Increasing prevalence of non-communicable diseases, aging, and population growth pose significant sustainability challenges to health systems. Especially the health systems of low- and middle-income countries are more vulnerable to the risks related to non-communicable diseases and demographic changes. As the Covid-19 pandemic demonstrates, the quality of health systems is vital to save lives, and even the most developed countries are not immune to the consequences of global health crises. The World Health Organization estimates that non-communicable diseases such as cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes cause around 40 million deaths in a year, and 15 million people aged between 30 and 69 suffer from premature deaths mostly in low- and middle-income countries. The United Nations aim to address this problem through the Sustainable Development Goal 3.4 that stresses to reduce by one third premature mortality from non-communicable diseases through prevention and promote mental health and well-being until 2030. Poor quality health systems and inadequate access to healthcare services by the most vulnerable groups are some of the main reasons for premature deaths. Improving the quality of health systems through innovation and digitalisation is strategic to deliver essential healthcare services to the most vulnerable people. Digital health technologies such as mobile health applications for chronic disease self-management play a key role in improving the health status of individuals and the accessibility of healthcare services. Type 2 Diabetes Mellitus (‘T2DM’) is one of the most prevalent non-communicable diseases suffered by almost half a billion people, and current developments in digital health technologies offer innovative methods for its treatment. Hence, this study investigates the effectiveness of a T2DM self-management smartphone application called DiaWatch and its potential benefits for the Sustainable Development Goals in terms of addressing the challenges of health systems. Methodology: Using the Technology Acceptance Model as an overall conceptual framework, a comprehensive literature review was performed to clearly define the objectives and methods for the study. Based on these findings, two sets of semi-structured qualitative interview questions have been prepared for collecting empirical data. Ten healthcare professionals working at a university hospital in Istanbul, Turkey, and ten T2DM patients using a T2DM self-management app called DiaWatch have been interviewed from mid-February to early-March. A thematic analysis has been carried out to analyse the empirical data collected through the semi-structured interviews. Results: Firstly, the results of the interviews with T2DM patients using the DiaWatch app suggest that the health status and chronic condition self-management experience of the majority of the interviewees improved since using the app and they adopted behavioural changes, such as being more adherent to the treatment, increased physical activity, having a healthier diet and measuring blood glucose level more regularly. The interviewees reported less dependency on healthcare facilities and increased accessibility of healthcare services, as they are tele-monitored by their physicians. Secondly, the results of the interviews with healthcare professionals highlight the benefits of digital health technologies for the health systems in terms of facilitating the job of healthcare staff, reducing the costs, and saving time. The interviewees state that tele-monitoring helps to decrease the number of redundant hospital admissions and screenings; however, data privacy and irreplaceability of face-to-face medical examinations are the main concerns before the acceptance of these technologies.

Digital transformation is evolving, and it is driving at the helm of the digital evolution. The amount of information accessible to us has revolutionized the way we gather information. Mobile technology and the immediate and ubiquitous access to information has changed how we engage with services including healthcare. Digital technology and digital transformation have afforded people the ability to self-manage in different ways than face-to-face and paper-based methods through different technologies. This study focuses on exploring the use of the most commonly used digital health technologies in the healthcare sector and how it affects physicians’ daily routine practice. The study presents findings from a qualitative methodology involving semi-structured, personal interviews with physicians from Sweden and a physician from Spain. The interviews capture what physicians feel towards digital transformation, digital health technologies and how it affects their work. In a field where a lack of information regarding how physicians work is affected by digital health technologies, this study reveals a general aspect of how reality looks for physicians. A new way of conducting medicine and the changed role of the physician is presented along with the societal implications for physicians and the healthcare sector. The findings demonstrate that physicians’ role, work and the digital transformation in healthcare on a societal level are important in shaping the future for the healthcare industry and the role of the physician in this future. / Den digitala transformationen växer och den drivs vid rodret för den digitala utvecklingen. Mängden information som är tillgänglig för oss har revolutionerat hur vi samlar in information. Mobila tekniker och den omedelbara och allmänt förekommande tillgången till information har förändrat hur vi tillhandahåller oss tjänster inklusive inom vården. Digital teknik och digital transformation har gett människor möjlighet att kontrollera sig själv och sin egen hälsa på olika sätt än ansikte mot ansikte och pappersbaserade metoder genom olika tekniker. Denna studie fokuserar på att utforska användningen av de vanligaste digitala hälsoteknologierna inom hälso- och sjukvårdssektorn och hur det påverkar läkarnas dagliga rutin. Studien presenterar resultat från en kvalitativ metod som involverar semistrukturerade, personliga intervjuer med läkare från Sverige och en läkare från Spanien. Intervjuerna fångar vad läkare tycker om digital transformation, digital hälsoteknik och hur det påverkar deras arbete. I ett fält där brist på information om hur läkare arbetar påverkas av digital hälsoteknik avslöjar denna studie en allmän aspekt av hur verkligheten ser ut för läkare. Ett nytt sätt att bedriva medicin och läkarens förändrade roll presenteras tillsammans med de samhälleliga konsekvenserna för läkare och vårdsektorn. Resultaten visar att läkarnas roll, arbete och den digitala transformationen inom hälso- och sjukvården på samhällsnivå är viktiga för att utforma framtiden för vårdindustrin och läkarens roll i framtiden.

The adoption of digital health technologies has dramatically changed the healthcare sector landscape and thus generates new opportunities to collect, capture, store, access and retrieve electronic personal health information (ePHI). With the introduction of digital health technologies and the digitisation of health data, an increasing number of hospitals and peripheral health facilities across the globe are transitioning from a paper-based environment to an electronic or paper-light environment. However, the growing use of digital health technologies within healthcare facilities has caused ePHI to be exposed to a variety of threats such as cyber security threats, human-related threats, technological threats and environmental threats. These threats have the potential to cause harm to hospital systems and severely compromise the integrity and confidentiality of ePHI. Because of the growing number of security threats, many hospitals, both private and public, are struggling to secure ePHI due to a lack of robust data security plans, systems and security control measures. The purpose of this study was to explore the security of electronic personal health information in a public hospital in South Africa. The study was underpinned by the interpretivism paradigm with qualitative data collected through semi-structured interviews with purposively selected IT technicians, network controllers’, administrative clerks and records management clerks, and triangulated with document and system analysis. Audio-recorded interviews were transcribed verbatim. Data was coded and analysed using ATLAS.ti, version 8 software, to generate themes and codes within the data, from which findings were derived. The key results revealed that the public hospital is witnessing a deluge of sophisticated cyber threats such as worm viruses, Trojan horses and shortcut viruses. This is compounded by technological threats such as power and system failure, network connection failure, obsolete computers and operating systems, and outdated hospital systems. However, defensive security measures such as data encryption, windows firewall, antivirus software and security audit log system exist in the public hospital for securing and protecting ePHI against threats and breaches. The study recommended the need to implement Intrusion Protection System (IPS), and constantly update the Windows firewall and antivirus program to protect hospital computers and networks against newly released viruses and other malicious codes. In addition to the use of password and username to control access to ePHI in the public hospital, the study recommends that the hospital should put in place authentication mechanisms such as biometric system and Radio Frequency Identification (RFID) system restrict access to ePHI, as well as to upgrade hospital computers and the Patient Administration and Billing (PAAB) System. In the absence of security policy, there is a need for the hospital to put in place a clear written security policy aimed at protecting ePHI. The study concluded that healthcare organisations should upgrade the security of their information systems to protect ePHI stored in databases against unauthorised access, malicious codes and other cyber-attacks. / Information Science / M. Inf. (Information Security)