Wearables for Health Tourism: Perspectives and Model Suggestion

Abstract

INTRODUCTION: Internet of Things (IoT) has been taking wide place in our daily lives. Among different solution ways in terms of IoT, wearables take a remarkable role because of their compact structures and the mobility. By using wearables, it is very easy to sense a person’s movements and gather characteristic data, which may be processed for desired outcomes if intelligent inferencing. As associated with this, wearables can be effectively used for health tourism operations. As wearables already proved their capabilities for healthcare-oriented applications, the perspective may be directed to health tourism purposes. In this way, positive contributions may be done in the context of not only patients’ well-being but also other actors such as health staff and tourism agencies.OBJECTIVES: Objective of this paper is to evaluate the potential of wearables in health tourism applications, provide a model suggestion, and evaluate it in the view of different actors enrolling in health tourism ecosystems. Within this objective, research targets were directed to the usage ways of wearables in health tourism, ensuring model structures as meeting with the digital transformation advantages, and gather some findings thanks to feedback by patients, health staff, and agencies.METHODS: The research firstly included some views on what is health tourism, how the IoT, mobile solutions as well as wearables may be included in the ecosystem. Following to that, the research ensured a model suggestion considering wearables and their connections to health tourism actors. Finally, the potentials of wearables and the model suggestion was evaluated by gathering feedback from potential / active health tourists, health staff, and agency staff. RESULTS: The research revealed that the recent advancements in wearables and the role of digital transformation affects health tourism. In this context, there is a great potential to track and manage states of all actors in a health tourism eco system. Thanks to data processing and digital systems, it is effective to rise fast and practical software applications for health tourism. In detail, this may be structured in a model where typical IoT and wearable interactions can be connected to sensors, databases, and the related users. According to the surveys done with potential / active health tourists, health staff, and agency staff, such a model has great effect to advance the health tourism.CONCLUSION: The research study shows positive perspectives for both present and future potentials of wearable and health tourism relation. It is remarkable that rapid advancements in IoT can trigger health tourism and the future of health tourism may be established over advanced applications including data and user-oriented relations.

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EAI Endorsed Transactions
on Pervasive Health and Technology Research Article
1
Wearables for Health Tourism: Perspectives and Model
Suggestion
Gamze Kose1, Liliana Marmolejo-Saucedo2, Miriam Rodríguez-Aguilar3, and Utku Kose4,*
1Aydin Adnan Menderes University, Turkey, Graduate School of Health Sciences, Aydin, Turkey, gamze.g.kose@gmail.com
2Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, México, lilianamarmolejos@gmail.com
3Instituto Mexicano del Seguro Social, Mexico, rodriguez.miriam@imss.gob.mx
4Suleyman Demirel University, Turkey, Dept. of Computer Eng., Faculty of Eng., Isparta, Turkey, utkukose@sdu.edu.tr
4University of North Dakota, USA, College of Engineering & Mines, Grand Forks, ND, USA, utku.kose@und.edu
Abstract
INTRODUCTION: Internet of Things (IoT) has been taking wide place in our daily lives. Among different solution ways
in terms of IoT, wearables take a remarkable role because of their compact structures and the mobility. By using wearables,
it is very easy to sense a person’s movements and gather characteristic data, which may be processed for desired outcomes
if intelligent inferencing. As associated with this, wearables can be effectively used for health tourism operations. As
wearables already proved their capabilities for healthcare-oriented applications, the perspective may be directed to health
tourism purposes. In this way, positive contributions may be done in the context of not only patients’ well-being but also
other actors such as health staff and tourism agencies.
OBJECTIVES: Objective of this paper is to evaluate the potential of wearables in health tourism applications, provide a
model suggestion, and evaluate it in the view of different actors enrolling in health tourism ecosystems. Within this objective,
research targets were directed to the usage ways of wearables in health tourism, ensuring model structures as meeting with
the digital transformation advantages, and gather some findings thanks to feedback by patients, health staff, and agencies.
METHODS: The research firstly included some views on what health tourism is, how the IoT, mobile solutions as well as
wearables may be included in the ecosystem. Following to that, the research ensured a model suggestion considering
wearables and their connections to health tourism actors. Finally, the potentials of wearables and the model suggestion was
evaluated by gathering feedback from potential / active health tourists, health staff, and agency staff.
RESULTS: The research revealed that the recent advancements in wearables and the role of digital transformation affects
health tourism. In this context, there is a great potential to track and manage states of all actors in a health tourism eco
system. Thanks to data processing and digital systems, it is effective to rise fast and practical software applications for health
tourism. In detail, this may be structured in a model where typical IoT and wearable interactions can be connected to sensors,
databases, and the related users. According to the surveys done with potential / active health tourists, health staff, and agency
staff, such a model has great effect to advance the health tourism.
