PATIENT-CENTERED SMART HEALTHCARE: INTEGRATING DIGITAL HEALTH LITERACY, REMOTE MONITORING, AND PERSONALIZED PREVENTIVE CARE

Rifki Agus Kurniawan; Danial Hariadi; Ahmad Hariyanto

doi:10.55681/aohj.v3i1.566

Authors

Rifki Agus Kurniawan Institut Teknologi dan Kesehatan Aspirasi
Danial Hariadi Institut Teknologi dan Kesehatan Aspirasi
Ahmad Hariyanto Institusi Teknologi dan Kesehatan Aspirasi

DOI:

https://doi.org/10.55681/aohj.v3i1.566

Keywords:

Health literacy, Remote monitoring, Personalized prevention

Abstract

Patient-centered smart healthcare requires more than the deployment of connected devices; it depends on patients’ capacity to understand digital information, participate in remote monitoring, and translate personalized feedback into preventive action. This study examined an integrated model linking digital health literacy, remote monitoring engagement, and personalized preventive care with patient-centered outcomes. A cross-sectional explanatory design was developed for 286 adult primary-care users who had experience with mobile health applications or connected monitoring devices. Data were collected using structured measures of digital health literacy, monitoring engagement, perceived personalization, self-management activation, and perceived continuity of care. The simulated dataset showed satisfactory internal consistency across constructs and indicated that digital health literacy was positively associated with monitoring engagement, while monitoring engagement and perceived personalization were associated with stronger self-management activation and continuity of care. The integrated regression model explained 48.6% of the variance in patient-centered outcome scores, with personalized preventive care emerging as the strongest predictor, followed by remote monitoring engagement and digital health literacy. Subgroup analysis suggested lower digital health literacy among older and less-educated participants, highlighting an equity risk when smart-healthcare pathways assume uniform digital capability. The study contributes an integrative patient-centered framework in which literacy functions as an enabling capability, remote monitoring as a continuous data pathway, and personalized prevention as the mechanism that converts data into meaningful action. The findings support combining technology implementation with literacy-sensitive onboarding, human support, interoperable monitoring, and shared preventive decision-making in routine primary care.

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References

Algifari, M. H., Zachary, L., Yuliani, R. P., Aditama, H., & Kristina, S. A. (2024). Digital health literacy and its associated factors in general population in Indonesia. Indonesian Journal of Pharmacy. https://doi.org/10.22146/ijp.5640

Andersson, S. W., & Gonzalez, M. P. (2025). Digital health literacy—a key factor in realizing the value of digital transformation in healthcare. Frontiers in Digital Health, 7, 1461342. https://doi.org/10.3389/fdgth.2025.1461342

Arias López, M. D. P., Ong, B. A., Borrat Frigola, X., Fernández, A. L., Hicklent, R. S., Obeles, A. J. T., Rocimo, A. M., & Celi, L. A. (2023). Digital literacy as a new determinant of health: A scoping review. PLOS Digital Health, 2(10), e0000279. https://doi.org/10.1371/journal.pdig.0000279

Brands, M. R., Gouw, S. C., Beestrum, M., Cronin, R. M., Fijnvandraat, K., & Badawy, S. M. (2022). Patient-centered digital health records and their effects on health outcomes: Systematic review. Journal of Medical Internet Research, 24(12), e43086. https://doi.org/10.2196/43086

Canali, S., Schiaffonati, V., & Aliverti, A. (2022). Challenges and recommendations for wearable devices in digital health: Data quality, interoperability, health equity, fairness. PLOS Digital Health, 1(10), e0000104. https://doi.org/10.1371/journal.pdig.0000104

De Guzman, K. R., Snoswell, C. L., Taylor, M. L., Gray, L. C., & Caffery, L. J. (2022). Economic evaluations of remote patient monitoring for chronic disease: A systematic review. Value in Health, 25(6), 897–913. https://doi.org/10.1016/j.jval.2021.12.001

Estrela, M., Semedo, G., Roque, F., Ferreira, P. L., & Herdeiro, M. T. (2023). Sociodemographic determinants of digital health literacy: A systematic review and meta-analysis. International Journal of Medical Informatics, 177, 105124. https://doi.org/10.1016/j.ijmedinf.2023.105124

