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The purpose of this paper is to examine the relevance of Cuba’s medical system, its health tourism and related diplomacy in the context of the recent COVID-19 pandemic for the global response to disease outbreaks. In addition to Cuba being a destination for leisure tourists in the Caribbean, the renowned Cuban medical system attracts thousands of health tourists seeking low-cost but high-quality treatment. This paper demonstrates how Cuba’s unique response to the pandemic, which included sending thousands of medical staff abroad, can inform structural and global issues and contribute to a more sustainable future.

The research in this study is primarily drawn from published academic and media sources that address Cuba’s medical system, its health tourism and the government’s response to the recent pandemic. The author, a political scientist and an author of many publications on Cuba, and the PI of a study focused on Cuban tourism, will also draw on her expertise.

This paper addresses the Cuban Government’s ongoing response to the COVID-19 pandemic and places this response in the context of Cuba’s medical system, its health tourism and related diplomacy. It reveals key lessons from Cuba’s response for other tourist destination states and, more broadly, for the worldwide response to global outbreaks and the management of health systems. The findings will further research in diplomacy and tourism as well as inform policy and practice.

This paper explores an ongoing topic and thus further research will be required following the pandemic.

This research note offers important implications for practice including providing accurate, research-based information that challenges misinformation about Cuba’s health system, its medical diplomacy program, health tourism and its response to COVID-19. It offers valuable lessons for public health authorities including the importance of preventative health measures, community medicine and the benefits of working globally to combat outbreaks through the sharing of medical staff and resources.

This research note reveals the health, political and social implications of Cuba’s response in this time of crisis. It shows the benefits of a robust but low-cost community-based medicine program, medical diplomacy and how a state’s response during crisis can moderate the global inequities and injustices such as unequal access to care that often accompany disease outbreaks such as COVID-19.

This research note is an early analysis of a response by an important tourist destination country to the pandemic. The author anticipates that the information provided to the international community via this open access journal will offer practical implications for the ongoing global efforts to manage this crisis and contribute to the research on tourism, diplomacy, justice and health policy.

The promotion of autonomous vehicles introduces privacy and security risks, underscoring the pressing need for responsible innovation implementation. To more effectively address the societal risks posed by autonomous vehicles, considering collaborative engagement of key stakeholders is essential. This study aims to provide insights into the governance of potential privacy and security issues in the innovation of autonomous driving technology by analyzing the micro-level decision-making processes of various stakeholders.

For this study, the authors use a nuanced approach, integrating key stakeholder theory, perceived value theory and prospect theory. The study constructs a model based on evolutionary game for the privacy and security governance mechanism of autonomous vehicles, involving enterprises, governments and consumers.

The governance of privacy and security in autonomous driving technology is influenced by key stakeholders’ decision-making behaviors and pivotal factors such as perceived value factors. The study finds that the governmental is influenced to a lesser extent by the decisions of other stakeholders, and factors such as risk preference coefficient, which contribute to perceived value, have a more significant influence than appearance factors like participation costs.

This study lacks an investigation into the risk sensitivity of various stakeholders in different scenarios.

The study delineates the roles and behaviors of key stakeholders and contributes valuable insights toward addressing pertinent risk concerns within the governance of autonomous vehicles. Through the study, the practical application of Responsible Innovation theory has been enriched, addressing the shortcomings in the analysis of micro-level processes within the framework of evolutionary game.

Quantifying the performance level of surgeons with digital virtual reality (VR) simulators can help ensure that quality requirements in healthcare are met. In order to better understand integration amongst quality principles, practices and technologies in the adoption and diffusion of VR simulators, the authors applied a technological innovation system (TIS) framework. The purpose of this study is to understand how the adoption and diffusion of VR surgical simulators in a Swedish healthcare context is influenced by various system factors.

In this study, single-case holistic design based on innovation system theory was used to analyse the adoption of digital quality technologies related to surgical performance in Swedish hospitals. The case employs a mixed methods approach triangulating data longitudinally from published documents and expert interviews.

Adoption of digital technologies regarding surgical performance is restricted by system factors relating to inconsistent normative and regulatory requirements for quantified performance criteria to judge surgical expertise. Addressing these systems' weaknesses with evidence-based training programmes can have a significant impact on the further development of the innovation system and can ultimately affect healthcare reliability and quality.

This paper explores quality management (QM) challenges in the context of digital transformation in healthcare. The paper attempts to fill the gap for TIS studies in a healthcare context and highlight the role of innovation function strength along the value chain and in relation to technology cycles to increase the understanding of adoption of digital technologies relating to surgical performance.

The study explores how Taiwan’s electronic health data systems can be used to build algorithms that reduce or eliminate medical errors and to advance precision medicine.

This study is a narrative review of the literature.

