## 4 Discussion
Secure data-sharing frameworks between transplant centers, laboratories, and specialists enhance continuity of care and reduce transplant-related risks. By enabling data-driven decision-making and improving communication, HIT fosters a holistic approach to transplant care, ultimately optimizing patient outcomes. Beyond improving provider coordination, health tools also empower patients by providing them with resources to participate actively in their care. Meanwhile, healthcare providers can use these tools to engage patients in self-management, monitor their progress remotely, and inform their decisions regarding patient health. Integrating digital health tools for patient and provider-centric purposes fosters a holistic approach to transplant care, enhancing communication, efficiency, and overall patient outcomes. By leveraging shared platforms, healthcare providers can make informed decisions such as altering medication dosages, treatment plans, and interventions based on the data provided by patients through health devices [31; 47]. Regarding the _barriers to using eHealth_, this study identified three categories of barriers, including (1) knowledge and access barriers [22; 24; 39; 44; 70; 75; 76], (2) usability and implementation challenges [22; 39; 44; 45], and (3) user experience and trust issues [9; 24; 38]. These three categories indicate interconnectedness and highlight a chain reaction, where problems within one category will induce problems in another. In the case of knowledge and access barriers, poor IT literacy can exacerbate usability challenges [44]. For instance, patients who are unfamiliar with digital tools may struggle to navigate platforms for scheduling appointments or tracking medications, leading to frustration and reluctance to use the tools. Similarly, if users need more understanding or training on how to use devices/software, usability challenges become more prominent [39]. Limited access to adequate resources, such as appropriate internet connection, can hinder the successful use and integration of digital tools [38; 52]. Furthermore, negative user experiences can reinforce knowledge barriers. If someone has a bad experience with technology, they might be less inclined to invest time learning about it or exploring its capabilities. Difficulties in using technology directly impact user experience [39]. For example, complex interfaces or functionalities often result in poor user experiences, which can trigger trust issues. A common example of this could be when a patient encounters an overly complicated health app that fails to track their data correctly, leading them to question the reliability of the platform. Trust issues, particularly concerning privacy and data security, can discourage users from fully engaging with eHealth tools [38]. Users might be concerned about the confidentiality of their health information or fear their data could be misused, which can lead to their reluctance in using certain devices or platforms [9]. These trust issues can undermine user engagement, thus compounding the barriers to successful technology adoption. Addressing one category of barriers involves considering and mitigating aspects from the other categories. For instance, improving user experience might involve simplifying usability, addressing knowledge gaps through education or training, and fostering trust by enhancing security measures. Ultimately, overcoming barriers to digital devices requires a holistic approach that considers the interconnected nature of these challenges and seeks comprehensive solutions to improve technology adoption and usage. By considering these interrelated barriers, stakeholders can develop tailored interventions and strategies that enhance user engagement, improve clinical workflows, and ultimately enhance patient care and outcomes.