Underserved Populations Research Articles

Development of a Diabetes Navigator Toolkit to Support Diabetes Technology Uptake: The IMPACT Toolkit

Advanced diabetes technologies (ADTs), including continuous glucose monitoring devices, insulin pumps, and automated insulin delivery systems, improve glycemic control in type 1 diabetes but are underutilized, particularly in minority and underserved populations. This article reports on a qualitative study to develop a diabetes toolkit. Participants identified barriers to the use of ADTs and proposed solutions to these barriers, which were then incorporated into a diabetes toolkit designed for use by a diabetes navigator or other diabetes care team members seeking to improve the uptake and sustained use of ADTs.

The Impact of Telemedicine on Chronic Disease Management: A Post-Pandemic Analysis of Patient Outcomes and Accessibility

This study explores the impact of telemedicine on chronic disease management, focusing on patient outcomes and healthcare accessibility in the post-pandemic context. Using a qualitative research approach, the study examines how telemedicine has transformed the management of chronic conditions, especially for patients facing geographical or mobility barriers. Data were collected through in-depth interviews with patients, healthcare providers, and policy experts to gain insights into the experiences and challenges associated with telemedicine for chronic care. The findings reveal that telemedicine has improved patient accessibility to healthcare services, enabling consistent monitoring and timely interventions, which positively impact patient health outcomes. However, the study also identifies challenges, including technological barriers and limitations in patient-provider communication, that may affect care quality and patient satisfaction. Despite these issues, telemedicine is seen as a valuable supplement to traditional healthcare, enhancing healthcare access, especially for underserved populations. This research provides key insights for healthcare policymakers and practitioners in improving telemedicine practices, ensuring that they address accessibility gaps without compromising quality. The study concludes that, with strategic improvements, telemedicine holds significant potential to transform chronic disease management and make healthcare more equitable.

The Promise of Remote Patient Monitoring.

The promise of remote patient monitoring (RPM) lies in its ability to revolutionize health care delivery by enabling continuous, real-time tracking of patient health outside traditional clinical settings. The COVID-19 pandemic accelerated the adoption of RPM, particularly in underserved and rural populations, highlighting both its potential and the persistent barriers that limit its widespread use. This paper explores the critical role of technological advancements-such as wearables, artificial intelligence (AI), and broadband expansion-in sustaining and optimizing RPM in the postpandemic era. We examine Michigan as a microcosm of national health care challenges, focusing on its diverse population and geographic barriers, and propose condition-specific RPM protocols to address these inequities. Key facilitators and barriers to RPM implementation are discussed, with a focus on AI integration, community engagement, and digital infrastructure. We also explore the role of policy reform and public-private partnerships in supporting RPM's scalability and long-term sustainability. Our findings suggest that while RPM offers a powerful tool for improving health care access and outcomes, especially for chronic conditions and rural maternal health, sustained investment in technology and infrastructure is critical. By addressing these challenges, RPM can become a cornerstone of modern health care, reducing disparities and improving care delivery for underserved populations.

Abstract Su908: Unfavorable prognostic features and temporal trends in Out-of-Hospital Cardiac Arrests (OHCA) presenting to an Academic Center at the Border in El Paso

Introduction: Early recognition of cardiac arrest with bystander cardiopulmonary resuscitation (CPR), and early defibrillation when appropriate, can improve outcomes after Out of Hospital Cardiac Arrest (OHCA). Data from the national registries indicate there are both regional as well racial and ethnic differences in rates of bystander CPR in witnessed OHCA cases with significantly lower rates of bystander CPR in non-white persons. However, Hispanic as well border populations are underrepresented in these studies. University Medical Center (UMC) El Paso, Texas is an academic medical center located 1 mile from the US- Mexico border which is also the only not for profit safety net hospital with a Level1 trauma center. Research Question: Outcomes after OHCA are strongly affected by peri-arrest circumstances including bystander CPR and certain features portend poor outcomes. We performed a descriptive observational study of OHCA cases presenting to UMC to analyze temporal trends in these factors in our community as local data from El Paso is currently not reported in any registries. Methods: We collaborated with the El Paso Fire Department (EPFD) to obtain resuscitation data on patients who suffered OHCA and were brought to the University Medical Center (UMC)Emergency Department (ED) and created a registry of patients who suffered OHCA in El Paso FROM 2017 to Nov 2021. Results: Initial analysis identified around 698 predominantly Hispanic patients who suffered OHCA. Of these 115 were due to non-cardiac causes such as trauma, and 583 were possible cardiac etiology. OHCA cases peaked in 2020 coinciding with COVID 19 surge. Less than one third (31.5%) had bystander CPR with only 11.9% having a shockable rhythm. 64% did not achieve Return of spontaneous circulation in the field. 39% expired in the ED or in the field. We also performed a temporal analysis of these features and bystander CPR rates peaked in 2019 (38.1%to 24.8% in 2021). Conclusion: In our Hispanic underserved population in El Paso, we identified poor outcomes after OHCA, with non-shockable rhythm being the most common adverse feature and decreased rates of bystander CPR (31.5%) with further decrease after 2019. Local community level data which is critical for appropriate local resource allocation to improve OHCA outcomes is missing from underserved populations and additional resources are required improve outcomes.

