OBJECTIVE:This study aimed to evaluate the quality, relevance and utility of a recently proposed Framework for developing adoptable and scalable Remote Patient Management Systems (FRPMS) through consensus-assessment among experts. METHOD:A modified Delphi approach was used with 15 experts from diverse fields, including health promotion, behavior change, digital health technology design, implementation science, and digital health policymaking, in two rounds of evaluations. The study focused on assessing the FRPMS's principles, feasibility, and potential outcomes. RESULTS:In the first round, strong consensus (above 80 %) was achieved for all phases of the FRPMS, indicating its potential for enhancing the adoption and scaling of Remote Patient Management Tools and Systems (RPMTS). However, consensus on eight features fell below the target in the first round. Despite this, in the second round consensus on six of the eight facets exceeded the target, suggesting overall agreement on the FRPMS's adequacy. CONCLUSION:The study concludes that there is sufficient expert consensus on the FRPMS's principles and potential for improving RPMTS adoption and scaling. Even though the target consensus was not reached on two features, the FRPMS framework is perceived as significantly useful and relevant by experts. Further research is recommended to promote the FRPMS's adoption and evaluate its impact on RPMTS design and implementation.

In order to enhance their impact on traditional healthcare systems and improve health outcomes, digital health interventions must undergo widespread adoption, scaling, and consistent use. However, achieving the adoption and scaling of digital tools in healthcare remains a challenging goal globally. This challenge is compounded by an inconsistent and fragmented approach to adoption and scaling, as well as a limited reliance on theoretical tools throughout a digital health intervention's lifecycle phase. This article argues that adoption and scaling requirements should be prominently integrated into each phase of traditional healthcare system development and project management processes to facilitate these systems' widespread adoption and use. Addressing this necessitates the operationalization of multiple theoretical tools across a digital health intervention's lifecycle. To tackle the identified weakness of limited reliance on theoretical tools, we conducted a qualitative evidence synthesis, culminating in a reusable framework for theory operationalization. To illustrate how the above framework can be applied in practice, we provide and discuss a use case scenario, involving a hypothetical design, development, and implementation of a remote patient management application. This work expands the existing literature on technology implementation in healthcare by introducing a framework that assists practitioners to connect theoretical concepts to traditional system development and project management activities and phases.

Healthcare funders and program planners are increasingly recognising that the value and impact of assistive digital health technologies (ADHT) on the traditional healthcare systems are not exclusively realised in their procurement or inhouse design and development phases. Instead, these benefits are more evident in their implementation, adoption, scaling and consistent use. However, predicting the potential for the adoption and use of future health technology such as ADHT remains a significantly challenging task. Invariably, there is limited information available for estimating their initial uptake and continued use before their procurement or design. This research relies on the results of a cross-sectional field survey of 679 participants to explore the intention-expectation gap in target adopters, as an early indicator of an ADHT's potential for adoption and use. The results confirm that behavioural expectation is a better predictor of ADHT's uptake and use than behavioural intention. Furthermore, the larger the intention-expectation gap, the less likely the initial ADHT's uptake. Consequently, promotional and educational campaigns become more valuable and necessary to close the above gap and avoid the probable subsequent intention-behaviour gap and its resultant non-adoption and use.

In recent studies, platform ecosystems, an extension of business ecosystems, have emerged as highly disruptive mechanisms for generating value within various industries. The transformative influence of digital technologies on conventional business landscapes is increasingly evident, facilitating inclusive and sustainable development. However, realizing value co-creation within digital platform ecosystems faces formidable hurdles in healthcare, primarily attributed to the complex challenges surrounding privacy, security, and effective data governance. Following the Joanna Briggs Institute Guidelines for scoping reviews, the study explores the extent literature on the integration of digital platform ecosystems in healthcare. The contribution of this article is to explore the applications of platform ecosystems in healthcare delivery, specifically focusing on electronic healthcare records, smartphones, artificial intelligence, big data, the Internet of Things, and blockchain technologies. The research identifies and discusses the challenges of implementing these technologies in the healthcare industry. Furthermore, the study proposes a healthcare platform ecosystem framework, integrating communication strategies, GDPR compliance, and architectural components. This study synthesizes the extant literature to formulate a theoretical healthcare ecosystem framework for improved patient-centric care. The review and resultant framework is intended to support understanding of digital health dynamics and guides healthcare organizations, technology developers, and policymakers in ensuring data security, compliance and interoperability.

