11 General introduction 1 modern technologies. It now encompasses a wide range of digital health technologies, including electronic health records, clinical decision support systems, telemedicine, health apps, wearables, and sensors. Providing a myriad of opportunities, it is considered essential for addressing the existing healthcare challenges at both national and global levels. Role and benefits of eHealth The widespread uptake and use of mobile phones and internet access globally have made mobile phones a powerful platform for delivering personalized health in a for patient convenient way. This form of eHealth has particularly gained traction in the treatment and management of chronic lung conditions such as asthma, and Chronic Obstructive Pulmonary Disease (COPD) (3-5). Managing these chronic diseases is a multidisciplinary process, requiring close collaboration between healthcare professionals and active engagement of patients themselves. As such, technologies like remote monitoring devices and mobile apps can offer ongoing individual selfcare support, facilitate regular monitoring for better health outcomes and stimulate patients in changing undesired behaviour into desired behaviour, such as adhering to a medication regimen (3). Lack of widespread adoption and implementation While the past decade is marked by an ongoing exponential growth of eHealth technologies, a substantial portion of these technologies pose health claims which are not supported by sufficient research to validate their effectiveness, safety, or impact on health outcomes. eHealth that is sufficiently evidence-based may still be challenged by poor uptake into practice. Hence, while there is an exponential growth in digital health technologies, only a small portion of them find their way into practice and benefit patients. This discrepancy between research and development efforts and practical application is characterized by low adoption rates, limited scalability, and inadequate integration into existing healthcare and reimbursement systems (6). During the COVID-19 pandemic telemedicine and remote patient monitoring have proved instrumental in maintaining access to care, mitigating the spread of the virus, and optimizing resource utilization and as such has raised awareness on the usage and benefits of eHealth. However, while the COVID-19 pandemic has propelled the use of telemedicine, it has also exposed important gaps in effective integration of telehealth within the current health system (7). Hence, though initially marked as the turning point in the digitalization of healthcare, enabled by regulatory changes that enabling greater access and reimbursement and an increased user and provider willingness (8), its long term impact remains debatable and most importantly limited to the use of telemedicine (9-11). Extensive literature before and after the COVID-19 pandemic has highlighted the reasons behind the failure of widespread eHealth adoption and implementation. As a result, research focus has shifted from primarily developing innovative digital health solutions to understanding the conditions necessary for successful implementation
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