Alexa,let's train now!——A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging

Background:There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging.Consequently,the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions.In this context,digital and home-based physical training interventions might be a promising alternative to center-based intervention programs.Thus,this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance.Methods:In this pre-registered systematic review(PROSPERO;ID:CRD42022320031),5 electronic databases(PubMed,Web of Science,Psyclnfo,SPORTDiscus,and Cochrane Library)were searched by 2 independent researchers(FH and PT)to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults.The systematic literature search yielded 8258 records(extra17 records from other sources),of which 27 controlled trials were considered relevant.Two reviewers(FH and PT)independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise(TESTEX scale).Results:Of the 27 reviewed studies,15 reported positive effects on cognitive and motor-cognitive outcomes(i.e.,performance improvements in measures of executive functions,working memory,and choice stepping reaction test),and a considerable heterogeneity concerning study-related,population-related,and intervention-related characteristics was noticed.A more detailed analysis suggests that,in particular,interventions using online classes and technology-based exercise devices(i.e.,step-based exergames)can improve cognitive performance in healthy older adults.Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence(≤85%)and monitoring of the level of regular physical activity in the control group.Conclusion:The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall,though there is limited evidence that specific types of digital and home-based physical training interventions(e.g.,online classes and step-based exergames)can be an effective strategy for improving cognitive performance in older adults.However,due to the limited number of available studies,future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.

Mobile health interventions for improving maternal and child health outcomes in South Africa:a systematic review

Background:Maternal and child health(MCH)remains a significant public health concern globally despite previous efforts made to improve MCH services.Initiatives such as antenatal care,postnatal care services exclusive breastfeeding,child vaccination and supplements have been rolled out to improve MCH outcomes.However,inadequate maternal healthcare,socioeconomic factors,obstetric haemorrhaging,complications of hypertension during pregnancy,lack of maternal information,poor universal health coverage and uptake of MCH services exacerbate maternal mortality and child mortality rates,especially in resource-constrained areas in many sub-Saharan African countries including South Africa.Objective:This study aimed to review mobile health(mHealth)interventions deployed to improve maternal and child health outcomes.Methods:The study adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model to search and retrieve relevant literature from reputable,prominent electronic databases(Google Scholar,Scopus,PubMed,Embase,CINAHL,Web of Science,etc.).A total of 26 papers were selected and analyzed.Results:The findings revealed several mHealth interventions such as MomConnect,Mobile Alliance for Maternal Action,NurseConnect,ChildConnect,CommCare,Road to Health Application and Philani Mobile Video Intervention for Exclusive Breastfeeding have been utilized by healthcare workers and women to improve access to MCH services.However,inadequate digital infrastructure,digital divide,resistance to change,inadequate funding,language barriers,short message service and data costs,lack of digital skills and support,compatibility,scalability and interoperability issues,legislative and policy compliance,lack of mHealth awareness,data security and privacy concerns hinder uptake and utilisation of mHealth interventions.There is a need to scale up and sustain mHealth interventions and update existing regulatory framework,policies and strategies.Conclusion:mHealth interventions offer unprecedented opportunities to improve access to maternal information and substantially improve maternal and child health services.Stakeholder engagement and the development of sustainable funding strategies are important for successfully implementing and scaling mHealth projects while addressing existing and emerging key issues.

ERAD: Enhanced Ransomware Attack Defense System for Healthcare Organizations

Digital integration within healthcare systems exacerbates their vulnerability to sophisticated ransomware threats, leading to severe operational disruptions and data breaches. Current defenses are typically categorized into active and passive measures that struggle to achieve comprehensive threat mitigation and often lack real-time response effectiveness. This paper presents an innovative ransomware defense system, ERAD, designed for healthcare environments that apply the MITRE ATT&CK Matrix to coordinate dynamic, stage-specific countermeasures throughout the ransomware attack lifecycle. By systematically identifying and addressing threats based on indicators of compromise (IOCs), the proposed system proactively disrupts the attack chain before serious damage occurs. Validation is provided through a detailed analysis of a system deployment against LockBit 3.0 ransomware, illustrating significant enhancements in mitigating the impact of the attack, reducing the cost of recovery, and strengthening the cybersecurity framework of healthcare organizations, but also applicable to other non-health sectors of the business world.

