---
title: "Clinical Protocol–Guided Chatbot to Support Telecarers in Diabetes Management"
id: "pubmed-42913398"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42913398"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42913398/"
doi: "10.2196/91058"
published_at: "2026-10-23T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Clinical Protocol–Guided Chatbot to Support Telecarers in Diabetes Management
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42913398
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42913398/)
- **DOI:** [10.2196/91058](https://doi.org/10.2196%2F91058)
- **Published At:** 2026-10-23T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Investigators evaluated a **chatbot** guided by clinical protocols to support telecare staff managing patients with **diabetes**. - The study used an embedded mixed methods design combining quantitative and qualitative elements; the source labels the approach but does not provide detailed protocol steps in the excerpt. - The project was based in Singapore and involved clinical, telecare, nursing, and research teams from Changi General Hospital, SingHealth, A*STAR, and Singapore General Hospital. - Authors reported the work in J Med Internet Res; the PubMed entry lists the publication DOI and PMID but the provided excerpt does not include numeric outcome data or statistical analyses. - The source identifies multidisciplinary collaborators including endocrinology, telecare unit staff, care coordination, and informatics researchers from A*STAR. - The PubMed abstract text available here did not present specific details on participant counts, inclusion criteria, chatbot algorithm logic, decision thresholds, or measured endpoints. - The entry does not include the study’s quantitative results, effect sizes, usage metrics, or thematic quotations from qualitative interviews in the provided text. - The source lists many named authors and affiliations; investigators reported institutional involvement but the excerpt lacks explicit dates, timelines, or follow-up intervals. - Data indicated an evaluation took place and was published; however, the provided PubMed content does not include safety signals, escalation pathways, or concrete implementation metrics. - Unanswered questions remaining in the excerpt: how the **telecarers** used the tool in routine workflow, what the accuracy of protocol adherence was, and what barriers or facilitators staff reported—these were not detailed in the provided text.
## Clinical Analysis & Structured Key Points
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](https://pubmed.ncbi.nlm.nih.gov/42913398/#heading) * [ Abstract ](https://pubmed.ncbi.nlm.nih.gov/42913398/#abstract) * [ Publication types ](https://pubmed.ncbi.nlm.nih.gov/42913398/#publication-types) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42913398/#mesh-terms) Title & authors Abstract Publication types MeSH terms J Med Internet Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Med+Internet+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Med+Internet+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42913398/) . 2026 Oct 23:28:e91058. doi: 10.2196/91058. # Evaluation of a Clinical Protocol-Guided Chatbot to Support Telecarers in Diabetes Management: Embedded Mixed Methods Study [Rebecca Hui Shan Ong](https://pubmed.ncbi.nlm.nih.gov/?term=Ong+RHS&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Hong Choon Oh](https://pubmed.ncbi.nlm.nih.gov/?term=Oh+HC&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-2 "Centre for Population Health Research and Implementation, SingHealth, Singapore."), [Bryan Peide Choo](https://pubmed.ncbi.nlm.nih.gov/?term=Choo+BP&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Linette Zhi Ai Tan](https://pubmed.ncbi.nlm.nih.gov/?term=Tan+LZA&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Melissa Hui Wen Gunn](https://pubmed.ncbi.nlm.nih.gov/?term=Gunn+MHW&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Jin Wee Ng](https://pubmed.ncbi.nlm.nih.gov/?term=Ng+JW&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Anne Ching Ching Teng](https://pubmed.ncbi.nlm.nih.gov/?term=Teng+ACC&cauthor_id=42913398)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-3 "Department of Endocrinology, Changi General Hospital, Singapore."), [Sharon Yu Bing Ong](https://pubmed.ncbi.nlm.nih.gov/?term=Ong+SYB&cauthor_id=42913398)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-4 "Regional Health System \(Transition\), Changi General Hospital, Singapore."), [Angela Hwee Koon Ng](https://pubmed.ncbi.nlm.nih.gov/?term=Ng+AHK&cauthor_id=42913398)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-4 "Regional Health System \(Transition\), Changi General Hospital, Singapore."), [Winnie Yi Ling Soo](https://pubmed.ncbi.nlm.nih.gov/?term=Soo+WYL&cauthor_id=42913398)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-5 "Department of Nursing Administrator, Changi General Hospital, Singapore."), [Yian Chin Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+YC&cauthor_id=42913398)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-6 "Department of Care Coordination, Changi General Hospital, Singapore."), [Halimah Binte Sarim](https://pubmed.ncbi.nlm.nih.gov/?term=Sarim+HB&cauthor_id=42913398)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-7 "Telecare Unit, Changi General Hospital, Singapore."), [Geok Choo Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+GC&cauthor_id=42913398)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-7 "Telecare Unit, Changi General Hospital, Singapore."), [Junaidah Binte Ibrahim](https://pubmed.ncbi.nlm.nih.gov/?term=Ibrahim+JB&cauthor_id=42913398)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-7 "Telecare Unit, Changi General Hospital, Singapore."), [Kryslyn Mei Ying Kae](https://pubmed.ncbi.nlm.nih.gov/?term=Kae+KMY&cauthor_id=42913398)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-7 "Telecare Unit, Changi General Hospital, Singapore."), [Jinyang Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+J&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Zhengyuan Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Z&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Mojisola Erdt](https://pubmed.ncbi.nlm.nih.gov/?term=Erdt+M&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Siti Umairah Md