CONCLUSION: The research study shows positive perspectives for both present and future potentials of wearable and
health tourism relation. It is remarkable that rapid advancements in IoT can trigger health tourism and the future of health
tourism may be established over advanced applications including data and user-oriented relations.
Keywords: wearables, internet of things, health tourism, healthcare, tourism, digital transformation
Received on 05 November 2023, accepted on 15 January 2024, published on 18 January 2024
Copyright © 2024 G. Kose et al., licensed to EAI. This is an open access article distributed under the terms of the CC BY-NC-SA 4.0,
which permits copying, redistributing, remixing, transformation, and building upon the material in any medium so long as the original
work is properly cited.
doi: 10.4108/eetpht.10.4310
*Corresponding author. Email: utkukose@sdu.edu.tr
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1. Introduction
As a result of digital transformation, the life has been
changing since especially start of the current century. It is
remarkable to express that the rapid advancements in terms
of data processing caused innovative changes in electronics.
In this context, changes took effect in information and
communication technologies (ICT). As the humanity has
been in an innovation era since the rise of computers and
Internet, resulting outcomes of ICT have started to take effect
in 2000s. Thanks to the digital transformation, our daily life
surrounded by digital systems and applications, which are
helping us to reach to desired information or perform tasks
just by using software interfaces [1, 2]. This was achieved as
a result of collecting user data in databases inside data
centres. Additionally, effective processing of such user data
required more advanced technological solutions since user-
oriented tasks took place in different fields from public
services to education, financial operations to communication,
and even trade to healthcare services. Although software
systems have been effective to deal with the services widely,
increases in data and personalized service requirements made
it necessary to sense user actions and process them through
advanced data systems. This became a requirement for even
machine to machine interactions in wider data processing and
inferencing architectures. As a result, Internet of Things
(IoT), which is a technological approach for communicating
devices [3, 4] appeared as an innovative solution way. In IoT
applications, mobile devices and wearables have a
remarkable role to gather users and machines in a common
ecosystem [5-7].
Wearables is a type of IoT solutions where sensors and
software-based mechanisms collect the data from individual
and even ensures instant feedback for improving the
experience [8]. When current state of technological
advancements is considered, it can be said that wearables can
be in the form of smart watches, smart clothes, shoes and
different types of daily life objects, which users interact with.
In this way, wearables take place in many daily life tasks to
collect data from user actions (e.g., walking, running, giving
feedback over applications), biometric states (e.g., heartbeat,
breathing, oxygen) and data-based collaborations with other
IoT devices [8-10]. As among IoT components, wearables
currently have the most flexible and adaptive role for
supporting real-time applications. So, they have been widely
used for sportive activities, travelling and healthcare
solutions [11]. Recently, as a trendy area, health tourism
seems to have great potential for applications of wearables.
Because health tourism already combines the activities
regarding healthcare and tourism.
Health tourism is defined as the international travel, which
patients perform for both healthcare and tourism purposes
[12-14]. Patients or individuals, who perform health tourism
may be called as health tourists. Health tourists desire to
receive different kind of healthcare services (e.g. operations,
basic treatments, well-being events) in another country where
they can benefit from touristic and cultural interactions. In
detail, health tourism choice is associated with both travel
desires and receiving healthcare with less costs in a different
country [14, 15]. Eventually, health tourism has gained more
importance as a result of opportunities for global travelling,
communication, changing conditions of health services and
economic benefits. As it can be understood, the globalism and
the technological advancements have been triggering the
popularity and influence of health tourism. So, talking about
today’s conditions, role of ICT and data use trigger digitalized
health tourism tasks and opportunities in this manner. As it is
already done in e-trade, e-banking and many other digitally
transformed areas, the field of health tourism is under the
influence of data and technology usage. As connected with
rising IoT and wearables, potentials for health tourism
applications can be improved greatly by these technological
components. Thanks to use of especially wearables, it would
be more effective to receive immediate signs from health
tourism actors to realize a well-defined digital health tourism
ecosystem.
Objective of this paper is to provide a general discussion
regarding how wearables can be effectively used for
advancing health tourism applications. Moreover, the paper
aims to design a model of ecosystem where users and
wearables work towards health tourism interactions.
Eventually, it is aimed to have some recent feedback by the
actors of health tourism to understand how such a model can
be welcomed if applied accordingly. It is believed that the
paper outcomes will be a recent and remarkable reference for
further developments in health tourism. It is critical that the
rise of health tourism is highly connected with the way of
ICT. So, as a recent component of ICT, wearables tend to
open newer doors of innovations through present needs in
health tourism area.
