Background: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Objective: The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to identify the internal and external factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Methods: This study aims to evaluate digital health projects carried out in the last 5 years in Pakistan with mixed methods. The qualitative and quantitative data obtained from field surveys were categorized according to the World Health Organization’s (WHO) recommended building blocks for health systems research, and the data were analyzed using a SWOT analysis strategy. Results: Of the digital health projects carried out in the last 5 years in Pakistan, 51 are studied. Of these projects, 46% (23/51) used technology for conducting research, 30% (15/51) used technology for implementation, and 12% (6/51) used technology for app development. The health domains targeted were general health (23/51, 46%), immunization (13/51, 26%), and diagnostics (5/51, 10%). Smartphones and devices were used in 55% (28/51) of the interventions, and 59% (30/51) of projects included plans for scaling up. Artificial intelligence (AI) or machine learning (ML) was used in 31% (16/51) of projects, and 74% (38/51) of interventions were being evaluated. The barriers faced by developers during the implementation phase included the populations’ inability to use the technology or mobile phones in 21% (11/51) of projects, costs in 16% (8/51) of projects, and privacy concerns in 12% (6/51) of projects.
The COVID-19 pandemic has changed many aspects of people’s lives, and seems to have affected people’s wellbeing and relation to technology now, and in the future. Not only has it changed people’s lives and the way citizens live, work, exercise, craft and stay connected, the pandemic has also altered the way Human Computer Interaction (HCI) professionals can engage in face-to-face interactions and consequently participatory, human-centered design and research. Limitations in being close to others and having physical, visible and shared interactions pose a challenge as these aspects are typically considered critical for the accomplishment of a transparent, attractive and critical understanding of technology and respective civic and digital engagement for wellbeing. Consequently, the risk now observed is that citizens in the new ‘normal’ digital society, particularly vulnerable groups, are beingeven less connected, supported or heard. Drawing from a study with an expert panel of 20 selected HCI related professionals in The Netherlands that participated on-line (through focus groups, questionnaires and/or interviews) discussing co-creation for wellbeing in times of COVID-19 (N=20), and civic values for conditional data sharing (N=11), this paper presents issues encountered and potential new approaches to overcome participatory challenges in the ‘new’ digital society. This study further draws on project reporting and a ‘one week in the life of’ study in times of COVID-19 with a physical toolkit for remote data collection that was used with older adults (65+, N=13) and evaluated with professionals (N=6). Drawing on such projects and professional experiences, the paper discusses some opportunities of participatory approaches for the new ‘distant’ normal.
Implementing new information systems and devices, in high-reliability organizations such as operating rooms (OR’s) in hospitals, is complex. To improve the success and efficiency of these implementations we constructed a protocol for implementation for digitization and devices in OR’s. This protocol consists of implementation factors, implementation activities, and implementation instructions. In this study, we evaluated this protocol. To gather data, we organized three focus group sessions with participants holding different job roles at different departments: a surgeon, a methodologist, anesthesiologists, a scrub nurse, a training officer, innovations officers, and OR-management. We gathered qualitative data regarding completeness, clearness, and the ability to execute. Sessions were video-recorded, transcribed, and coded in Nvivo for Windows according to Toulmins Argumentative Pattern. Based on this analysis, revisions to factors, activities, and instructions are presented for protocol enhancement; experts confirm that an implementation protocol is needed to increase implementation efficiency and adoption of new devices.
Onderdeel van het RAAK Publiek-project was het ontwikkelen van een eHealth platform (www.vkbmonitor.nl) waarin bestaande smart devices werden gebruikt (bijvoorbeeld Fitbit One) of nieuwe zijn ontwikkeld (bijvoorbeeld iCaptur). Na een periode van intensief gebruik werden de belemmerende en bevorderende factoren van het gebruik van de VKB-monitor en de smart devices zoals ervaren door professionals en patiënten in kaart gebracht. Deze inventarisatie maakte duidelijk, dat fysiotherapeuten, ondanks dat zij doordrongen zijn van de voordelen van technologieën, veel barrières ervaren om eHealth en smart devices in de praktijk te implementeren. Er blijkt dus een verschil te zijn tussen wat fysiotherapeuten in theorie ondersteunen en de mate waarin fysiotherapeuten in de zorgpraktijk eHealth en smart devices daadwerkelijk (kunnen) inzetten. Onze ervaring vanuit het RAAK Publiek-project is dat de inzet van technologieën voor het monitoren van herstel van mensen na een VKB-reconstructie in ieder geval geen vanzelfsprekendheid is. Voor het duurzame inzetten van deze technologieën heeft men competenties nodig, zoals digitale geletterdheid waaronder ‘mediawijsheid’, die vertaald moeten worden naar het dagelijks fysiotherapeutisch methodisch handelen van de zorgprofessional. Denk hierbij o.a. aan ‘het veilig en ethisch omgaan met technologie’ en ‘afwegingen kunnen maken tussen e-zorg en face-to-face behandeling’. Toekomstige zorgprofessionals dragen in het ideale geval ook bij aan de (door)ontwikkeling van technologie om deze optimaal te laten aansluiten bij de dagelijkse praktijk. Hiervoor moeten zij verbeterpunten kunnen herkennen en samen met ontwikkelaars (Bèta Sciences & Technology, CMD