Characteristic of mental health app usage: a cross-sectional survey in the general population.

Mental health apps (MHA) have gained popularity in recent years. Most freely available apps are of low quality and lack evidence for effectiveness. Yet, download rates indicate high usage. MHA are potentially beneficial for individuals with no/low symptom severity as prevention, or as an option to reach underserviced populations. However, currently very little is known about the characteristics of MHA users in the general population, about the kind of MHA used, or the motivation behind MHA usage. We collected survey-data from N = 1,247 individuals from the general population to investigate MHA usage. Descriptive statistics revealed that 41% had used MHA in the past 12 months; prescription app-use however was low (1.5% of MHA users). Mindfulness, moodtracking, and relaxation were the most popular categories of MHA. Perceived helpfulness, fun, and availability were the top reasons for MHA usage. Non-users reported distrust, lack of perceived need, and data security concerns as usage barriers. MHA users and non-users did not differ regarding sociodemographic variables. Multiple regression analyses revealed that sub-threshold symptoms of psychological disorders as well as higher levels of anxiety and stress were linked to higher probability of MHA usage. Higher levels of depression were associated with lower likelihood of MHA usage in general, but increased likelihood of usage of self-help apps specifically for depression. It follows that MHA use is common in the general population independent of sociodemographic characteristics. MHA can reach people who might benefit, but more awareness and better structure of the market is needed to reduce distrust, increase usage of high-quality MHA, and improve the fit between app and user.

Abstract 4115235: Disparities in Youth Cardiac Screening by Childhood Opportunity Index: Insights from the Heartbytes Database

Intro: The AHA endorses screening youth athletes to identify risk for sudden cardiac arrest (SCA). Rates of SCA can be predicted by social determinants of health (SDOH) such as education level and proportion of Black residents in ZIP Code. The Child Opportunity Index (COI) quantifies neighborhood factors that influence health and development. The link between COI and youth cardiac screening findings and outcomes remains unclear. Hypothesis: Cardiac screening data will differ significantly by COI. Aims: To identify differences in cardiac screening data in children of varying COI. Methods: The HeartBytes Database, including sports exams, self-reported physical activity (PA), and zip codes from Simon's Heart screenings was augmented with COI index zip code data. Chi-squared and logistic regression were used to analyze demographics, cardiac risk factors, and screening results. Data: Screening data of 11,431 youth athletes (median age 14.3 (IQR = 3), BMI 20.6 (4.8), 53.7% male, 70.6% White) was analyzed. The majority of children had very high overall COI (Figure 1). Hypertension, hyperlipidemia, Kawasaki disease, and heart infection were similar across COI levels (p > 0.05). Levels of physical activity varied significantly across levels of overall COI, with the highest levels reported in the lowest COI group (50.4% with > 10 hours PA/week) (Chi-Squared; p = 0.007). Positive screening rates varied significantly by level of COI (p = 0.013) (Figure 2). The overall level of education, health environment, and socioeconomic COI did not predict positive screening outcomes in logistic regression analysis (all p>0.05). Conclusion: Prevalence of cardiac risk factors did not vary significantly across COI levels, however, positive screening rates were highest in moderate and very low COI levels. Simon’s Heart engaged communities across the COI spectrum; however, a majority of children had high or very high COI. Further efforts are needed to expand access to underserved populations of lower COI.