Vision transformer architecture and applications in digital health:a tutorial and survey

The vision transformer (ViT) is a state-of-the-art architecture for image recognition tasks that plays an important role in digital health applications. Medical images account for 90% of the data in digital medicine applications. This article discusses the core foundations of the ViT architecture and its digital health applications. These applications include image segmentation, classification, detection, prediction, reconstruction, synthesis, and telehealth such as report generation and security. This article also presents a roadmap for implementing the ViT in digital health systems and discusses its limitations and challenges.

Utilising digital health to improve medication-related quality of care for hypertensive patients:An integrative literature review

BACKGROUND Hypertension or high blood pressure is considered as a significant contributor and risk factor to many serious conditions,approximately 1.13 billion people have hypertension globally.However,the integrated technologies can upscale health provisions and improve the effectiveness of the healthcare system.WHO has recommended that the digital health interventions(DHIs)and the Health System Challenges should be used in tandem in addressing health.AIM To summarise the outcomes from a range of research which investigated the use of DHI to improve the medication-related quality of care(MRQOC)for hypertensive patients.METHODS An integrative literature review was undertaken in October 2019 using the Medline,Cumulative Index of Nursing and Allied Health Literature,and Scopus databases for publications in English with no date limit.RESULTS In total,18433 participants were included in this review from 28 studies meeting the eligibility criteria.There were 19 DHI identified within eight countries:Australia,Canada,India,South Korea,Lebanon,Pakistan,the United Kingdom,and the United States of America.The DHI were provided as community-based,clinical-based and home-based program through mobile phone,mobile health system,short message service,and telehealth,digital medicine,and online healthcare(web-based).The mean age of participants was 59 ranging from 42 to 81 years with an average mean systolic blood pressure of 143.3 mmHg at baseline,ranging from 129.0 mmHg to 159.0 mmHg.The proportion of male participants ranged from 13.9%to 92.0%.Eighteen interventions showed evidence of reduction in blood pressure and improvement of self-management in relation to medication adherence and blood pressure control.The reduction of systolic blood pressure ranged between 1.9 mmHg and 26.0 mmHg,with a mean of 10.8 mmHg.The digital health was found positively associated with the MRQOC for hypertensive patients such as improvement in medication adherence and medication management;better blood pressure control;maintaining followups appointment and self-management;increasing access to healthcare particularly among patients living in rural area;and reducing adverse events.However,some interventions found no significant effect on hypertensive care.The follow up duration varied between 2 mo and 18 mo with an average attrition rate of 10.1%,ranging from 0.0%to 17.4%.CONCLUSION Utilising digital health innovation for hypertensive care in different settings with tailored interventions positively impacted on MRQOC leading to an improvement of patient outcomes and their quality of life.Nevertheless,inconclusive findings were found in some interventions,and inconsistent outcomes between DHI were noted.A future research and evidence-based DHI for hypertension or chronic diseases should be developed through the evidenceto-decision framework and guidelines.

mHealth as a health system strengthening tool in China

Over the past 70 years,there was a rapid epidemiological transition in disease burden in China,from infectious disease to non-communicable diseases(NCDs),which requires long-term prevention and management.Rapid growth in mobile phone use,internet connectivity and digital health technology,presents new opportunities for improvement in NCD healthcare delivery and population-based outcomes.Although there were a growing number of research to evaluate the feasibility and effectiveness of the mobile health(mHealth)interventions for NCD management,the extent to which mHealth contributes towards the health system strengthening in China remains unknown.In this paper,we provided a high-level overview of mHealth in China and its role for Chinese health system strengthening.We conclude with several recommendations for the future of mHealth research in China based on existing evidence identified.

Virtual healthcare services and digital health technologies deployed during coronavirus disease 2019(COVID-19)pandemic in South Africa:a systematic review

Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their use.Metiiods:To determine the status of digital health utilization during COVID-19 in South Africa,the preferred reporting items for systematic reviews and meta-analyses model was used to perform a systematic and in-depth critical analysis of previously published studies in well-known and trusted online electronic databases using specific search keywords words that are relevant to this study.We selected published peer-reviewed articles available from the onset of COVID-19 to July 2021.Results:Total of 24 articles were included into this study.This study revealed that South Africa adopted digital technologies such as SMS-based solutions,mobile health applications,telemedicine and telehealth,WhatsApp-based systems,artificial intelligence and chatbots and robotics to provide healthcare services during COVID-19 pandemic.These innovative technologies have been used for various purposes including screening infectious and non-infectious diseases,disease surveillance and monitoring,medication and treatment compliance,creating awareness and communication.The study also revealed that teleconsultation and e-prescription,telelaboratory and telepharmacy,teleeducation and teletraining,teledermatology,teleradiology,telecardiology,teleophthalmology,teleneurology,telerehabilitation,teleoncology and telepsychiatry are among virtual healthcare services delivered through digital health technologies during COVID-19 in South Africa.However,these smart digital health technologies face several impediments such as infrastructural and technological barriers,organization and financial barriers,policy and regulatory barriers as well as cultural barriers.Conclusion:Although COVID-19 has invigorated the use of digital health technologies,there are still some shortcomings.The outbreak of pandemics like COVID-19 in the future is not inevitable.Therefore,we recommend increasing community networks in rural areas to bridge the digital divide and the modification of mHealth policy to advocate for the effective use of innovative technologies in healthcare and the development of sustainable strategies for resources mobilization through private-public partnerships as well as joining available international initiatives advocating for smart digital health.

Big tech,big data and the new world of digital health

This commentary shows the exponential growth of digital health and the accompanying explosion of health data.It discusses three major shifts in the global health landscape.The first will be the move of the big tech companies into healthcare,the second will be the monetization of consumer data and the creation of health data marketplaces;and the third will be the growth of Asia as a leader in digital health.Big tech already has the advantage of a massive consiuner base,data and analytics which enable them to understand consumers;and complementary technologies,like wearables,that will drive the consumerization of healthcare.This expansion can happen quickly and already is creating challenges for regulators as they try to catch up.The vast volumes of data and the ability of technology such as blockchain to enable data owners to monetize their data,will lead to the development of health data marketplaces,which can connect and monetize data for data owners and make it available for scientific discovery.The developments in self-sovereign identity,will make it possible for individuals to monetize their health data in the future.Finally,we see the emergence of Asia as a powerhouse for the digital health of the future,with vast populations,mobile technology and increasing adoption of wearable devices.Consumer focused health care driven by data will change the institutional models of the past.

Opportunities to Integrate Primary Health Care Digital Innovations in Maternal and Child Health Care Services in Kenya

Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa with infant mortality of 51/1000 live births in the WHO Africa region [1]. There is potential to improve access and utilization of health services through investing in Primary Health Care (PHC) digital innovations [2] especially in underserved settings [3]. In the last quarter of the year 2021 after lifting of the COVID-19 restrictions, Tekeleza project, aims to integrate digital health innovations into MNCH care within PHC settings in Kenya. The project team undertook a baseline survey in three rural counties (Kisii, Kajiado and Migori) characterized with low social-economic status to identify opportunities to leverage on the use of evidence-based digital innovations to reverse the adverse trends in Maternal and Child Health. Methods: A cross-sectional and descriptive study was conducted in 15 Community Health Units (CHUs) in Kenya that were linked to selected Primary Health Care (PHC) facilities from three rural counties. Mixed methods were used to collect data from 404 Households (HHs) selected across the sampled CHUs on Probability Proportionate to Size (PPS). The selected households were assigned unique household or respondent identifiers. The sampling frame for household surveys consisted of all women 18 - 49 years of age, who were either pregnant or in their 18 months post-delivery. From the constructed sampling frame, a simple random sampling procedure was used to select the study sample. An audit was also carried out at the selected PHC facilities and sixty-two (62) Primary Health Workers (PHCWs) including facility managers were interviewed to establish challenges affecting ICT infrastructure and sustainable financing of MNCH services. Findings: The majority of the sampled women (64.9%) were lactating at the time of the study, with 34.4% being pregnant and 0.7% both pregnant and lactating. Despite the high proportions of mothers who received Skilled Birth Attendance, discontinuity in seeking antenatal and postnatal care services was observed in all three counties. The proportion of mothers (n = 404) who reported to have attended at least one ANC was 46.8%. This was attributed to limited access to health facilities, poor staff attitude, and negative cultural practices that got exacerbated by the COVID-19 pandemic. An average of 53.2% of the respondents started attending ANC clinics much later after 12 weeks of gestation to minimize the costs and time they will spend on attending ANC clinics. It also emerged that 68.7% of the respondents had low knowledge levels of selected perinatal and infant care practices. On the making of Sexual and Reproductive Health (SRH) health-seeking decisions, 54.7% of the respondents said, it is their husbands who decide. The PHCWs expressed limited access to Continuing Professional Development (CPDs), a situation that worsened with the COVID-19 Pandemic. Notably, only 54.9% of the PHCWs reported having access to either a Smartphone or desktop at the point of service delivery. Nearly the same proportion (54.8%) has access to the internet at their workstations. Facilities reported delayed reimbursement of National Hospital Insurance Fund (NHIF) and only 54% of the women interviewed had registered in Linda mama NHIF package meant to enable them to access free maternity care. Only one county (Migori) had significant utilization of CHVs. Conclusion: There is increasing access to Skilled Birth Attendance (SBA) in rural Kenya but discontinuous pregnancy care is still a problem and it got worse during the COVID-19 pandemic. Rural PHC facilities have poor ICT infrastructure and despite the 98% rural access to a phone by women, there is limited bankable usage of handheld technology to improve health information literacy on self and infant care among women of reproductive age. Recommendations: Feasibility studies to be conducted on how to sustainably deploy Primary Health Care digital solutions to improve the quality of, access to, and Utilization of Maternal and Child Health (MNCH) services.

