Towards interoperable e-Health system in Tanzania: analysis and evaluation of the current security trends and big data sharing dynamics

This research article published by the International Journal of Advanced Technology and Engineering Exploration (IJATEE), Volume-6 Issue-59 October-2019In this paper an insight on various e-health interoperable systems was reviewed to discover strengths and challenges faced during sustainable implementation. It covered local, national and regional coverage of integrated systems towards implementation of a single unified e-health system. Peer reviewed and grey literatures were consulted to discover global and local trend and efforts towards implementations of e-health interoperable systems. The available systems and frameworks from the European Union, Asia, America, Oceania and Africa were analyzed for their strengths and challenges. Various policies, guides as well as free and proprietary standards associated with e-health interoperability was reviewed to understand the common standards adopted by the majority of existing systems. The findings of the analysis are useful for policy makers on the best ways to implement interoperable systems in developing countries by focusing on the existing infrastructures and the environment. Similarly, the strengths and challenges encountered by interoperable systems were also examined to provide recommendations for future studies

Preparedness for e-health in developing countries: the case of Ghana

As Ghana embarks on a national e-Health initiative there is the need to explore its preparedness in terms of socioeconomic and development, technology infrastructure and operational preparedness, and skills and human resources. This paper reports on a literature review as part of a research program, which aims to inform the development of an effective roadmap for the successful implementation of the national e-Health initiative in Ghana. The literature was searched for factors of e-Health adoption in developing countries; and realization of the anticipated benefits through IEEE, Medline, Google scholar and Google search engines. Sixteen (16) articles were reviewed were from 176 related articles that were found. The literature review found the two highest priority objectives in in e-Health Africa: providing health education for health professionals (identified in 7 of the 16 projects reported on in the literature) and improvement of primary health care services 9 of the 16 projects). Six (6) or 39% each of the 16 projects reported a lack of skills and Human Resources Socioeconomic issues, and Technology infrastructure problems reported in 22% or the remaining four (4) projects. The paper concluded that the effects of these challenges could lead to Ghana like many other developing countries struggling to adopt e-Health, its inability to realize the potential benefits of e-Health and its ability to institutionalize and sustain e-Health

The development of telemedicine programs in Sub-Saharan Africa: Progress and associated challenges

Monitoring the progress of telemedicine use in Sub-Saharan Africa (SSA) countries has received a considerable attention from many health organizations and governmental agencies. This study reviewed the current progress and challenges in relation to the development of telemedicine programs in SSA. The results from reviewing 66 empirical studies revealed an unbalanced progress across SSA countries. Further, technological, organisational, legal and regulatory, individual, financial, and cultural aspects were identified as the major barriers to the success of telemedicine development in SSA. This study reported the current trends in telemedicine application, as well as highlighting critical barriers for consideration by healthcare decision makers. The outcomes from this study offer a number of recommendations to support wider implementation and sustainable usage of telemedicine in SSA

How does the collection and use of private data slow the development of eHealth solutions and which are the recommendations that can speed up innovation of eHealth solutions ?

The concept of eHealth was created in the late 1990s to automate and optimise healthcare. Even though various eHealth technologies exist nowadays, only some of them are available to consumers, while similar technologies are actually being used in other industries, such as the transportation industry. The aim of this paper is to understand how personal data can impact the development of eHealth solutions in Europe, by doing literature research and giving recommendations. The role of computers and data has changed since the 1930s, moving from the first large digital computer in 1939 to the current mobile connected devices that are able to process lots and lots of information in real time. In the past, stored data was difficult to access and use, while nowadays, people can easily access to all kinds of data anywhere and anytime. Not only the role of computers and data has changed, but also the healthcare sector. Today, healthcare workers can provide people with better healthcare by using new technologies, such as eHealth. EHealth automates and optimises medical services and tasks and improves the sharing of medical information. Nowadays, the healthcare sector faces many challenges regarding personal data. First of all, there is so much data that especially large companies do not even know how their data is being used and by whom. Secondly, cybercriminals have been stealing more and more personal data. Starting from 2017, the healthcare sector has become their main target, since health data is more valuable than credit card data. Next to this, consumers trust medical companies less to handle their personal data with care. Finally, new regulations force life science companies to be accountable for tracking personal data, which is very complicated due to the large amount of data. To accelerate the innovation speed of eHealth solutions, several steps can be taken. By handing out labels and giving certifications, medical solution makers do not have to prove the safety of their products anymore. Also, research on treatments, devices and drugs can be accelerated by using the latest data protection solutions, because data sharing will become easier. Furthermore, if life science companies adopt a subscription business model, they will have a constant flow of revenue allowing them to update their devices and software regularly. Last but not least, a joint eHealth association will enable the creation of cheaper and safer healthcare devices and software and after that, distribution at a quicker pace

Privacy and data protection in eHealth in Africa - an assessment of the regulatory frameworks that govern privacy and data protection in the effective implementation of electronic health care in Africa: is there a need for reform and greater regional collaboration in regulatory policymaking?