Exploring patient loyalty in telemedicine through bibliometric analysis and future horizons

Purpose In an era of rapid telemedicine expansion, patient loyalty is paramount for effective health-care delivery. This study aims to understand loyalty behaviours in telemedicine to refine services. The primary objectives are to elucidate the current state of scholarly inquiry concerning loyalty within the telemedicine sphere and to address existing research deficiencies within this domain. This exploration seeks to provide valuable insights and contribute to the advancement of knowledge in this critical area of inquiry. Design/methodology/approach This study uses a bibliometric analysis to investigate patient loyalty in telemedicine. By reviewing existing literature and analysing bibliometric data, the research identifies key deficiencies and addresses pertinent research questions within the telemedicine loyalty domain. This methodological approach aims to offer a comprehensive understanding of the current state of research and highlight areas requiring further investigation. Findings This study reveals significant gaps in existing research on telemedicine loyalty, identifying a need for more focused studies on patient loyalty behaviours. Through a bibliometric analysis, the findings highlight critical areas for improvement and potential strategies for enhancing patient loyalty in telemedicine. These insights are crucial for refining telemedicine services and ensuring effective health-care delivery. Research limitations/implications The findings may not capture all dimensions of patient loyalty in telemedicine, requiring further empirical studies. Future research should expand on these limitations by incorporating diverse methodologies and broader data sets to validate and extend the study’s insights. Practical implications The insights from this study can help health-care providers refine their telemedicine services to enhance patient loyalty. By understanding loyalty behaviours, providers can develop targeted strategies to improve patient satisfaction and retention. These practical implications are essential for the continuous improvement of telemedicine services, ensuring they meet patient needs and expectations effectively. Social implications Enhancing patient loyalty in telemedicine leads to significant societal benefits, particularly by improving health-care access for underserved populations in rural or economically disadvantaged areas. Continuous and trusted care helps reduce health-care disparities and fosters health equity, positively impacting quality of life through timely medical consultations. In the context of medical tourism, telemedicine facilitates reliable remote consultations, boosting confidence in health-care systems abroad and benefiting local economies. In addition, tourists can access health-care services while travelling, enhancing their sense of safety and well-being. Overall, these advancements highlight telemedicine’s potential to create a more equitable and accessible health-care landscape. Originality/value This study fills a critical gap in telemedicine research by focusing on patient loyalty, an area often overlooked in existing literature. The bibliometric analysis offers a novel approach to understanding and addressing loyalty behaviours. The findings contribute valuable knowledge, advancing the discourse on telemedicine loyalty and providing a foundation for future research and service improvements.

QOL-28. CANCER-RELATED DISTRESS IN NEURO-ONCOLOGY: PATIENTS INFORM PROGRAM DEVELOPMENT FOR ENHANCING QUALITY OF LIFE

Abstract BACKGROUND Brain tumor diagnosis and treatment result in significant negative sequelae, including cognitive decline, fatigue, and psychosocial symptoms. This study aimed to identify brain tumor patients’ sources of cancer-related distress and examine their interest in various treatment modalities targeting cognitive decline to inform program development for this underserved population. METHODS In pursuit of program development, patients with both primary and secondary brain tumors completed an anonymous survey. They reported demographics, tumor characteristics, subjective cognitive functioning; and, rated sources of cancer-related symptom distress (i.e., cognitive changes, fatigue, physical symptoms, motor functioning, balance, mood, and relationship) and interest in treatments targeting cancer-related cognitive decline (i.e., cognitive rehabilitation, mindfulness-based practices, psychotherapy, and medication). Descriptive statistics, t-tests, chi-square, and linear regressions were conducted. RESULTS Among participants (N=137, Mage=49.6±15.8, 58.1% female, 84.8% White), 50.4% endorsed subjective cognitive functioning below the mean (MFACT-Br-CI=22.6±7.5). Nearly half reported significant distress due to cancer-related fatigue (49.6%) and cognitive change (48.9%). Patients’ mean severity of distress due to cognitive decline was significantly greater relative to all other cancer-related symptoms (ps<.001), except fatigue (p>.05). Age, gender, or time since diagnosis were not significant predictors (ps>.05) of distress due to cognitive decline. Most patients with distress due to cognitive change were interested in cognitive rehabilitation (63.6%) and mindfulness-based practices (61.6%), and only 40.4% were interested in medication. Interest in cognitive rehabilitation was not predicted by symptom distress, subjective cognitive functioning, age, gender, or time since diagnosis (ps>.05). Gender was the only significant predictor of interest in mindful movement (b=.18, p=.041), with greater interest among women (χ2(1)=4.65, p=.031). CONCLUSIONS Fatigue and cognitive decline were the most distressing cancer-related symptoms for neuro-oncology patients. These findings emphasize the need for integrated interventions, including cognitive rehabilitation and mindfulness, as well as multi-targeted and individualized treatments for fatigue and cognitive decline in neuro-oncology.