en ICT) naar oplossingen zoeken (‘sociale en culturele vaardigheden’ en ‘communicatie’). We denken de kans op het gebruik van technologie in de fysiotherapiepraktijk te kunnen vergroten door expliciet aandacht te besteden aan deze 21st century skills binnen de fysiotherapieopleiding van Zuyd (http://curriculumvandetoekomst.slo.nl/21e-eeuwse-vaardigheden). Tijdens het RAAK Publiek-project was er al intensieve betrokkenheid van studenten, onderzoekers en docenten van de opleidingen fysiotherapie, communicatie en multimedia design (CMD), ergotherapie, biometrie, Bèta Sciences & Technologie en ICT en de lectoraten ‘Voeding, Leefstijl en Bewegen’ en ‘Smart Devices’. De betrokken studenten hebben vooral binnen het top-traject van deze opleidingen (jaar 3,4) kennis gemaakt met de inhoud van het project (afstudeerproject of werkstudent). Ook is er een workshop ontwikkeld (onderwijs) om fysiotherapeuten met de VKB-monitor vertrouwd te maken. Willen eHealth en smart devices een grotere kans van slagen hebben om structureel ingebed te worden in de fysiotherapiepraktijk, zullen alle toekomstige fysiotherapeuten vroegtijdig gesensibiliseerd en opgeleid moeten worden om de benodigde competenties hiervoor te ontwikkelen. Voor een duurzame inbedding moet het onderwerp: 1) vroeger aan bod komen in het onderwijs (jaar 1,2), waarbij de bovengenoemde competenties (bijvoorbeeld ‘afwegen tussen e-zorg en face-to-face’) centraal staan en 2) aan alle studenten aangeboden worden. Daarnaast moeten studenten fysiotherapie leren om interprofessioneel samen te werken met (toekomstige) professionals vanuit Bèta Sciences & Technologie, CMD en ICT om technologieën te optimaliseren voor de praktijk. In dit project willen we daarom een verdiepingsslag maken naar duurzame inbedding van de thematiek in het onderwijs via de ontwikkeling van een set van interprofessionele en interfacultaire onderwijseenheden, in de vorm van bijvoorbeeld casuïstiek en co-creatie technieken.
This PD project explores alternative approaches to audiovisual technologies in art and creative practices by reimagining and reinventing marginalized and decommodified devices through Media Archaeology, artistic experimentation, and hands-on technical reinvention. This research employs Media Archaeology to uncover “obsolete” yet artistically relevant technologies and hands-on technical reinvention to adapt these tools for contemporary creative practices. It seeks to develop experimental self-built devices that critically engage with media materiality, exploring alternative aesthetic possibilities through practice-based investigations into the cultural and historical dimensions of media technologies. These developments provide artists with new creative possibilities beyond mainstream commercial standardized tools and infrastructures. A key component of this project is collaborative innovation with artist-run analog film communities, such as Filmwerkplaats. By fostering knowledge exchange and artistic experimentation, this research ensures that reinvented tools remain relevant to both analog film communities and contemporary media art practices. The intended outcomes directly benefit two key groups: • Artist-run film labs gain sustainable methods for evolving their practices, reducing dependence on scarce, out-of-production equipment. • Digital-native artists are introduced to alternative methods for engaging with analog processes and media materiality, expanding their creative toolkit. This collaboration also strengthens art and design education by embedding alternative technological perspectives and research methodologies into curricula, providing students and practitioners with resourceful, sustainable approaches to working with technology. It advocates for a more diverse educational paradigm that incorporates media-technological history and critical reflection on the ideologies of linear technological progress. Ultimately, this research fosters critical discourse on media culture, challenges the dominance of corporate proprietary systems, and promotes innovation, redefining the relationship between creativity and technology.
My research investigates the concept of permacomputing, a blend of the words permaculture and computing, as a potential field of convergence of technology, arts, environmental research and activism, and as a subject of future school curricula in art and design. This concept originated in online subcultures, and is currently restricted to creative coding communities. I study in what way permacomputing principles may be used to redefine how art and design education is taught. More generally, I want to research the potential of permacomputing as a critical, sustainable, and practical alternative to the way digital technology is being taught in art education, where students mostly rely on tools and techniques geared towards maximising productivity and mass consumption. This situation is at odds with goals for sustainable production and consumption. I want to research to what degree the concept of permacomputing can be broadened and applied to critically revised, sustainable ways of making computing part of art and design education and professional practice. This research will be embedded in the design curriculum of Willem de Kooning Academy, focused on redefining the role of artists and designers to contribute to future modes of sustainable organisation and production. It is aligned with Rotterdam University of Applied Sciences sectorplan masters VH, in particular managing and directing sustainable transitions. This research builds upon twenty years of experience in the creative industries. It is an attempt to generalise, consolidate, and structure methods and practices for sustainable art and design production experimented with while I was course director of a master programme at WdKA. Throughout the research I will be exchanging with peers and confirmed interested parties, a.o.: Het Nieuwe Instituut (NL), RUAS Creating 010 kenniscentrum (NL), Bergen Centre for Electronic Arts (NO), Mikrolabs (NO), Varia (NL), Media Arts department at RHU (UK), Media Studies at UvA (NL).