This thesis examines and evaluates the legal protection of privacy and personal data in South Africa and across Africa in the electronic health care industry, that is, where medical services are provided to individuals by way of networked technological platforms including mobile telephones. This thesis presents a critical understanding of, and pragmatic solution to, the questions that lie at the intersection of the following: an individual's right to privacy and data protection, cultural disparities when defining privacy, the emergence of electronic health care, the sensitivity of health related data, the need for health care in areas, where lack of resources and lack of accessibility are often commonplace, and the introduction of networked technologies within the health care system as a solution. Firstly, eHealth services and applications are described. Secondly, notions of privacy and data protection are considered. Thirdly, the prevailing legal determinants that form the basis of African and South African data protection regulatory measures are ascertained. Fourthly, selected illustrations are presented of the practical implementation of eHealth services and certain recent influencers within the digital environment, which may inform the future eHealth privacy regulatory framework. Finally, criticisms of the Malabo Convention are presented and recommendations advanced. As there is limited guidance with regard to policymaking decisions concerning privacy and data protection in the implementation of eHealth in developing countries, possibilities for reform are suggested. These will allow a more careful balance between, on the one hand, the normative commitment to providing accessible health care using electronic means and, on the other, the rights to privacy and data protection of the user, which require safeguarding within an African context. In proposing a solution, it is argued that adequate privacy regulation of electronic health must (1) be sensitive to societal and cultural differences in what is considered private, (2) be responsive to rapid technological transformation in healthcare industries, and (3) build user confidence in data protection in this context, to enable nascent electronic health initiatives to reach their potential in Africa. It is proposed that the adoption of an accepted social imperative protected by a powerful triumvirate of ethical constraints, effective legal provisions and regulations, and operational necessities, is possible. Greater regulatory collaboration across the continent is called for based on harmonised domestic and international laws, national policies, and industry codes of conduct that are sensitive to local conditions and challenges

Possible futures of health technologies for South Africa towards 2035

The purpose of this treatise is to develop four alternative scenarios for Possible Futures of Health Technologies for South Africa towards 2035. A desired future in the form of a future vision will be presented as well as recommendations made to the relevant decision-making stakeholders for implementation. This study employs a futures studies methodology known as the Six Pillars used in mapping the present and future, further deepening and broadening the future through the development of scenarios, and lastly, transforming the future by tapering it down to the preferred vision. The four scenarios in this study are informed by current affairs, a qualitative study with industry experts as well as global views and research. The scenarios are as follows: ‘Health Technology Hub’, which is the ‘best case’ scenario, to which the country aspires; ‘Medicating Backwards’, the ‘worst case’ scenario, in which everything turns negative; ‘Frozen Revolution’, in which no change occurs, making it ‘business as usual’ and ‘Trans-humans’, the outlier future based on a disruptive or emerging issue. The way the world works is changing rapidly due to disruptive technologies. Demographic shifts such as the high birth rate in Africa will bring about opportunities for the economy. Health technologies, for this study, is regarded as the application of knowledge and skills in the form of devices, medicines, vaccines, procedures and systems as well as the convergence of digital technologies with health to improve the efficiency of healthcare delivery, solve health issues, offer personalised medicines and improve the quality of lives. Technologies such as artificial intelligence (AI), virtual reality (VR), Internet of Things (IoT), 3D printing, robotics, nanotechnology are seen as the next disruptors. Healthcare in Africa is under pressure to transform, and future trends that stem from the Fourth Industrial Revolution will need to provide innovative, affordable, accessible, good quality, efficient and sustainable solutions. Along with these technologies comes the factors such as the fear of the impact on jobs, inequality, privacy, security and healthcare in South Africa. The outcomes of the extensive analysis of futures studies in this study provide credibility to the argument that current planning for the future of health technologies in South Africa needs intense modifications. The development of insightful plausible futures is essential to the planning process and is seen to be an effective strategic tool employed by businesses. It is the responsibility of private and public sectors to ascertain which path is preferred and what decisions need to be made to ensure that vision is realised and that SA progresses toward economic growth and sustainable development. The ‘Future Vision of Health Technologies in South Africa Towards 2035’ is attainable if all stakeholders agree to work collaboratively, communicate transparently, educate the people of the land, regulate appropriately, build trust, increase innovation, include communities and share the purpose