Barriers to Cancer Care in the LGBTQ+ Community.

Individuals that identify as lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) make up a medically underserved population, that experience disparities in cancer care. Specific cancer incidence and mortality in this population is understudied, as national cancer registries and cancer surveys have limited data about sexual orientation or gender identity. The LGBTQIA community face disparate cancer outcomes in prevention, screening, diagnosis, and treatment due to barriers that limit access to cancer care. To better understand these concerns, we will take a deep dive into the three primary barriers that prevent access to cancer care: personal, provider and systems barriers.

The modern role of paraprofessionals in delivering brief psychological interventions

AbstractThe increasing global demand for mental health services, compounded by the COVID‐19 pandemic, has spurred innovative approaches. Among these, the utilisation of paraprofessionals for delivering brief psychological interventions (BPIs) is gaining significant traction across diverse settings and populations. Paraprofessionals (individuals equipped with specialised mental health training but lacking formal qualifications) have emerged as a valuable resource. They have the potential to offer cost‐effective, culturally sensitive and readily accessible support. The integration of paraprofessionals into various healthcare settings, such as inpatient psychiatric units and primary care clinics, underscores their potential to enhance holistic well‐being and early intervention. This integration not only lightens the load on licensed therapists but also broadens access to services while reducing treatment costs. At a global scale, paraprofessionals, armed with local knowledge and community connections, play a pivotal role in improving mental health outcomes among underserved populations. Furthermore, the rise of telemental health, an increasingly crucial aspect of mental healthcare, presents new avenues for paraprofessionals to deliver psychological care. Despite their potential, paraprofessionals encounter challenges related to work‐life balance, boundary‐setting and the stigma attached to their roles. Their integration into healthcare systems requires clear roles and responsibilities, along with continuous support to ensure effective intervention and the well‐being of both providers and recipients. Further research and development are necessary to harness their full potential and meet the increasing demand for accessible mental health services.

The Role of Community-Based Organizations in Promoting Menstrual Health Through Menstrual Product Distribution: A Qualitative Investigation

In Canada, many individuals, particularly underserved populations living in poverty, struggle to access menstrual supplies. Amidst growing awareness of menstrual inequities, community-based organizations have emerged as vital actors in collecting and distributing menstrual supplies. We conducted a qualitative study to understand the experiences of community-based organizations in promoting menstrual health through the distribution of menstrual supplies. Close community connections allow organizations to reach underserved populations and provide tailored support. However, the sustainability of distribution is inhibited by unreliable sourcing of menstrual products and limitations in financial infrastructure. We recommend additional research into the experiences of community-based organizations and funding to allow organizations to engage in monitoring and programming evaluation.

Special Section on Patient-Reported Outcomes and Informatics: Collection of Patient-Reported Outcome Measures in Rural and Underserved Populations.

The NIH Pragmatic Trials Collaboratory supports the design and conduct of 31 embedded pragmatic clinical trials, and many of these trials use patient-reported outcome measures (PROMs) to provide valuable information about their patients' health and wellness. Often these trials enroll medically underserved patients, including people with incomes below the federal poverty threshold, racial or ethnically minoritized groups, or rural or frontier communities. In this series of trial case reports, we provide lessons learned about collecting PROMs in these populations. The unbiased collection of PROM data is critical to increase the generalizability of trial outcomes and to address health inequities. Use of electronic health records (EHRs) and other digital modes of PROM administration have gained traction. However, engagement with these modes is often low among disparities prone populations due to lessened digital proficiency, device access, and uptake of EHR portals and web interfaces. To maximize the completeness and representativeness of their trial outcome data, study teams tested a range of strategies to improve PROM response rates with emphasis on disparities prone and underserved patient groups. This manuscript describes the approaches, their implementation, and the targeted populations. Optimized PROM collection required hybrid approaches with multiple outreach modes, high-touch methods, creativity in promoting digital uptake, multi-modal participant engagement, and text messaging.