SACI Protocol: Preliminary Guidelines for the Development of Digital Health Technologies for Clinical Trials in Brazil

In the last decade, evidence-based medical practice has been supported on a large scale by computerized decision support tools, aiming to reduce diagnostic and therapeutic uncertainty, complementing the actions of the health professional. With technological developments, it is now possible to consider these systems as part of clinical intervention, both for the diagnosis and treatment of diseases. The literature has described the implementation of e-health tools, that is, technological innovations in the health area such as software, applications, serious games, among others, as a strategy to improve the process and adherence to treatment. However, there is still no standardized instrument in Brazil that can be used to guide the development, from the research phase, and the implementation of these tools as a health intervention, also impacting patient outcomes. With the objective of investigating a new therapeutic and preventive form, based on intervention with a computerized system, this work proposes the creation of guidelines for the registration and implementation of e-health tools as a clinical intervention. The proposal aims to be able to assist in the reporting standardization from the development stage to the application of the e-health tool helping in the treatment of diseases, registering all the experience lived in the research and applying it in different contexts of health.

Telenutrition for the management of inflammatory bowel disease:Benefits,limits,and future perspectives

Patients with inflammatory bowel disease(IBD)require lifelong and personalized care by a multidisciplinary healthcare team.However,the traditional medical model is not ideal for patients who require continuous close monitoring and whose symptoms may dramatically worsen between regularly scheduled visits.Additionally,close dietary follow-up and monitoring of IBD in a traditional setting are challenging because of the disease complexity,high pressure on outpatient clinics with a small number of IBD specialist dietitians,and rising incidence.Given the significant burden of IBD,there is a need to develop effective dietary management strategies.The coronavirus disease 2019 pandemic caused an unprecedented shift from in-person care to delivering health care via technological remote devices.Traditional nutrition therapy and consultation can be provided by telenutrition through remote electronic communication applications that could greatly benefit patient care.Telenutrition might be useful,safe,and cost-effective compared with standard care.It is likely that virtual care for chronic diseases including IBD will continue in some form into the future.This review article summarizes the evidence about telenutrition applications in the management of IBD patients,and we gave an overview of the acceptance and impact of these interventions on health outcomes.

Revolutionizing digital healthcare networks with wearable strain sensors using sustainable fibers

Wearable strain sensors have attracted research interest owing to their poten-tial within digital healthcare,offering smarter tracking,efficient diagnostics,and lower costs.Unlike rigid sensors,fiber-based ones compete with their flexibility,durability,adaptability to body structures as well as eco-friendliness to envi-ronment.Here,the sustainable fiber-based wearable strain sensors for digital health are reviewed,and material,fabrication,and practical healthcare aspects are explored.Typical strain sensors predicated on various sensing modalities,be it resistive,capacitive,piezoelectric,or triboelectric,are explained and analyzed according to their strengths and weaknesses toward fabrication and applica-tions.The applications in digital healthcare spanning from body area sensing networks,intelligent health management,and medical rehabilitation to mul-tifunctional healthcare systems are also evaluated.Moreover,to create a more complete digital health network,wired and wireless methods of data collec-tion and examples of machine learning are elaborated in detail.Finally,the prevailing challenges and prospective insights into the advancement of novel fibers,enhancement of sensing precision and wearability,and the establishment of seamlessly integrated systems are critically summarized and offered.This endeavor not only encapsulates the present landscape but also lays the founda-tion for future breakthroughs in fiber-based wearable strain sensor technology within the domain of digital health.