In recent studies, platform ecosystems, an extension of business ecosystems, have emerged as highly disruptive mechanisms for generating value within various industries. The transformative influence of digital technologies on conventional business landscapes is increasingly evident, facilitating inclusive and sustainable development. Nevertheless, realizing value co-creation within digital platform ecosystems faces formidable hurdles in healthcare, primarily attributed to the complex challenges surrounding privacy, security, and effective data governance. Following the Joanna Briggs Institute Guidelines for scoping reviews, the study explores the integration of digital platform ecosystems in healthcare. Findings explore the applications of platform ecosystems in healthcare delivery, specifically focusing on electronic healthcare records, smartphones, artificial intelligence, big data, the Internet of Things, and blockchain technologies. The research identifies and discusses the challenges of implementing these technologies in the healthcare industry. Furthermore, the study proposes a healthcare platform ecosystem framework, integrating communication strategies, GDPR compliance, and architectural components. It emphasizes the urgency of addressing these challenges for a secure, interoperable, and patient-centric future in healthcare delivery. The article contributes to our understanding of digital health dynamics and may help guide the work of healthcare organizations, technology developers, and policymakers in ensuring data security, compliance and interoperability.

ObjectiveTo enhance the predictive power of the Fit between Individuals, Task and Technology (FITT) framework in mobile, individual consumer settings by restructuring the individual-task fit to prominently emphasise the task-skills fit.DesignA mixed study involving a quantitative survey of 679 potential patients (adopters) and a qualitative content analysis of ten semi-structured interviews with clinic assistants.SettingFor the survey, three combined random samples of potential patients from Atteridgeville, Bapong and Garankuwa (South Africa). Ten Unjani clinic assistants were also interviewed about their tasks, skills, and related properties and attributes using a semi-structured interview guide.ParticipantsParticipants in the survey were potential patients over 18 years of age in the three sampled locations. In the qualitative study, interviewed participants were employed as clinic assistants in ten clinics within the Unjani Clinic Network.Main outcome measuresin the quantitative study, the statistical significance of the relationships between smartphone experience and health motivation on the one hand and the adopter's perceived self-efficacy on the other. In the qualitative study, the extent to which task properties, context, and the adopters' levels of education and training affect their perceived self-efficacy.FindingsThere is a significant relationship between smartphone experience and perceived self-efficacy and a moderately significant relationship between health motivation and perceived self-efficacy. Furthermore, task properties, task context, and an adopter's level of education and training considerably influence their perceived self-efficacy on a given future assistive digital health technology (ADHT).ConclusionExtending the FITT to the FISTT framework to explicitly include the task-skills fit may improve the explanatory and predictive power of the traditional FITT framework in mobile individual consumer settings.

As global health concerns become more complex, technological intervention is needed to achieve the Sustainable Development Goal. This study explores the use of the internet of things (IoT) and augmented reality (AR) applications for medication adherence. IOT devices can collect, transmit, and store up information not including the need for human or computer involvement. It has potential to streamline and improve healthcare. AR, is an advancement in technology which permits patients to interact with virtual objects in a natural way by proactively predicting health conditions, detecting, providing care, and observing patient role while inside and outside the healthcare center. A systematized scoping literature review was conducted on academic databases: Google Scholar, ACM, ScienceDirect, IEEE Xplore, and SpringerLink. The study identified components of IoT, AR, gaming strategy relevant to the healthcare domain and medication adherence. Further discourses applications of AR in the medical disciplines and focus on improving adherence to medication through gaming. The study, point out how AR has enhanced user experience in adherence to medication through gaming. Using AR in health care will provide us with a better understanding of how to deliver health services and how AR technology will be used to enhance global health care in the coming decade.

