IoMT Device Performance in Chronic Disease Management: A Mixed-Methods Clinical Validation in a Public LMIC Healthcare System

The Internet of Medical Things (IoMT) holds promise for chronic disease management, yet evidence from low- and middle-income countries (LMICs) remains scarce, limiting equitable digital health policy development. No previous studies have clinically validated IoMT device performance against electronic health records (EHRs) within Central American public healthcare systems, leaving assumptions about consumer device adequacy untested in resource-constrained settings. This mixed-methods study evaluated IoMT implementation in Costa Rica's Caja Costarricense de Seguro Social (CCSS) system, examining (1) diagnostic accuracy stratification between consumer and clinical-grade devices, (2) healthcare system interoperability challenges, and (3) cost implications of false alerts. Among 50 chronic disease patients, consumer wearables demonstrated 43% sensitivity for cardiac event detection versus 92% for clinical-grade devices (p