Digital health in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease(COPD)can be prevented and treated through effective care,reducing exacerbations and hospitalizations.Early identification of individuals at high risk of COPD exacerbation is an opportunity for preventive measures.However,many patients struggle to follow their treatment plans because of a lack of knowledge about the disease,limited access to resources,and insufficient clinical support.The growth of digital health-which encompasses advancements in health information technology,artificial intelligence,telehealth,the Internet of Things,mobile health,wearable technology,and digital therapeutics-offers opportunities for improving the early diagnosis and management of COPD.This study reviewed the field of digital health in terms of COPD.The findings showed that despite significant advances in digital health,there are still obstacles impeding its effectiveness.Finally,we highlighted some of the major challenges and possibilities for developing and integrating digital health in COPD management.

Are the coronavirus disease 2019 (COVID-19)-themed applications launched during the pandemic sustainable?

Many digital applications(Apps)were launched during the coronavirus disease 2019(COVID-19)pandemic for various purposes such as information sharing,risk assessment,self-management of symptoms,contact tracing,home monitoring,and decision making.Since the quality of COVID-19-themed Apps varied and was less reliable based on measurements using the mobile Apps rating scale method,some of these Apps are considered useful while some are said to have the potential to harm users.This suggests the need for authorized institutions to validate and ensure the safety and security of these Apps before it was launched in public.This is necessary considering the potential dangers arising from App inaccuracies,as well as the potential misuse of user data due to data breaches.With these considerations in mind,we consider that the vaccine passport is an App with a COVID-19 theme that must be refined and applied sustainably amid the ongoing global crisis and the uncertainty of this pandemic.

Barriers and Facilitators to Implementation of Digital Solutions

Intro/background: The NHS Long term plan calls for “digital-first” solutions, however, many good innovations fail. Barriers to digital innovation in healthcare are well-rehearsed and often predictable. This paper aims to highlight issues to be considered in implementation. Methods: It is a qualitative study of experiences of telehealth implementation. Findings: Staff engagement is crucial to acceptance;compatibility with existing practises helps but where impossible, pathway redesign is necessary. There is a notion that staff of any grade can become digital champions, yet the role is challenging for staff without power. Funding systems can restrict adoption due to associated savings impacting elsewhere in the system. Organisational support for innovation is often apparent but does not trickle down to service level sufficiently. Conclusions: Senior management needs to lead on and support at a micro level the implementation of digitally enabled health care. Funders and commissioners need to recognise that innovation takes time and that measured approaches are more successful.

Internet-based nationwide evaluation of patient preferences for mobile health features in ankylosing spondylitis

Background Ankylosing spondylitis(AS)generally occurs in young adults.The functional impairments resulting in limitation in activities and social participation might exert lifetime impacts.The present study investigated the preferences for mobile health(mHealth)features motivating the self-management behaviors in AS.Methods The present study was an internet-based,nationwide quantitative study based on the Chinese Ankylos-ing Spondylitis Prospective Imaging Cohort(CASPIC)study,which was a nationwide,ongoing,prospective cohort study launched in conjunction with Smart-phone SpondyloArthritis Management System(SpAMS)in China.Par-ticipants with AS from the CASPIC were invited to report their mHealth preferences from December 2019 to February 2020.The questionnaire was designed to determine the patient preferences for 28 mHealth features.Sociodemographic characteristics,including age,gender,and work status,were collected.Results Among all the visitors to the online questionnaire(n=872),93.9%(819/872)respondents fully com-pleted the questionnaire and were enrolled in the present study.The mean age was(33.4±9.0)years,and 70.57%(578/819)of the respondents were males.The mean scores of 22(78.57%)features were greater than 4(like or strongly like).The mean standard deviation(SD)score of exercise instructions was 4.70(0.63),which was the most preferred feature,whereas the social interaction features were preferred the least.Pain analysis was more preferred among female respondents(4.72 vs.4.60,P=0.012),whereas all items of the social interaction theme and social interaction as a whole(3.73 vs.3.52,P<0.001)were less preferred among female respondents.Additionally,the following themes were more preferred by respondents aged≤40 years:credibility and styling(4.37 vs.4.19,P<0.001);disease action support(4.55 vs.4.47,P=0.007);and incentivization(4.35 vs.4.24,P=0.025).Conclusion AS patients show great interest for the majority of mHealth features.Exercise instructions and exercise scheduling are the most preferred features,whereas social interaction is the least preferred feature.In addition,gender-related and age-related differences exist in mHealth feature preferences.

