The contemporary patient typically conducts online research prior to consulting a physician. They are no longer solely reliant on healthcare professionals for information, instead empowered to engage in independent research and collaborate with fellow individuals who possess first-hand experiences with their condition. In this digital age, social networking sites are progressively emerging as a popular resource for patients seeking information and support. This highlights the transformative potential of social networking platforms as channels for apomediation-where patients actively seek and share medical information and support, primarily through online platforms, beyond the confines of traditional healthcare channels. Ultimately, the modern patient plays an active and empowered role in their healthcare journey. Understanding their specific requirements becomes crucial in amplifying the value of tools such as social networking services. These platforms serve as vehicles to enhance apomediation, facilitating the exchange of health-related information and support among patients. The purpose of this study was to understand the requirements of individuals with autoimmune disease in respect of apomediation. By comprehensively examining these requirements, the study aimed to contribute to a better understanding of how the needs of individuals with autoimmune disease can best be served in a disintermediated setting using technology-based interactions.

The prevalence of medical identity theft continues to increase. The deceptions involved in medical identity theft can affect the healthcare industry, health insurance providers and their members alike. Health insurance members remain unaware that they are victims of medical identity theft until they receive high medical bills or are notified by their healthcare providers. The lack of awareness of medical identity theft among health insurance members is cause for concern. The main objective of this paper is to propose best practices that can be used to address awareness of medical identity theft in the healthcare sector. A qualitative content analysis approach is used to identify twenty-six pre-emptive measures that can be taken prior to an incident to minimize individuals’ chances of becoming victims of medical identity theft. Additionally, nine retroactive measures that can be taken after an incident and can guide victims of medical identity theft in dealing with its repercussions, emerged from the content analysis.

The introduction of fitness wearables has encouraged users to take control of their health and fitness habits. These wearables are capable of collecting real-time data through the sensors embedded within the devices. The collection of real-time data about the users is a concern, as exactly what data is collected by these wearables is not clear to the users. Security threats and vulnerabilities in the fitness wearable domain continue to increase due to the increasing use of these wearables. This study aims to investigate and analyse security vulnerabilities and threats that affect fitness wearables from a security and privacy perspective. The execution of this study involves two phases of methodology. The first phase employs a systematic literature review and qualitative content analysis to identify the threats and vulnerabilities affecting fitness wearables. The second phase employs the Microsoft STRIDE framework and CIA triad to conduct an analysis of the threats and vulnerabilities. The output of this study indicates that security is still a great concern, as these fitness wearables are exposed to various security threats. Furthermore, these security threats increase due to the many components that are part of the fitness wearable architecture creating multiple entry points for attackers.

Statista suggests that there would be 368.2 million wearables shipped globally in 2020 with a projection of 500 million by 2024. These predictions are becoming a reality considering the fast growing of Intent of Things (IoT) domain. These wearables come in different forms, shapes, and sizes. The existence of fitness wearables encourages people to participate in a healthy lifestyle through tracking of health and fitness-related activities. The functionality of these devices includes gathering, processing, transmitting, and storing user data. However, these devices carry with them vulnerabilities that can negatively affect the security and privacy of a user. Therefore, the primary objective of this study is to identify security controls to mitigate the vulnerabilities that affect fitness wearables from a security and privacy perspective. However, to identify these security controls, the researcher firstly identifies the vulnerabilities affecting these fitness wearables. This study executed a methodology in two stages. The first stage conducted a literature review to identify the vulnerabilities affecting fitness wearables and related components within the ecosystem of fitness wearables. The second state follows a systematic analysis approach to identify security controls for the fitness wearable manufacturers to mitigate these vulnerabilities. The final output of this study indicates the security complexities surrounding the fitness wearables by presenting the study limitations.

The prevailing state of rural economies continues to constrain the use of digital applications for improved healthcare. These constraints are attributed to the unavailability of key infrastructure and financial resources. Moreover, a prevailing shortage of skilled health workers highlights the critical role digital solutions have to play in alleviating health service delivery challenges. Resource-constrained settings need secure low cost and long shelf-life solutions that leverage existing resources to provide adequate and secure health services. The objective of this paper is to identify the existing resources that can be engaged in the protection of the broader health information assets (including digital applications). To meet the objective, a single case study was conducted. Questionnaires were distributed to twenty-five Community Health Workers to identify existing stressors and resources in the context. The paper leads with a description of resource-constrained settings, highlights the challenges facing healthcare systems in these contexts and emphasizes the need for health information asset protection. The findings, recommendations and conclusions are subsequently presented. The contribution of this paper is a set of recommendations for improving health information asset protection in resource-constrained settings as informed by stressors and resources identified in the case study.