Gilbert, R. M. (2022). Reimagining digital healthcare with a patient-centric approach: The role of user experience (UX) research. Frontiers in Digital Health, 4, 899976. https://doi.org/10.3389/fdgth.2022.899976

Jiang, X., Wang, L., Leng, Y., Xie, R., Li, C., Nie, Z., Liu, D., & Wang, G. (2024). The level of electronic health literacy among older adults: A systematic review and meta-analysis. Archives of Public Health, 82, 204. https://doi.org/10.1186/s13690-024-01428-9

Koehle, H., Kronk, C., Lee, Y. J., et al. (2022). Digital health equity: Addressing power, usability, and trust to strengthen health systems. Yearbook of Medical Informatics, 31(1), 20–32. https://doi.org/10.1055/s-0042-1742512

Kwon, H., et al. (2025). The application of preventive medicine in the future digital health era. Journal of Medical Internet Research, 27, e59165. https://doi.org/10.2196/59165

Leo, D. G., Buckley, B. J. R., Chowdhury, M., Harrison, S. L., Isanejad, M., Lip, G. Y. H., Wright, D. J., & Lane, D. A. (2022). Interactive remote patient monitoring devices for managing chronic health conditions: Systematic review and meta-analysis. Journal of Medical Internet Research, 24(11), e35508. https://doi.org/10.2196/35508

Lewinski, A. A., Walsh, C., Rushton, S., et al. (2022). Telehealth for the longitudinal management of chronic conditions: Systematic review. Journal of Medical Internet Research, 24(8), e37100. https://doi.org/10.2196/37100

Ma, Y., Zhao, C., Zhao, Y., Lu, J., Jiang, H., Cao, Y., & Xu, Y. (2022). Telemedicine application in patients with chronic disease: A systematic review and meta-analysis. BMC Medical Informatics and Decision Making, 22, 105. https://doi.org/10.1186/s12911-022-01845-2

Pannunzio, V., Morales Ornelas, H. C., Gurung, P., et al. (2024). Patient and staff experience of remote patient monitoring—What to measure and how: Systematic review. Journal of Medical Internet Research, 26, e48463. https://doi.org/10.2196/48463

Rachmani, E., et al. (2022). Development and validation of digital health literacy competencies for citizens (DHLC), an instrument for measuring digital health literacy in the community. Computer Methods and Programs in Biomedicine Update, 2, 100082. https://doi.org/10.1016/j.cmpbup.2022.100082

Richardson, S., Lawrence, K., Schoenthaler, A. M., & Mann, D. (2022). A framework for digital health equity. npj Digital Medicine, 5, 119. https://doi.org/10.1038/s41746-022-00663-0

Shaik, T., Tao, X., Higgins, N., Li, L., Gururajan, R., Zhou, X., & Acharya, U. R. (2023). Remote patient monitoring using artificial intelligence: Current state, applications, and challenges. WIREs Data Mining and Knowledge Discovery, 13(2), e1485. https://doi.org/10.1002/widm.1485

Shi, Z., Du, X., Li, J., Hou, R., Sun, J., & Marohabutr, T. (2024). Factors influencing digital health literacy among older adults: A scoping review. Frontiers in Public Health, 12, 1447747. https://doi.org/10.3389/fpubh.2024.1447747

Tan, S. Y., Sumner, J., Wang, Y., & Yip, A. W. (2024). A systematic review of the impacts of remote patient monitoring interventions on safety, adherence, quality-of-life and cost-related outcomes. npj Digital Medicine, 7, 192. https://doi.org/10.1038/s41746-024-01182-w

Vandenberk, B., & Raj, S. R. (2023). Remote patient monitoring: What have we learned and where are we going? Current Cardiovascular Risk Reports, 17(6), 103–115. https://doi.org/10.1007/s12170-023-00720-7

Verweel, L., Newman, A., Michaelchuk, W., Packham, T., Goldstein, R., & Brooks, D. (2023). The effect of digital interventions on related health literacy and skills for individuals living with chronic diseases: A systematic review and meta-analysis. International Journal of Medical Informatics, 177, 105114. https://doi.org/10.1016/j.ijmedinf.2023.105114

Sugiyono. (2022). Metode penelitian kuantitatif, kualitatif, dan R&D. Bandung: Alfabeta. (National research-methods book; no DOI assigned.)