Salleh](https://pubmed.ncbi.nlm.nih.gov/?term=Md+Salleh+SU&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Siti Maryam Binte Ahmad Subaidi](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmad+Subaidi+SMB&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Sakinah Binte Yusof](https://pubmed.ncbi.nlm.nih.gov/?term=Yusof+SB&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Nabilah Binte Md Johan](https://pubmed.ncbi.nlm.nih.gov/?term=Md+Johan+NB&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Kavineshaan Ramdas](https://pubmed.ncbi.nlm.nih.gov/?term=Ramdas+K&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Jia Shern Ang](https://pubmed.ncbi.nlm.nih.gov/?term=Ang+JS&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Qi Yuan Tay](https://pubmed.ncbi.nlm.nih.gov/?term=Tay+QY&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Yong Mong Bee](https://pubmed.ncbi.nlm.nih.gov/?term=Bee+YM&cauthor_id=42913398)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-9 "Department of Endocrinology, Singapore General Hospital, Singapore."), [Nancy F Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+NF&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Pavitra Krishnaswamy](https://pubmed.ncbi.nlm.nih.gov/?term=Krishnaswamy+P&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Joan Joo Ching Khoo](https://pubmed.ncbi.nlm.nih.gov/?term=Khoo+JJC&cauthor_id=42913398)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#full-view-affiliation-3 "Department of Endocrinology, Changi General Hospital, Singapore.") Affiliations Expand ### Affiliations * 1 Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833. * 2 Centre for Population Health Research and Implementation, SingHealth, Singapore. * 3 Department of Endocrinology, Changi General Hospital, Singapore. * 4 Regional Health System (Transition), Changi General Hospital, Singapore. * 5 Department of Nursing Administrator, Changi General Hospital, Singapore. * 6 Department of Care Coordination, Changi General Hospital, Singapore. * 7 Telecare Unit, Changi General Hospital, Singapore. * 8 Agency for Science, Technology and Research (A*STAR), Institute for Infocomm Research, Singapore. * 9 Department of Endocrinology, Singapore General Hospital, Singapore. * PMID: **42913398** * DOI: [ 10.2196/91058 ](https://doi.org/10.2196/91058) Item in Clipboard # Evaluation of a Clinical Protocol-Guided Chatbot to Support Telecarers in Diabetes Management: Embedded Mixed Methods Study Rebecca Hui Shan Ong et al. J Med Internet Res. 2026. Show details Display options Display options Format Abstract PubMed PMID J Med Internet Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Med+Internet+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Med+Internet+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42913398/) . 2026 Oct 23:28:e91058. doi: 10.2196/91058. ### Authors [Rebecca Hui Shan Ong](https://pubmed.ncbi.nlm.nih.gov/?term=Ong+RHS&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Hong Choon Oh](https://pubmed.ncbi.nlm.nih.gov/?term=Oh+HC&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-2 "Centre for Population Health Research and Implementation, SingHealth, Singapore."), [Bryan Peide Choo](https://pubmed.ncbi.nlm.nih.gov/?term=Choo+BP&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Linette Zhi Ai Tan](https://pubmed.ncbi.nlm.nih.gov/?term=Tan+LZA&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Melissa Hui Wen Gunn](https://pubmed.ncbi.nlm.nih.gov/?term=Gunn+MHW&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Jin Wee Ng](https://pubmed.ncbi.nlm.nih.gov/?term=Ng+JW&cauthor_id=42913398)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-1 "Health Services Research, Changi General Hospital, 2 Simei St 3, 529889, Singapore, 65 7888833."), [Anne Ching Ching Teng](https://pubmed.ncbi.nlm.nih.gov/?term=Teng+ACC&cauthor_id=42913398)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-3 "Department of Endocrinology, Changi General Hospital, Singapore."), [Sharon Yu Bing Ong](https://pubmed.ncbi.nlm.nih.gov/?term=Ong+SYB&cauthor_id=42913398)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-4 "Regional Health System \(Transition\), Changi General Hospital, Singapore."), [Angela Hwee Koon Ng](https://pubmed.ncbi.nlm.nih.gov/?term=Ng+AHK&cauthor_id=42913398)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-4 "Regional Health System \(Transition\), Changi General Hospital, Singapore."), [Winnie Yi Ling Soo](https://pubmed.ncbi.nlm.nih.gov/?term=Soo+WYL&cauthor_id=42913398)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-5 "Department of Nursing Administrator, Changi General Hospital, Singapore."), [Yian Chin Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+YC&cauthor_id=42913398)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-6 "Department of Care Coordination, Changi General Hospital, Singapore."), [Halimah Binte Sarim](https://pubmed.ncbi.nlm.nih.gov/?term=Sarim+HB&cauthor_id=42913398)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-7 "Telecare Unit, Changi General Hospital, Singapore."), [Geok Choo Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+GC&cauthor_id=42913398)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-7 "Telecare Unit, Changi General Hospital, Singapore."), [Junaidah Binte Ibrahim](https://pubmed.ncbi.nlm.nih.gov/?term=Ibrahim+JB&cauthor_id=42913398)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-7 "Telecare Unit, Changi General Hospital, Singapore."), [Kryslyn Mei Ying Kae](https://pubmed.ncbi.nlm.nih.gov/?term=Kae+KMY&cauthor_id=42913398)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-7 "Telecare Unit, Changi General Hospital, Singapore."), [Jinyang Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+J&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Zhengyuan Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Z&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Mojisola Erdt](https://pubmed.ncbi.nlm.nih.gov/?term=Erdt+M&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-8 "Agency for Science, Technology and Research \(A*STAR\), Institute for Infocomm Research, Singapore."), [Siti Umairah Md Salleh](https://pubmed.ncbi.nlm.nih.gov/?term=Md+Salleh+SU&cauthor_id=42913398)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42913398/#short-view-affiliation-8 "Agency for Science, Technology and
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