## 4 Discussion
In terms of _benefits that eHealth_ provides to users, this study identified four categories of benefits associated with using health devices for transplantation pre- and post-care, including (1) improvement in patient care and engagements [17; 18; 26; 29; 30; 32; 41; 49; 52; 54; 55; 69; 72], (2) convenience and accessibility [17; 22; 35; 56; 59; 61], (3) empowerment and safety [22; 33; 52; 55], and (4) cost-efficiency and time-saving [35; 56; 59; 64; 65]. These four categories indicate interconnectedness and highlight areas that influence and generate impact in one another. Empowered patients are more engaged in their care, leading to better adherence to treatment plans and improved outcomes [58]. When patients feel empowered with a suitable health device, they will take a more proactive approach to their health [39; 58]. Remote monitoring and accessibility reduce the need for in-person visits, lowering healthcare costs and saving time for patients and transplant providers [12; 24]. Feeling empowered and safe using health devices increases the willingness of individuals to adopt and use them [59]. This, in turn, improves accessibility to healthcare services, especially for those who might face barriers to traditional healthcare access [10]. One critical factor affecting the effectiveness of eHealth solutions in transplantation is the underlying digital communication infrastructure. Networking and communication play a crucial role at every stage of the transplant process, from pre-transplant evaluation to post-transplant monitoring and long-term follow-up care [18; 36]. Before transplantation, effective networking between transplant centers and donor registries is essential for organ allocation, ensuring that organs are matched efficiently based on real-time patient data and compatibility criteria [77]. During the transplant process, seamless communication between multidisciplinary teams, including transplant surgeons, nephrologists, hepatologists, and coordinators, is necessary to optimize surgical planning and resource allocation [77]. Post-transplant, continuous digital communication enables real-time monitoring of transplant recipients, facilitating early detection of complications such as organ rejection or infections [33; 47]. For example, networked Internet of Medical Things (IoMT) devices transmit patient vitals directly to healthcare providers, ensuring timely interventions [10; 15; 18]. Long-term, networking enhances remote patient engagement, allowing transplant recipients to consult specialists from different locations and access digital health resources for medication adherence and lifestyle management [9; 53; 57]. The need for networking becomes even more critical in regions with limited transplant facilities, as digital communication helps bridge geographical barriers, improving equity in access to transplant care [35]. Several studies in this review indicate that real-time telehealth monitoring, EHRs, and AI-driven analytics rely on cloud-based data systems and high-speed networks. The integration of 5G, IoMT devices, and blockchain security has the potential to improve data security, remote accessibility, and telehealth service reliability [10; 15; 18]. Regarding the _development process of eHealth interventions_, this study identified two crucial factors in developing the process of digital health, which are (1) patient-centered [12; 37; 70] and (2) preparation and readiness [37; 73]. A patient-centered approach in the development of eHealth tools emphasizes the need to ensure that health devices, as well as transplant providers, clinicians, and pharmacists, are all aligned with patient needs. This approach requires eHealth tool developers to prioritize patient-specific needs in the design of health devices [12; 37]. For instance, personalizing features on digital tools ensures that patients feel actively involved in their care, tailoring their experience to their specific needs and preferences [12; 37].