The ubiquity of mobile computing devices in the workplace has created a vast landscape of opportunity in rural communities centered on the increased population access owing to the improved mobility. Healthcare workers are able to reach previously disconnected communities and homesteads to deliver health related services through the use of custom mobile computing devices or applications that facilitate the viewing, recording and updating of patient records. Notably, the presence of electronic patient information presents privacy and confidentiality challenges that if not addressed, may affect the delivery of health services thereby negatively impacting on the overall health outcomes of the communities. Deficit based solutions target the needs and challenges of the communities in developing solutions and have been widely used; however, little emphasis has been placed on utilizing the existing asset resources that contribute positively to the overall health outcomes in the development of solutions. This paper leverages off an asset model developed by Morgan and Ziglio to identify existing community assets in a rural community through the use of a survey issued to community health workers and the supporting IT staff. The results point to assets in the cohesive social structures centered on the trust bond between the patients and the providers. Moreover, mentoring support structures and periodic training activities keep the health worker skills up to date. Furthermore, a positive appreciation of health information sensitivity and the need for patient privacy and confidentiality provide for productive interactions between health workers and patients.

The South African government provides a social assistance programme that pays out monetary grants to qualifying persons. In 2012, the South African Social Security Agency (SASSA) who manages these social grants, instituted a new form of identification that required the capturing of biometric features such as fingerprints and voice samples, to better identify the grant recipients in order to reduce fraud. This paper describes the development of a framework for an appropriate implementation of biometrics for the social grant programme taking into account the security requirements as well as the vulnerability of the grant recipients.

Healthcare professionals are dedicated to maintaining the confidentiality of patient information but are resistant to maintaining an information security compliant environment within a health information system. In this paper, a literature review is used to gain knowledge about the factors that affect this information security compliance. An overview of the security threats and those specific to healthcare is presented. The information security misuse deterrence and compliance promoting factors that affect information security compliant behavior are identified. Their role in strengthening information security compliant behavior is examined. The information security compliance model is introduced and its part in fostering compliant security behavior is reviewed. Its components comprise a body of knowledge, skills and attitude, and behavioural intervention, together with the misuse deterrence and compliance promoting factors. The application of the model is intended to instill, within the user, an attitude that is more conducive to information security compliant behaviour in the healthcare context.

Although e-health can potentially facilitate the management of scarce resources and improve the quality of healthcare services, implementation of e-health programs continues to fail or not fulfil expectations. A key contributor to the failure of e-health implementation in rural hospitals is poor quality management of projects. Based on a survey 35 participants from five rural hospitals in the Eastern Cape Province of South Africa, and using a qualitative case study research methodology, this article attempted to answer the question: does the adoption of quality assurance (QA) models add value and help to ensure success of information technology projects, especially in rural health settings? The study identified several weaknesses in the application of QA in these hospitals; however, findings also showed that the QA methods used, in spite of not being formally applied in a standardised manner, did nonetheless contribute to the success of some projects. The authors outline a generic quality assurance model (GQAM), developed to enhance the potential for successful acquisition of e-health solutions in rural hospitals, in order to improve the quality of care and service delivery in these hospitals.

The “What” and “Why” to do for information system development in resource restricted environments is already well covered in literature. However, the “How” to do it is still not explored. The research reported in this paper, focuses on developing a locally flavored participatory user requirements elicitation (PURE) framework for the development of information systems in resource restricted environments. It uses, existing participatory practices, user requirements elicitation (URE) literature and local participatory norms and traditions to achieve this.

