Healthcare 4.0 digital technologies impact on quality of care: A systematic literature review

Dounia Marbouh, Vikas Swarnakar, Mecit Can Emre Simsekler, Jiju Antony, Fabiane Letícia Lizarelli, Raja Jayaraman, Jose Arturo Garza-Reyes, Alireza Shokri, Elizabeth Cudney*, Samer Ellahham

*Corresponding author for this work

Research output: Contribution to journalLiterature reviewpeer-review

1 Citation (Scopus)


The healthcare industry is transforming into Healthcare 4.0 (H4.0), an era characterized by smart and connected healthcare systems. This study presents a conceptual framework that classifies H4.0 digital technologies into information and communication technology bundles within the healthcare value chain. It also identifies barriers and evaluates digital technologies’ impact on quality measures through a systematic literature review and meta-analysis approach following the PRISMA protocol. The analysis reveals that digital technologies in the healthcare sector traditionally consist of sensing-communication and processing-actuation technologies. The findings highlight the significant influence of H4.0 digital technologies on three quality measures: patient safety, patient experience/satisfaction, and clinical effectiveness. While these technologies offer potential benefits, they pose challenges for patients and clinicians, including intellectual property and significance concerns, especially in North America. The proposed framework addresses these issues and enables stakeholders to prioritize, review, and analyze H4.0 digital technologies to enhance patient safety, experience, and clinical effectiveness. This research contributes to the existing literature by being the first comprehensive analysis of the impact of H4.0 technologies on the quality of care. The framework provided in this study offers valuable guidance for stakeholders in selecting appropriate technologies to improve patient outcomes and support the healthcare value chain.
Original languageEnglish
Pages (from-to)1-26
Number of pages26
JournalTotal Quality Management and Business Excellence
Early online date25 Jul 2023
Publication statusE-pub ahead of print - 25 Jul 2023

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