The body of medical knowledge has grown far too large for human clinicians to parse. In theory, electronic health records could augment clinical decision-making with electronic clinical decision support systems (CDSSs). However, computer scientists and clinicians have made remarkably little progress in building CDSSs, because health data tend to be siloed across many different systems that are not interoperable and cannot be linked using common identifiers. As a result, medicine in the USA is often practiced inconsistently with poor adherence to the best preventive and clinical practices. Poor information technology infrastructure contributes to medical errors and waste, resulting in suboptimal care and tens of thousands of premature deaths every year. Taiwan’s national health system, in contrast, is underpinned by a coordinated system of electronic data systems but remains underutilized. In this paper, the authors present a theoretical path toward developing artificial intelligence (AI)-driven CDSS systems using Taiwan’s National Health Insurance Research Database. Such a system could in theory not only optimize care and prevent clinical errors but also empower patients to track their progress in achieving their personal health goals.

While research teams have previously built AI systems with limited applications, this study provides a framework for building global AI-based CDSS systems using one of the world’s few unified electronic health data systems.

This study aims to develop a hierarchical model that uncovers the relationships between challenges confronting Africa's organ transplant supply chain systems.

Eleven challenges (variables) were identified after a comprehensive review of the existing literature. The contextual interactions among these variables were analysed from the perspectives of health-care stakeholders in two sub-Saharan Africa (SSA) countries (Nigeria and Uganda), using Delphi-interpretive structural modelling-cross-impact matrix multiplication applied to classification (MICMAC) techniques.

The findings reveal that weak regulatory frameworks, insufficient information systems and a lack of necessary skills make it challenging for critical actors to perform the tasks effectively. The interaction effects of these challenges weaken organ supply chains and make it less efficient, giving rise to negative externalities such as black markets for donated organs and organ tourism/trafficking.

This paper establishes a solid foundation for a critical topic that could significantly impact human health and life once the government or non-profit ecosystem matures. The MICMAC analysis in this paper provides a methodological approach for future studies wishing to further develop the organ supply chain structural models.

The study provides valuable insights for experts and policymakers on where to prioritise efforts in designing interventions to strengthen organ transplantation supply chains in developing countries.

This study is one of the first to empirically examine the challenges of organ transplant supply chains from an SSA perspective, including theoretically grounded explanations from data collected in two developing countries.

This paper aims to describe the results of applying ethical AI requirements to a healthcare use case. The purpose of this study is to investigate the effectiveness of using open educational resources for Trustworthy AI to provide recommendations to an AI solution within the healthcare domain.

This study utilizes the Hackathon method as its research methodology. Hackathons are short events where participants share a common goal. The purpose of this to determine the efficacy of the educational resources provided to the students. To achieve this objective, eight teams of students and faculty members participated in the Hackathon. The teams made suggestions for healthcare use case based on the knowledge acquired from educational resources. A research team based at the university hosting the Hackathon devised the use case. The healthcare research team participated in the Hackathon by presenting the use case and subsequently analysing and evaluating the utility of the outcomes.

The Hackathon produced a framework of proposed recommendations for the introduced healthcare use case, in accordance with the EU's requirements for Trustworthy AI.

The educational resources have been applied to one use-case.

This is the first time that open educational resources for Trustworthy AI have been utilized in higher education, making this a novel study. The university hosting the Hackathon has been the coordinator for the Trustworthy AI Hackathon (as partner to Trustworthy AI project).

Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with “health inequity”. Governing power is impacting people's lives through laws, policies and professional decisions, and can be used intentionally to combat health inequity by addressing and changing people's living- and working conditions. Little attention is paid to how these ways of exercising governing power unintentionally can structure further conditions for health inequity. In this paper, the authors coin the term “governance determinants of health” (GDHs). The authors' discussion of GDHs potential impact on health inequity can help avoid the implementation of governing strategies with an adverse impact on health equality. This paper aims to discuss the aforementioned objective.

The authors identify Governance Determinants of Health, the GDHs. GDHs refer to governance strategies that structurally impact healthcare systems and health equality. The authors focus on the unintended, blind sides of GDHs that maintain or reinforce the effects of socioeconomic inequality on health.

The power to organize healthcare is manifested in distinct structural approaches such as juridification, politicalization, bureaucratization and medical standardization. The authors explore the links between different forms of governance and health inequalities.

The authors' discussion in this article is innovative as it seeks to develop a framework that targets power dynamics inherent in GHDs to help identify and avoid GDHs that may promote unequal access to healthcare and prompt health inequity. However, this framework has limitations as the real-world, blurred and intertwined aspects of governing instruments are simplified for analytical purposes. As such, it risks overestimating the boundaries between the separate instruments and reducing the complexity of how the GDHs work in practice. Consequently, this kind of theory-driven framework does not do justice to the myriad of peoples' complex empirical practices where GDHs may overlap and intertwine with each other. Nevertheless, this framework can still help assist governing authorities in imagining a direction for the impacts of GDHs on health equity, so they can take precautionary steps to avoid adverse impacts.

The authors develop and explore – and demonstrate – the relevance of a framework that can assist governing authorities in anticipating the impacts of GDHs on health inequity.