A secure and interoperable blockchain-based information sharing system for healthcare providers in developing countries

A Dissertation Submitted in Partial Fulfilment of the Requirements for the Degree of Doctor of Philosophy in Information and Communication Sciences and Engineering of the Nelson Mandela African Institution of Science and TechnologySystems in the health sector are very crucial for human life and they should be efficient, reliable and secure. Unfortunately, electronic health record (EHR) systems do not work effectively when managing multi-institutional medical records. The EHR, which is a digital system in which patient health information is systematically stored. The information stored includes medical history, laboratory test results, demographics, and billing information, poses problems to patients related to interoperability, privacy, and data integrity. Most solutions to these threats focus on a centralized architecture that faces a single point of failure and internal threats, such as unreliable system administrators. The promising solution that many researchers are interested in is the use of blockchains. However, in developing countries, and particularly in sub-Saharan Africa, very little attention has been given to the issues of interoperability, privacy and data integrity for EHRs using blockchain technology. As such, this research has designed and developed self-sovereign identity management and secure information sharing system for health systems in developing countries, based on blockchain technology, which helps to solve the mentioned problems. The study used a Design Science Research (DSR) methodology to develop solutions to the research problem through three sub studies. The first and the second sub studies conducted under problem awareness and suggestion phases of DSR, and third sub study conducted under development and evaluation phases of DSR. The first sub study deal with the assessment of three most common blockchain based healthcare systems (MedicalChain, Patientory, and MediLedger). The second sub study studies the problem of existing EHR systems in Tanzania regarding privacy issues in identity management and secure sharing of medical data from one healthcare facility to the other. The third sub study deal with the development of two systems, one for identity management using blockchain (self-sovereign identity), and one for secure sharing of medical data from one healthcare facility to another through blockchain technology. The systems provide additional privacy protection tools to the existing infrastructures. They reduce development cost, transparency, data integrity, protection against single-point-offailure vulnerabilities, and prevention of internal threats such as untrusted system administrators. The systems will make the existing and future health information systems trustable to healthcare service providers and the end-users of the healthcare systems. Also, will help the stakeholders in the healthcare sector to properly manage the healthcare systems

Precision health approaches: ethical considerations for health data processing

This thesis provides insights and recommendations on some of the most crucial elements necessary for an effective, legally and ethically sound implementation of precision health approaches in the Swiss context (and beyond), specifically for precision medicine and precision public health. In this regard, this thesis recognizes the centrality of data in these two abovementioned domains, and the ethical and scientific imperative of ensuring the widespread and responsible sharing of high quality health data between the numerous stakeholders involved in healthcare, public health and associated research domains. It also recognizes the need to protect not only the interests of data subjects but also those of data processors. Indeed, it is only through a comprehensive assessment of the needs and expectations of each and every one regarding data sharing activities that sustainable solutions to known ethical and scientific conundrums can be devised and implemented. In addition, the included chapters in this thesis emphasize recommending solutions that could be convincingly applied to real world problems, with the ultimate objective of having a concrete impact on clinical and public health practice and policies, including research activities. Indeed, the strengths of this thesis reside in a careful and in-depth interdisciplinary assessment of the different issues at stake in precision health approaches, with the elaboration of the least disruptive solutions (as far as possible) and recommendations for an easy evaluation and subsequent adoption by relevant stakeholders active in these two domains. This thesis has three main objectives, namely (i) to investigate and identify factors influencing the processing of health data in the Swiss context and suggest some potential solutions and recommendations. A better understanding of these factors is paramount for an effective implementation of precision health approaches given their strong dependence on high quality and easily accessible health datasets; (ii) to identify and explore the ethical, legal and social issues (ELSI) of innovative participatory disease surveillance systems – also falling under precision health approaches – and how research ethics are coping within this field. In addition, this thesis aims to strengthen the ethical approaches currently used to cater for these ELSIs by providing a robust ethical framework; and lastly, (iii) to investigate how precision health approaches might not be able to achieve their social justice and health equity goals, if the impact of structural racism on these initiatives is not given due consideration. After a careful assessment, this thesis provides recommendations and potential actions that could help these precision health approaches adhere to their social justice and health equity goals. This thesis has investigated these three main objectives using both empirical and theoretical research methods. The empirical branch consists of systematic and scoping reviews, both adhering to the PRISMA guidelines, and two interview-based studies carried out with Swiss expert stakeholders. The theoretical branch consists of three chapters, each addressing important aspects concerning precision health approaches