measuring user acceptance and satisfaction. Methods: A total of 41 surveys were conducted with patients who received a pacemaker and used publicly reimbursed transportation. The projected costs were calculated for two simulated protocols: the first involved in-person visits every six months, while the second involved in-person visits every two years with remote consultations every six months, over the expected lifespan of the devices. EZR, version 1.61, was used. Results: Our data showed a 74% overall reduction in face-to-face visits. The implementation of remote follow-up would result in a cost saving of EUR 373/patient (21.2%), with total reimbursement (p = 0.01151). The savings increased to 33.3%, reaching EUR 764/patient (p = 0.0002742) for distances greater than 60 km (round trip) for ambulance users with total reimbursement. Acceptance and satisfaction achieved 88%. Conclusions: Remote monitoring of pacemakers can be a financially viable alternative with high acceptance and satisfaction. Full article

Background: Primary Sclerosing Cholangitis (PSC), Primary Biliary Cholangitis (PBC), and Autoimmune Hepatitis (AIH) are rare immune-mediated liver conditions that significantly affect patients’ quality of life. In Romania, access to specialized information and patient support resources is limited, underscoring the need for tailored educational tools. The aim was to describe the methodology for developing, implementing, and conducting a feasibility study of an online platform for patients with PSC, PBC, and AIH, as a pilot study, providing early insights. Methods: The platform offers educational materials, registration, a discussion forum, and digital tools for quality-of-life assessment. Data on demographics, usage, and quality of life were collected using standardized questionnaires (CLDQ-PSC, PBC-10) and non-standardized questionnaires, and analyzed with Microsoft Office Excel and DATATab. Results: The website was created using an online platform requiring no advanced IT skills. Content was developed in accordance with international guidelines (EASL, AASLD) and translated and adapted for Romanian patients. As of 15 July 2025, 81 patients had been registered (26% PSC, 68% PBC, 6% AIH), with a predominance of urban participants (all patients: 87% female, mean age at diagnosis = 44.5 years). Most participants used mobile devices and reported improved understanding and engagement with their health after using the platform. Conclusions: The first dedicated digital platform has been established in Romania to address the health literacy needs of patients with PSC, PBC, and AIH. The study offers insights into future directions and a replicable model for similar initiatives. The pilot evaluation of the platform faced several limitations, including self-selection bias, non-standardized assessments, and a small sample size. Full article

Background and Objectives: Falls are a leading cause of morbidity and mortality among older adults in hospitals and long-term care facilities (LTCFs). Digital healthcare approaches are increasingly being applied to fall detection and prevention; however, their effectiveness remains uncertain. This review evaluated the effectiveness, usability, and clinical applicability of detection- and prediction-based systems in institutional settings. Materials and Methods: We systematically searched major international and Korean databases—PubMed, Embase, Ovid-MEDLINE, CINAHL, the Cochrane Library, IEEE, KMbase, KISS, KoreaMed, and RISS—for studies published up to December 2024. The eligible studies included randomized controlled trials, quasi-experimental, and observational studies involving older adults in hospitals or LTCFs. Two reviewers independently screened the studies, extracted data, and assessed their quality using standardized tools. Results: Thirty-three studies comprising 20 fall detection systems and 13 fall prediction models were included. Detection systems using inertial, pressure, radar, or multimodal sensors have improved monitoring and achieved high usability (>80% acceptance); however, they did not consistently reduce fall incidence or the occurrence of injurious falls. For instance, one trial reported a nonsignificant reduction in injurious falls (aRR 0.56, 95% CI 0.17–1.79), whereas another trial observed a nonsignificant increase (aIRR 1.60, 95% CI 0.83–3.08). Frequent false alarms contribute to alarm fatigue. The prediction models showed moderate-to-strong discrimination. Gradient boosting and neural networks performed best for continuous gait features, while regression and boosting approaches were effective for categorical EHR data. Most models lacked external validation and were not linked to clinical care pathways. Conclusions: Digital approaches show potential for fall prevention in hospitals and LTCFs; however, current evidence remains inconsistent and limited. Detection systems improve surveillance but offer limited preventive effects, whereas prediction models demonstrate technical promise without establishing clinical benefits. Future research should refine the technology, validate models externally, and integrate them into patient-centered workflows. Full article

Objective: To explore the lived experiences of type 2 diabetes mellitus (T2DM) patients undergoing peritoneal dialysis (PD) or hemodialysis (HD) using continuous glucose monitoring (CGM). Research Design and Methods: A qualitative phenomenological study was conducted with 50 adult T2DM patients on PD or HD who used CGM for at least 14 days. Semi-structured interviews were audio-recorded and transcribed verbatim. A thematic analysis framework was applied to identify major themes regarding insulin management, CGM utilization, and emotional and social dimensions. Results: Four main themes emerged, each with multiple subthemes. PD patients emphasized enhanced autonomy and frequent insulin adjustments due to dialysate glucose absorption. Conversely, HD patients reported severe post-dialysis fatigue, emotional distress, and limited social engagement often associated with intra-dialytic hypoglycemia. CGM was valued by 85% of participants for improving metabolic awareness and self-management. However, 15% reported barriers such as device cost and technical difficulties. The insights clearly distinguish the differential impact of dialysis modality on daily glucose control and patient well-being. Conclusions: These findings underscore the critical need for patient-centered care incorporating access to CGM and tailored insulin regimens. Equitable implementation of CGM in dialysis settings could significantly enhance glycemic control, emotional resilience, and overall quality of life. Full article