Digital health combines digital technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery. It includes mHealth, eHealth, telemedicine, telehealth, telecare, remote care, and assisted living, aiming to improve healthcare services. The success of current mHealth interventions is driven by the need to tackle global healthcare and social challenges.

In April 2019, the “WHO Global Strategy on Digital Health 2020-2024” was launched, envisioning universal health coverage by promoting the adoption of suitable digital health interventions. This vision aligns with the digital transformations occurring in many countries, including South Africa, and supports the United Nations Sustainable Development Goal 3, which aims to provide quality and equitable healthcare to all by 2030.

Mobile technologies have been crucial in increasing the adoption of digital health interventions. Furthermore, the capabilities of 5G and beyond networks—such as ultra-reliable low latency, enhanced mobile broadband, and massive machine-type communications—along with technologies like IoT, big data, machine learning, artificial intelligence, and blockchain, are poised to revolutionize healthcare delivery.

Despite efforts to develop applications and services leveraging these technologies, the World Health Organization (WHO) reports a lack of evidence regarding the efficacy and safety of emerging digital health applications and services in improving health outcomes and their cost-effectiveness. According to the WHO’s 2019 Global Strategy on Digital Health (2020-2025), there is a need to create digital health test beds to evaluate and validate the numerous digital health interventions developed to date.

This research aims to establish a 5G/6G test network, the UCT 5G Digital Health test bed, to generate such evidence through the development, evaluation, and validation of both existing and new digital health applications.

The TCC projects at the University of Cape Town are divided into four work packages: TCC-WP1, TCC-WP2, TCC-WP3, and TCC-WP4. 

TCC-WP1: Blockchain Technology for Security in mHealth Applications

The benefits of digital health solutions come with increased security risks due to the large number of connected devices, the open nature of wireless networks, and the elevated use of virtualisation and cloud services. Rules, regulations, and guidelines for developing security solutions to protect patient health information as networks evolve to 5G and beyond are being defined. However, innovative security mechanisms are needed to fully realize the benefits of digital health interventions. This project investigates the application of blockchain technology in connected health systems. The blockchain-based security system will be evaluated and validated on the UCT Digital Health test bed.

TCC-WP2: Virtual Clinic for Rural, Remote, and Under-Resourced Communities

The COVID-19 pandemic highlighted the inequity in access to quality care for rural, remote, and under-resourced communities. Many rural areas, especially in Sub-Saharan Africa, including South Africa, have limited access to medical doctors. A virtual clinic service, defined as a planned contact between a patient and a clinician for clinical consultation, advice, and treatment planning, presents opportunities for increasing access to quality care in these communities. This project aims to develop and evaluate a virtual clinic service for employees at the South African Square Kilometre Array (SKA) project site in Carnarvon, Northern Cape province. A telemedicine solution will be developed and evaluated on the UCT Digital Health test bed, with field trials conducted in Carnarvon.

TCC-WP3: mHealth

Achieving universal health coverage is a challenge for many developing countries, with African health systems suffering from a high burden of disease, poor health infrastructure, and a critical shortage of skilled health professionals. Evidence of the effectiveness of digital health technologies in strengthening health systems is increasing. Solutions include remote patient monitoring, consultations, disease diagnosis, population-based screening for diseases such as tuberculosis and HIV/AIDS, and self-management of long-term conditions like diabetes, cardiovascular disease, and cancer. This project aims to develop a point-of-care latent TB screening system using hyperspectral images to enable remote screening for latent TB infection. Additionally, a framework for implementing an mHealth system to enable people living with HIV/AIDS to continuously access antiretroviral treatment (ART) regardless of their location will be developed. These projects address the poor health outcomes associated with HIV/AIDS, the leading cause of death in South Africa, and the fatal co-infection of TB and HIV/AIDS.

TCC-WP4: Modelling 5G Smart Hospitals

Health systems in many African countries, including South Africa, struggle to meet the health requirements of their populations due to shortages of health professionals, poor health infrastructures, and a high burden of diseases. 5G and beyond wireless systems, combined with machine learning, artificial intelligence, and medical IoTs, can drive the integration of hospital and clinical processes and services across the health ecosystem. 5G smart hospitals aim to modernize infrastructure by integrating digital and physical assets into a unified framework, tying clinical and business workflows and assets together. This project aims to develop a model 5G smart hospital by developing and testing concepts such as real-time access to data, end-to-end security, integrated specialty services, and efficient coordination across different networked medical devices and services. The UCT Digital Health test bed and various use case applications already developed, such as tele-audiology, telehaptics, mobile phone-based latent TB screening, and tele-ultrasound, will be used as test tools for the 5G smart hospital.

In conclusion, the TCC projects at UCT aim to leverage advanced technologies to improve healthcare delivery, particularly in under-resourced and rural areas. Through the development of the 5G/6G test network, blockchain security systems, virtual clinics, mHealth frameworks, and 5G smart hospitals, this project seeks to address significant healthcare challenges and enhance the efficiency, accessibility, and quality of healthcare services.