Background and Purpose: Mobile-Health, or m-health, is regarded as an enabler for rural communities to access medical services through mobile devices. Research points to the fact that many of these initiatives fail in rural communities, not only to meet the expectations of the communities, but also to bring about any development. The traditional view of development utilizes tangible indicators such as the gross domestic product of a region to assess development. Within the African context, however, for an initiative to be deemed successful, it must provide the answer to a very fundamental question: “Have our need(s) been met?” A positive response to an intervention in this respect can lead to development. We propose an approach to identify m-health needs within a rural community based on an amendment of Sen’s Capability Approach (CA) paradigm to include community capabilities, as communities as entities play such an important role within the African landscape. Sen defines development as human development and capabilities as being what people are effectively able to do and to be. Sen argues that the assessment of capabilities should focus on what people are able to do and be by removing obstacles from their lives. We applied our approach within a rural South African community. Methods: Our proposed framework views community health-needs as capability-deprivation that can be expressed as either a lack of an opportunity itself or a lack of the means to take advantage of an opportunity. The developed framework requires the investigation of both “the community” and “m-health” as two entities that together define the community health-capability. The community entity consists of current health-capabilities and health-goals ; what the prevalent technology within the community delineated to health is; and finally the community’s potential health-capabilities . Potential capabilities can be defined as the projected outcomes in terms of capability development that the introduction of the relevant intervention could produce. The community entity elements are influenced by external factors (not explained here for purposes of brevity). The m-health entity on the other hand comprises of what outcomes m-health can enable; what affordable, familiar technology is prevalent as a delivery mechanism for m-health; as well as what intended and unintended potential capability development a particular m-health intervention can have. Predetermined characteristics and the identified pitfalls of m-health influence the subsequent elements respectively. Results: The community identified very little current health-capabilities. This capability deprivation stems not only from the lack of access to health related services in the area, but also from the inability to make use of these services when they are available due to transport-deprivation. The community, in terms of its capability set, can make use of- and has access to mobile phone technology. One potential capability was identified as “being healthier”; a result of regular access to health-related services. M-health has the ability to address some of the identified health-needs such as regular access to certain health-information, health-guidance or streaming video consultations. The smart-phone was identified as the affordable technology that fulfils the predetermined characteristics of an m-health delivery mechanism. Conclusions: The proposed framework addresses community health-needs analysis with regard to m-health from a community-capabilities perspective. This first iteration of the framework performed adequately and showed promise as a reliable working part of a larger Community Capability Approach (CCA) framework to attain human development as a result of an m-health intervention. Keywords: M-Health, Capability Approach, Needs Analysis, Community Capabilit ies, Human Development

This paper explores citizen attitudes towards personal health records. The study was conducted in the Eastern Cape Province of South Africa. A cross-sectional design was used and structured questionnaires administered by data collectors. Most respondents (90%) believed it to be important to extremely important for their healthcare provider to have their complete medical records. Less than half of them (42%), however, believed that the healthcare provider did have their complete medical record available to them. Nevertheless, 69% do not keep a medical record as a way to address this concern. Most of them (84%) were not aware of the existence of electronic tools to capture a personal health record prior to participating in the survey. Concerns relating to the use of online PHRs were identified as privacy (58%), lack of time (27%) and a disinterest in computers (22%). It was found that the existence of a medical chronic condition is a strong predictor of keeping a medical record (albeit mostly in paper-based format).

Biometric implementations have emerged as an improved solution in many spheres of life where security controls are necessary for authentication. However, not all human mannerisms and features can be used as a biometric measure. For example, the movement of an elbow will not satisfy the requirements for a useful biometric. There are a number of characteristics which are deemed important and that may be taken into account when choosing a human mannerism or feature to be used as a biometric for the purposes of identification. Some characteristics are more necessary than others. For example, the uniqueness of the fingerprint is more important than its acceptance as an identification mechanism by the public at large. One can find a number of these suggested characteristics in the literature and place them into various categories. The primary category will be its inherent nature but there may also be a technical and a procedural category. Technical considerations are where the typical technical implementation of the biometric may add further characteristics to the biometric. Finally, there may be procedural actions that will further have an influence on the biometric implementation. A categorized technical or procedural characteristic should add quality to the original inherent characteristics for any particular biometric. If a biometric feature and its further implementation (technical and/or procedural) satisfy a certain subset of these categorized characteristics which are deemed more important, then this may constitute a better choice than that which appears to satisfy a different subset of characteristics. This paper looks at the characteristics found in the literature and attempts to categorize them as inherent, technical or procedural in nature. The paper will subsequently look at some of the more popular biometric features and their inherent characteristics that have been found in the literature. Readers of this paper will be able to select appropriate biometric features based on the characteristics that are identified in this paper.