Awareness of Family Planning Services among Pregnant Women in Arumeru District, Tanzania: Implications for Public Health Interventions

The demand for health literacy in family planning continues to be a global issue, particularly in developing regions. It is also estimated that over 225 million women in developing countries face challenges accessing and utilizing family planning services. Sub-Saharan Africa has the lowest family planning prevalence, at 24%, with high unmet needs, despite global efforts to improve access and knowledge. This study aimed at assessing the family planning services among pregnant women in Arumeru District, Tanzania. Using a sample size of 269 respondents, data was collected through questionnaires and interviews with healthcare officers between February and March 2024. Data were then analyzed using descriptive statistics techniques for quantitative data whereas qualitative data were analyzed using content analysis approach. Results reveal that 92.9% of respondents were aware of family planning services, with varying levels of understanding. Education and occupation played significant roles in awareness, with younger, educated individuals showing higher knowledge. Improving awareness about maternal and child health can lead to better healthcare practices, timely interventions, and increased utilization of services, ultimately reducing mortality rates and contributing to broader public health goals of improved health equity and universal health coverage. However, cultural, religious, and literacy barriers continue to hinder full understanding. The study concludes that respondents in the study area have high level of awareness regarding family planning, particularly among younger individuals and those with higher education levels. The study recommends targeted awareness programs, especially for underserved populations, and emphasizes the importance of involving men in family planning education to improve reproductive health outcomes.

INNOVATIVE MACHINE LEARNING APPROACHES TO FOSTER FINANCIAL INCLUSION IN MICROFINANCE

This study examines the application of machine learning algorithms to enhance financial inclusion in microfinance, focusing on credit scoring, risk and fraud detection, and customer segmentation. We performed feature engineering and employed models such as Logistic Regression, Decision Trees, Random Forests, Gradient Boosting Machines (XGBoost and LightGBM), Support Vector Machines (SVM), Autoencoders, Isolation Forests, and K-means Clustering. LightGBM achieved the highest accuracy (89.6%) and AUC (0.92) in credit scoring, while Random Forests demonstrated strong performance in both loan approval (86.7% accuracy) and fraud detection (87.6% accuracy, AUC of 0.88). SVM also performed competitively, and unsupervised methods like Autoencoders and Isolation Forests showed potential for anomaly detection but required further refinement.K-means Clustering excelled in customer segmentation with a silhouette score of 0.72, enabling tailored services based on client demographics. Our findings highlight the significant impact of machine learning on improving credit scoring accuracy, reducing fraud risks, and enhancing customer service delivery in microfinance, thereby promoting financial inclusion for underserved populations. Ethical considerations and model interpretability are crucial, particularly for smaller institutions. This study advocates for the broader adoption of machine learning in the microfinance sector.

Interventions to improve access to cancer care in underserved populations in high income countries: a systematic review

BackgroundUnderserved populations both globally and in Canada face serious cancer inequities that result from systemic economic, environmental, and social conditions. These pose barriers in access to cancer care and lead to suboptimal cancer care experiences and outcomes. Knowledge of effective interventions to improve access to cancer care is needed to inform the design of tailored interventions for these populations.AimTo identify interventions and programs to improve access to cancer care for underserved populations in high income countries with universal health coverage (UHC) and the United States (US) throughout the cancer care continuum.MethodsWe conducted a systematic review following the PRISMA standards. We searched Medline, EMBASE, PsycINFO, CINAHL, Scopus, and the Cochrane Library. Inclusion criteria: quantitative and qualitative studies published in English in the last 10 years (2013–2023), describing interventions/programs to improve access to cancer care for underserved populations (18 years and over). We included studies in the US given the body of scholarship on equity in cancer care in that country. Screening, data extraction and analysis were undertaken by two independent reviewers.ResultsOur search yielded 7,549 articles, and 74 met the inclusion criteria. Of these, 56 were conducted in the US, 8 in Australia, 6 in Canada, and 4 in the United Kingdom. Most (90.5%) were quantitative studies and 47.3% were published between 2020–2023. Seven types of interventions were identified: patient navigation, education and counselling, virtual health, service redesign, financial support, improving geographical accessibility and multicomponent interventions. Interventions were mainly designed to mitigate language, distance, financial, lack of knowledge and cultural barriers. Most interventions focused on access to cancer screening, targeted rural populations, racialized groups and people with low socioeconomic status, and were conducted in community-based settings. The majority of interventions or programs significantly improved access to cancer care.ConclusionOur systematic review findings suggest that interventions designed to remove specific barriers faced by underserved populations can improve access to cancer care. Few studies came from countries with UHC. Research is required to understand tailored interventions for underserved populations in countries with UHC.

Teamworking in Dentistry: The Importance for Dentists, Dental Hygienists and Dental Therapists to Work Effectively Together-A Narrative Review.