Digital health technologies have for number years now been expected to reduce the skyrocketing health related costs as well as the care burden on traditional healthcare systems. However, their adoption and scaling have consistently been unsatisfactory and sometimes, outright disappointing. Scholars have offered several valuable, insightful, and pertinent contributions to address the above challenge. However, these contributions are in most cases atomistic, transitory, non-spatial, and dispersed. The above state of affairs has left practitioners in limbo as to where and when to apply which insights to what type of digital health intervention and in which context. In this article, a new holistic and integrated theoretical framework, specifically focusing on remote patients’ health management tools and systems (RPMTSs) used to engage patients and potential patients at distance or away from healthcare facilities is proposed and introduced to address the above existing fragmentation and gaps. The new framework demonstrates how a clear and holistic understanding of “adoption” and “scaling” processes in the context of a given type and nature of digital health intervention along with an adaptive complex, processual and systems thinking approach can help confront the complexity of the healthcare apparatus while at the same time responding to its constantly evolving, dynamic nature with “agents” who may sometimes act irrationally or behave in unpredictable ways. In the process, a new framework is added to the knowledge base to guide and support the adoption and scaling of RPMTSs.

Background Despite all the excitement and hype generated regarding the expected transformative impact of digital technology on the healthcare industry, traditional healthcare systems around the world have largely remained unchanged and resultant improvements in developed countries are slower than anticipated. One area which was expected to significantly improve the quality of and access to primary healthcare services in particular is remote patient monitoring and management. Based on a combination of rapid advances in body sensors and information and communication technologies (ICT), it was hoped that remote patient management tools and systems (RPMTSs) would significantly reduce the care burden on traditional healthcare systems as well as health-related costs. However, the uptake or adoption of above systems has been extremely slow and their roll out has not yet properly taken off especially in developing countries where they ought to have made the greatest positive impact. Aim The aim of the study was to assess whether or not recent , relevant literature would support the development of in-community, design, deployment and implementation framework based on three factors thought to be important drivers and levers of RPMTS’s adoption and scalability . Methods A rapid, scoping review conducted on relevant articles obtained from PubMed, MEDLINE, PMC and Cochrane databases and grey literature on Google and published between 2012 and May 2020, by combining a number of relevant search terms and phrases. Results Most RPMTSs are targeted at and focused on a single disease, do not extensively involve patients and clinicians in their early planning and design phases, are not designed to best serve a specific catchment area and are mainly directed at post-hospital, disease management settings. This may be leading to a situation where patients, potential patients and clinicians simply do not make use of these tools, leading to low adoption and scalability thereof. Conclusion The development of a user-centred, context-dependent, customizable design and deployment framework could potentially increase the adoption and scalability of RPMTSs, if such framework addressed a combination of diseases, prevalent in a given specific catchment area, especially in developing countries with limited financial resources.

The Fourth Industrial Revolution (4IR) is upon us, emerging at a rapid pace and providing digitalisation and technology systems that can improve the agility and efficiency of the South African petroleum industry. Owing to the dynamism of and unfamiliarity with 4IR ways of working, leaders are grappling with how changes brought upon by 4IR affect their role in the organisation. In this study, the current leadership styles employed in the South African petroleum industry were investigated, and the type of leadership style required to lead a 4IR organisation effectively was determined, in order to provide recommendations of changes that leadership needs to undergo to best support the 4IR. A conceptual model was developed in which the study was sub-divided into a pre-4IR phase, transitioning to the 4IR phase, and then to fully functioning 4IR organisations. A structured questionnaire was sent to leaders in the South African petroleum industry, in which they were asked their views on leadership theories, factors influencing leadership, and leadership models pertinent to each of the three phases of 4IR. The findings of the study show that, for leaders to thrive in 4IR, they must move away from authoritarian, bureaucratic, and task-orientated leadership styles and embrace transformational, people-orientated, and charismatic leadership styles. Keywords Leadership 4.0; leadership theory; leadership styles; petroleum industry; 4IR; 4IR transitional phases

