Impact of industry 4.0 on healthcare systems of low- and middle- income countries: a systematic review.

Purpose: A growing body of empirical research has emerged, focused on leveraging Industry 4.0 technologies to develop and optimise systems within various operational contexts, including healthcare delivery. However, even though a significant number of studies have been published on application of digital technologies in enhancing delivery and health outcomes of health systems, systematic studies that review how extensively these technologies have been applied within a low- and middle-income economies' context remain scarce in the literature. This work attempts to close that gap by investigating the impact of industry 4.0 on healthcare systems in emerging economies.

Methods: The study follows a systematic review approach and uses PRISMA guidelines to conduct the research and synthesise its findings. A final sample of 72 articles is selected for in-depth review following a systematic screening from an initial list of 597 results.

Results: The study successfully synthesises the latest research in the subject area and reveals that, hitherto, approaches to use of digital tools have been fragmented and thus unable to provide holistic optimisation solutions for healthcare systems in low-resource settings. The analysis exposes a heavy skew towards adoption of mobile health and telemedicine technologies, with conspicuous research gaps in the use of augmented reality, additive manufacturing as well as simulation and digital twin technologies.

Conclusions: The study provides researchers, health-care practitioners and systems engineers with knowledge on the state-of-the-art in healthcare systems optimisation and points out research gaps that may be addressed through future empirical studies.