Mwogosi Augustino, Mambile Cesilia
University of Dodoma, Department of Information Systems and Technology, Dodoma, Tanzania.
Digit Health. 2025 Sep 12;11:20552076251377933. doi: 10.1177/20552076251377933. eCollection 2025 Jan-Dec.
Digital ecosystems integrate interconnected tools, platforms, and stakeholders to support healthcare delivery. While prior research has examined their technological architecture, limited attention has been paid to their role in enhancing communication and collaboration, particularly in low-resource settings. This scoping review explores how digital ecosystems facilitate these functions, identifying key components, applications, barriers, and enablers.
Following the Arksey and O'Malley framework, enhanced by Levac et al., a scoping review was conducted using Scopus, PubMed, JSTOR, and Emerald. The review included studies published between 2009 and 2024 and adhered to PRISMA-ScR reporting standards. A total of 15 eligible studies were analysed thematically.
Five core ecosystem components emerged: interoperability, stakeholder diversity, patient-centred tools, innovative platforms, and knowledge sharing. Ecosystems supported real-time communication, improved service coordination, and enhanced care accessibility through tools such as telemedicine and mHealth. In low-resource settings, barriers included fragmented digital infrastructure, privacy regulations, and provider resistance. Enablers included strong stakeholder engagement, supportive policies, and low-bandwidth digital solutions like SMS-based platforms.
This review highlights the communicative and collaborative functions of digital ecosystems as central to their value in healthcare not just their technological capacity. It contributes a contextual perspective by detailing implementation challenges and adaptations in low- and middle-income countries. To advance the field, future research should adopt standardized frameworks, expand empirical studies in underrepresented settings, and emphasize inclusive, scalable designs that respond to local healthcare realities.
数字生态系统整合了相互连接的工具、平台和利益相关者，以支持医疗服务的提供。虽然先前的研究已经考察了它们的技术架构，但对于它们在加强沟通与协作方面的作用，尤其是在资源匮乏的环境中的作用，关注较少。本综述探讨数字生态系统如何促进这些功能，确定关键组成部分、应用、障碍和推动因素。
遵循由Levac等人改进的Arksey和O'Malley框架，使用Scopus、PubMed、JSTOR和Emerald进行了一项综述。该综述纳入了2009年至2024年发表的研究，并遵循PRISMA-ScR报告标准。对总共15项符合条件的研究进行了主题分析。
出现了五个核心生态系统组成部分：互操作性、利益相关者多样性、以患者为中心的工具、创新平台和知识共享。生态系统通过远程医疗和移动健康等工具支持实时通信、改善服务协调并提高医疗服务的可及性。在资源匮乏的环境中，障碍包括数字基础设施碎片化、隐私法规和提供者的抵触。推动因素包括强大的利益相关者参与、支持性政策以及基于短信平台等低带宽数字解决方案。
本综述强调数字生态系统的沟通与协作功能是其在医疗保健领域价值的核心，而不仅仅是其技术能力。它通过详细说明低收入和中等收入国家的实施挑战和调整，提供了一个背景视角。为了推动该领域的发展，未来的研究应采用标准化框架，扩大在代表性不足环境中的实证研究，并强调能够应对当地医疗现实的包容性、可扩展设计。