Incomplete patient medical history compromises the quality of care provided to a patient while well-kept, adequate patient medical records are central to the provision of good quality of care. According to research, patients have the right to contribute to decision-making affecting their health. Hence, the researchers investigated their views regarding a paper-based system and an electronic medical record (EMR). An explorative approach was used in conducting a survey within selected general practices in the Nelson Mandela Metropole. The majority of participants thought that the use of a paper-based system had no negative impact on their health. Participants expressed concerns relating to the confidentiality of their medical records with both storage mediums. The majority of participants indicated they prefer their GP to computerise their consultation details. The main objective of the research on which this poster is based was to investigate the storage medium of preference for patients and the reasons for their preference. Overall, 48% of the 85 participants selected EMRs as their preferred storage medium and the reasons for their preference were also uncovered.

Socio-technical interaction deals with the understanding of human behaviour in technology-mediated settings. In this research, home-based healthcare was selected as the case and the focus for the development of the practical application was on the needs of care givers. Service design methods were used to obtain a better understanding of the care givers’ needs where they were active participants in this process. The insights gained from the co-design, co-development and co-implementation approach contributed to the understanding of socio-technical design and development considerations applicable to the development of mobile health care applications for the benefit of South African Home-based Health care workers and the communities they serve.

Objective: Various benefits are associated with the adoption and meaningful use of health information technologies (HITs) in the healthcare sector. Despite the associated advantages with the adoption and use of HITs, the South African healthcare sector has been slow to adopt HITs, such as electronic record systems. The purpose of this study was to identify factors that should be addressed to encourage the adoption and meaningful use of HITs in the South African healthcare landscape.Design: A three-round Delphi study was conducted to identify such factors.Setting and subjects: The Delphi panel included 21 participants who were considered to be suitably knowledgeable about the acceptance and significant use of HITs in the context of the South African healthcare setting.Results: A total of 58 factors were uncovered by the participants. Consensus was reached on 42 factors that were considered to have a direct to significant impact on the adoption and meaningful use of HITs in the South African healthcare sector.Conclusion: The results of this study highlight factors that should be addressed to encourage the adoption and meaningful use of HITs in South Africa's healthcare setting. These results indicate that a wide range of factors need to be addressed and involve a multitude of stakeholders. (C) SAAFP

There are various benefits associated with the adoption and meaningful use of health information technologies (HITs) in the healthcare sector. Despite these benefits, the South African healthcare sector has been slow to adopt HITs such as electronic record systems. The purpose of this research project was to formulate guidelines to encourage the adoption and meaningful use of HITs in the South African healthcare landscape. A three-round Delphi study was conducted to identify factors that should be addressed to encourage the adoption and meaningful use of HITs in the South African healthcare landscape. The Delphi panel included 21 participants that were considered to be suitably knowledgeable regarding the area under consideration. Consensus was reached on 42 factors that were rated as having a direct to significant impact on the adoption and meaningful use of HITs in the South African context. These factors were further analysed to formulate 20 guidelines that indicate that there are a wide range of factors that would have to be addressed involving a multitude of stakeholders.

The privacy of patient information is important yet healthcare professionals are resistant to Health Information Systems, Information Technology usage and particularly information security mechanisms. In this paper, a literature review is used to gain knowledge about the medical and information security cultures involved. The gap between the intention to use Information Technology and actual compliance is examined with an investigation of behavioural change agents as Information Technology-usage motivators. Research reveals emotions as strong motivators of attitudes and behaviours. The Coping Model of User Adaptation is reviewed together with the Appraisal Tendency Framework. Logical argumentation is used to propose a theory that uses a behavioural change agent with the Coping Model of User Adaptation and the Framework for Classifying Emotions (an off-shoot of the Appraisal Tendency Framework) as tools. This theory will promote emotions that are conducive to information security obedience (or ‘good’ information security behaviour) in the healthcare context.

The adoption of technology into the health care industry has been criticized as being overtly techno-centric. It is assumed that health information technologies will fit into the environment and be easily adopted by the user. This, however, is a fallacy. Research has shown that a socio-technical approach, optimizing the interaction between the relevant social, environmental and technical sub-systems, is preferred. In this paper, a socio-technical perspective is gained on the adoption of health information technologies in the home community based care context, specifically the use of mobile phones for remote data collection. Based on data gathered through interviews with and observations of caregivers administering care in the community, this paper identifies and discusses the social, environmental and technical factors that affect community health care workers while they are using mobile phones to capture patient data in the home community based care environment in developing countries.