Background: Globally, community health workers (CHW) are increasingly viewed as an integral part of the health system as opposed to simply being an extension of it. Given this view, most low- or middle-income countries (LMICs) have refocused their efforts on reorganising CHW initiatives to maximise their impact. The ongoing endeavours to augment the practice of community health workers using technological solutions are characterised by as many challenges as opportunities. In low- and middle-income countries, including South Africa, information and communication technology (ICT) has become a promising development in the enhancement of the equitable coverage of health services by community health workers. However, there has not been a wide-scale implementation and adoption of ICT; most technology initiatives fail to scale up during the implementation stage, which is attributable to human and context-related factors. Although there has been an effort to develop solutions to address ICT infrastructure and technical barriers, conceptualising an evidence-based understanding of the contextual and user-related factors that influence the efficacy of technology adoption by CHWs within their multidimensional system remains critical. Objective: The purpose of the study is to conceptualise the social factors to consider when implementing a bespoke ICT solution suited to the specific demands of CHWs in primary healthcare in developing contexts, with a particular focus on the South African context. Methodology: The methodology involves synthesizing, extracting, and consolidating the findings of a systematised scoping review into concepts and factors. The review adapts Arksey and O’Malley’s scoping review approach to the study and incorporates 59 relevant articles. Results: Although the knowledge base on CHWs is extensive, there is a considerable gap in addressing structural challenges within the community system, which contributes significantly to the overall performance of CHW programs. Factors promoting policy adaptations, common practice within the health system, CHW competencies, a community’s development in terms of knowledge and economic advancement, safety and security, the environment, and the socio-cultural context all play a significant role in facilitating or impeding the success of health interventions from the individual to the national level. Conclusions: Within several practical limitations, the study shows that despite the efforts of various developing countries to promote technology adoption, the barriers to ICT adoption outweigh the benefits gained in developing countries. The paper argues that addressing these challenges before and during implementation is critical. The authors conclude with some essential concerns about assisting CHWs towards realising the desired health outcomes through ICT.

Tuberculosis is a deadly disease that has been at the forefront of many deaths around the world, but patient nonadherence to medication has been a foremost contributor to this result. Nonetheless, there could be innovative, technological intervention to aid patients' adherence to medication and prevent the many deaths. However, some of the medication nonadherence causes as well as technological interventions could have legal consequences, but the impact of this has not been investigated, especially with regards to the impact on the human rights of the patients and on the society. The article is written to add to the body of expertise on the topic and will be useful for policymakers and all stakeholders in the related area of using technology to improve patient health in the bid to attain the Sustainable Development Goals of bringing an end to the tuberculosis epidemic by 2030 (SDGs).

To date, applications of Systems Thinking (ST) in sport sciences are lacking with little existing practical work that adopted the approach. The aim of the article is to present an instantiation of ST in running towards demonstrating its utility. Two qualitative, principle tools in ST is demonstrated for a systemic problem in sport, namely recurring overuse injuries related to running. First, the growth-and-underinvestment system archetype is illustrated as a mechanism to differentiate short and long term solutions, incorporating the recent Nike Vaporfly running shoes and gait retraining. Secondly, a populated ice-berg model is provided of the runner and their environment: the runner-environment system is broken down into constituent units and then synthesised as the synergy between units; specifically considering the runner’s biomechanical properties, wearables and social media platforms. This article forms part of a more extensive project to contribute to a practical departure for ST in sport science; future work includes the quantified dynamic model of injury development from emergent interactions.