FAIR Equivalency with Regulatory Framework for Digital Health in Uganda

This study explores the possibility of opening a policy window for the adoption of the FAIR Guidelines—that data be Findable, Accessible, Interoperable, and Reusable(FAIR)—in Uganda’s e Health sector. Although the FAIR Guidelines were not mentioned in any of the policy documents relevant to Uganda’s e Health sector, the study found that 83% of the documents mentioned FAIR Equivalent efforts, such as the adoption of the National Identification Number(NIN) as a unique identifier in Uganda’s national Electronic Health Management Information System(e HMIS)(findability), the planned/ongoing integration of various information systems(interoperability), and the alignment of various projects with international best practices/standards(reusability). A FAIR Equivalency Score(FE-Score), devised in this study as an aggregate score of the mention of the equivalent of FAIR facets in the policy documents, showed that the documents at the core of Uganda’s digital health/e Health policy have the highest score of all the documents analysed, indicating that there is a degree of alignment between Uganda’s National e Health Vision and the FAIR Guidelines. Therefore, it can be concluded that favourable conditions exist for the adoption and implementation of the FAIR Guidelines in Uganda’s e Health sector. Hence, it is recommended that the FAIR community adopt a capacity building strategy through organisations with a worldwide mandate, such as the World Health Organization, to promote the adoption of the FAIR Guidelines as part of international best practices.

FAIR Equivalency in Indonesia's Digital Health Framework

The objective of this study was to assess the regulatory framework for health data in Indonesia in order to understand the policy context and explore the possibility of expanding the adoption and implementation of the FAIR Guidelines,which state that data should be Findable,Accessible,Interoperable and Reusable(FAIR),in Indonesia.Although the FAIR Guidelines were not explicitly mentioned in any of the policy documents relevant to the Indonesian digital health sector,six out of the eight documents analysed contained FAIR Equivalent principles.In particular,Indonesia’s Population Identification Number(NIK)has the potential,as a unique identifier,to support the integration and interoperability(findability)of data,which is crucial to all other aspects of the FAIR Guidelines.There is also a plan to build standards and protocols into the implementation of information systems in each ministry and government agency to improve data accessibility(accessibility),the integration of the various information systems is planned/ongoing(interoperability),and the need for a standardised arrangement for health information systems related to health data following the community standard is recognised(reusability).The documents at the core of Indonesia’s digital health/e Health policy have the highest FAIR Equivalency Score(FE-Score),showing some degree of alignment between the Indonesian digital health implementation vision and the FAIR Guidelines.This indicates that Indonesia’s digital health sector is open to using the FAIR Guidelines.

FAIR Equivalency with Regulatory Framework for Digital Health in Ethiopia

This paper investigates whether or not there is a policy window for making health data ‘Findable’, ‘Accessible’(under well-defined conditions), ‘Interoperable’ and ‘Reusable’(FAIR) in Ethiopia. The question is answered by studying the alignment of policies for health data in Ethiopia with the FAIR Guidelines or their ‘FAIR Equivalency’. Policy documents relating to the digitalisation of health systems in Ethiopia were examined to determine their FAIR Equivalency. Although the documents are fragmented and have no overarching governing framework, it was found that they aim to make the disparate health data systems in Ethiopia interoperable and boost the discoverability and(re)usability of data for research and better decision making. Hence, the FAIR Guidelines appear to be aligned with the regulatory frameworks for ICT and digital health in Ethiopia and, under the right conditions, a policy window could open for their adoption and implementation.

Chronic disease in a digital health environment

Although we know that there are benefits to individual patients from electronic data,the next potential,and potentially the biggest,benefit will come from the technologies known as big data,machine learning,and artificial intelligence.Harnessing the potential of computers to sift through large amounts of data will result in the possibility of generating insights into individual patients,and into whole populations,predicting the risk of hospital admission for an individual,or track-ing influenza epidemics to prepare adequate responses.Once the data are reliable,recorded in a computer-interpretable way,new horizons will open.