To consider teamworking in dentistry, focusing especially on the role of dental hygienists (DHs) and dental therapists (DTs) as part of the dental team. A narrative review of studies that have investigated teamworking in periodontology and dentistry in general together with consideration of examples of relevant regulatory and governmental policy documents. The inclusion of DHs and DTs as key members of the dental team yields significant patient benefits in terms of access to care (particularly among under-served populations), efficient and effective treatment and improved healthcare outcomes for patients. However, barriers can exist to full implementation of effective working in dental teams, including both systemic and regulatory barriers, as well as attitudinal barriers. Furthermore, DHs and DTs are not always working to their full scope of practice, thereby limiting the care that these team members can provide. Mutual respect between dental team members, high-quality communication and a common ethos and shared clinical standards are all essential for effective teamworking. DHs and DTs have a clear role to play in achieving sustainable improvements in oral and dental health for patient populations globally. Full and effective integration of DHs and DTs into healthcare teams will benefit not only the dental team, but also healthcare systems and patient populations, via more effective teamworking, improved access to care and enhanced treatment outcomes.

Impact of Insurance Status on Postoperative Recovery After Microsurgical Breast Reconstruction.

Persistent disparities in breast reconstruction access have been widely documented, yet a significant research gap remains in understanding the impact of social determinants of health (SDOH) on postoperative outcomes and complications. A retrospective chart review was performed on all patients who underwent abdominal-based free-flap breast reconstruction between August 2018 and December 2022 at a racially, ethnically, and socioeconomically diverse urban academic institute with a historically underserved patient population. Patients were stratified by the public (Medicare and Medicaid) versus private insurance as a proxy for SDOH. Patient demographics, length of stay (LOS), timing in progression through postoperative recovery milestones, and complications were compared. A total of 162 patients were included, and 57% of patients had public insurance, with this group more likely to be Hispanic (OR2.7; p=0.003) and Spanish-speaking (OR3.4; p=0.003). Privately insured patients were more likely to be non-Hispanic black (OR2.7; p=0.006). Patients with public insurance had a higher rate of unplanned return to the operating room within 90 days and a higher incidence of complications, though not statistically significant. They also experienced a significantly longer LOS than privately insured patients (3.6±1.0 days vs 3.0±0.7 days; p<0.0001). Logistic regression identified a LOS exceeding 3 days as independently associated with public insurance status (OR3.0; p=0.03), bilateral procedure (OR5.6; p=0.0007), preoperative functional-dependent status (OR7.0; p=0.04), and higher BMI (OR1.1; p=0.03). Patients with public insurance were more likely to encounter delays in achieving recovery milestones. Public insurance status, serving as a proxy for a disadvantage in SDOH, is predictive of extended LOS and postoperative recovery delays following microsurgical breast reconstruction. This underscores the need for future quality improvement efforts to address and mitigate these disparities.

Experiences with diagnostic delay among underserved racial and ethnic patients: a systematic review of the qualitative literature

ObjectiveDiagnostic delay is a pervasive patient safety problem that disproportionately affects historically underserved populations. We aim to systematically examine and synthesise published qualitative studies on patient experiences with diagnostic delay...

Designing Culturally Competent Clinical Decision Support Systems to Reduce Health Disparities in Underserved Populations

Income inequality is associated with poor health. Both the cost of medical care and the utilization of services vary. The high expense of health care pushes a significant portion of Indian households into poverty. The surroundings in which people live, grow, work, and interact with one another are known as social determinants, and they have a big influence on people's well-being which can be reduced by computerized clinical decision support systems. In today's healthcare, computerized clinical decision support systems, or CDSS, represent a paradigm change. Clinicians can use CDSS to support them in making complicated decisions. Rapid advancements have been made in CDSS since they were used in the 1980s. Due to the growing worldwide usage of advanced electronic medical records, they are frequently administered using computerized clinical processes and electronic medical records.

The Impact and Future of Teletherapy in Mental Health Support

Teletherapy, a digital form of mental health support, has become an essential aspect of psychological care, driven by technological advancements and evolving societal needs. This paper examines the evolution, benefits, and challenges of teletherapy, emphasizing its accessibility, especially for underserved populations. It highlights innovations such as artificial intelligence (AI) and secure messaging and discusses ethical considerations like confidentiality and informed consent. Despite limitations, such as technical barriers and reduced non-verbal communication, teletherapy is poised to grow, offering flexible, accessible mental health services. The future of teletherapy will likely see further integration with emerging technologies, potentially reshaping the landscape of mental health care. Keywords: Teletherapy, mental health support, digital therapy, online therapy, telehealth, accessibility.