Running-related injuries, specifically overuse injuries, are complex and multifaceted. A different way of thinking is required to fully comprehend why, and how, these injuries occur. The systems thinking perspective offers tools and techniques to capture system-wide interactions in causal, closed-loop structures which may be studied and quantified in a practical way. The value of systems thinking in sport may only realise when pragmatic models follow descriptive, qualitative models. This article instantiates a qualitative, systems thinking perspective of the runner as a complex adaptive system with a hybrid simulation model. The approach is substantiated with principles from physics and physiology and is partially driven by data from a running watch. Results demonstrate that the scientific, reductionist method may be augmented with dynamic, closed-loop thinking and simulation modelling.

The use of mobile technologies at schools in teaching and learning is emerging, enabling teaching and learning to happen anywhere anytime. CSIR implemented a project in resource-constrained environments schools specifically in Gauteng, Limpopo and Northwest Province in South Africa. Teachers were trained to use mobile technologies in teaching and learning. The study focussed on identifying the components and factors that may have an influence on the user experience (UX) of teachers using mobile technologies in a resource-constrained environment. The study used an explorative qualitative research strategy to explore the users’ opinions, beliefs and perception through a questionnaire, where a thematic analysis approach was applied to analyse the qualitative data. The paper proposes a user experience conceptual framework for teachers using mobile technologies.

The Task-Technology Fit (TTF) theory provides a means of quantifying the effectiveness of technology in a system by assessing the relationship between the technology and the tasks the technology aims to support. The theory is widely recognized and has been applied in various ways, but little work has been done to summarize and synthesize the application of TTF in literature. The aim of this study is to identify and summarize the focus areas of studies that applied TTF, the environment in which it was applied, and the technologies which were considered by conducting a scoping review. It was found that applied studies focused primarily on generating theory or assessing certain real-world phenomena; was applied in a wide range of environments with the majority being in healthcare; and considered various technologies, with an increasing number of studies focusing on mobile technology. The findings of this study contribute to the understanding of TTF applications and assists in framing future research to further analyze TTF studies.

The literature on information and communication technology comprises numerous studies on the role of mobile technologies in developing communities, including examples of innovative mobile applications which improve literacy and access to healthcare, banking and agricultural services. There is a growing understanding that sustainable development requires more than rational, scientific and technological means - it also requires a web of support from both social networks and business infrastructure. Innovation ecosystems consist of economic agents and relations, as well as non-economic components such as technology, institutions, sociological interactions and culture, which facilitate idea-making, innovation and the diffusion of such innovations. There is, as yet, no evidence-based innovation ecosystem conceptualisation to describe the situation in Botswana. This study aims to identify and present the essential components of a mobile application innovation ecosystem, by using Design Science Research methodology and adopting a pragmatic research approach which draws on two theoretical streams: the Computing, Connectivity, Content and Capacity (4Cs) framework for information and communications technology, and a systems theory-based Triple Helix Model of Innovation. In addition to making a theoretical contribution towards understanding information and communications technology for development innovation frameworks, the study provides practical recommendations in respect of supporting mobile application innovations in Botswana.

Almost every facet of a cyber user's personal and business life is impacted by Information Communication Technologies (ICT) within cyberspace. In the twenty-first century, cyber users have to be ICT literate to be able to keep themselves safe from cybercrime and cyber risks. It is important to start from an early age to educate cyber users about cyber safety in order to ensure that they are cyber safety aware. It is of the utmost importance that South Africa, as a developing country, should start creating and implementing cyber safety awareness policies, procedures, measures and initiatives for the education of all cyber users within its borders. The aim of this research is to explore and identify relevant cyber safety literacy (knowledge), skills and components needed from school management, and then to develop a theoretical framework to support educators and school management to enhance cyber safety awareness in a school environment.