Connected with the objectives of the paper, the rest of the
content is organized as follows: The next section provides
general explanations about why IoT and wearables have
connections with health tourism. Additionally, it also
expresses about the potentials of wearables for shaping the
technological way of health tourism. After this section, the
third section suggests a general health tourism model where
the wearables and known components of typical health
tourism applications are interacting each other. Next, the
fourth section ensures a general evaluation, which was done
via survey work prepared for health tourists, health staff, and
agencies. This section also ensures a general discussion by
moving from the obtained feedback, Finally, the paper is
ended with conclusions.
2. IoT, Wearables and Health Tourism
As a result of technological improvements in ICT, it has been
critical to use data and shape it according to even remote users
located at different places over the world. Although Internet
has been an effective way for worldwide communication and
data sharing, advancements in user tools caused appear of
new requirements. It is remarkable that new requirements are
result of new ICT, which have been always shaped the society
and the human. Eventually, cutting-edge advancements
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Wearables for Health Tourism: Perspectives and Model Suggestion
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caused the IoT to appear in the scientific literature. As a
technological approach for creating networks in which
devices are able to interact with their environments. The
environments may include other devices, static components
of the environment, and users [16, 17]. In order to achieve
that, IoT devices are supported with sensors and actuators,
which are electronic tools for sensing and giving feedback to
surroundings. Out of hardware components, they also include
specific software systems, which are based on data processing
and Artificial Intelligence algorithms. Nowadays, typical IoT
devices include mobile phones, tablet PCs, webcams, robotic
home devices, and any type of devices employing the
mentioned hardware and software infrastructure [18-20].
From a general perspective, some IoT devices may not have
advanced architectures, so their roles are simpler with data
transferring, data processing, improving communication of
the ecosystem. In detail, typical IoT ecosystems may be
explained in terms of six characteristics: sensors and
actuators, devices, communication, identification, tracking /
localization, and security [21] (Figure 1).
Figure 1. Characteristics of IoT [21].
Characteristics of IoT made it an effective technology to
develop smart homes, buildings, and even cities. As a result
of increasing development speed of the technology, last
decade faced with advancements regarding IoT-based
applications. All these applications have been common in
daily life since IoT devices became compact and more
flexible to locate in ongoing ecosystems. As a result of
becoming more compact, the concept of wearables has been
widely used to define such IoT devices. A typical wearable is
a IoT device, which employs sensors and actuators to run
according to wearer’s states and actions [22, 23].
Currently, wearables have many different versions to
interact with the wearer’s body. As a widely used wearable,
smart watch is a complicated device, which can sense many
actions as well as biometrics, and run background software
for further data analyses. On the other hand, there are smart
clothes, skin patches, eye-wears, and shoes, which are able to
track many occurrences from muscle activity to sweat,
movements to cognitive processes or emotions [24]. Multiple
use of such wearables may also be associated with wider
ecosystems, which are able to extend the benefits of
wearables to track sportive advances, understand people’s
complex actions (for e.g., managerial or security-oriented
purposes) and conduct healthcare applications for check-ups,
diagnosis and treatments [25-27].
From a general perspective, wearables have been
effectively used for specific purposes, in order to improve
people’s experiences and ensure improved services. Peake et
al. provides a remarkable view about how wearables became
consumer tools and triggered a new economy of IoT for
advancing the life standards [24]. Because it is important to
track actions in sportive events, wearables have already been
discussed about real-time tracking possibilities. Rana and
Mittal pointed the kinematic analysis thanks to wearables use
[28]. Morris et al. ensures a remarkable study to focus on
instant performance and training tracking [29]. On the other
hand, Zadeh et al. revealed the effective use of wearables for
predicting injuries during sport events [30]. As connected
with advancing tracking of health state, wearables for sports
have been widely studied in recent years [31-33].
One of the most critical application ways of wearables
have been healthcare. Because wearables are near to track
instant health signs of a person, the literature has received a
high interest in terms of research studies. Iqbal et al. provides
a wide review regarding application ways of wearables in
healthcare and discuss about the potentials for effective
diagnosis and treatment [34]. Malwade et al. discussed about
effective use of mobile devices and wearables for especially
ageing population [35]. Paradiso et al. developed a fabric
sensor-based system (WEALTHY-a), which is a very
remarkable contribution to improve flexibility and coverage
of wearables in terms of healthcare monitoring [36]. In a
recent study, Gao et al. developed robust and extensible
fibrous mechanical sensors to advance wearables for health
monitoring [37]. Recently, wearables for healthcare purposes
faced different advancements in terms of sensors. These
advancements include usage of innovative components such
as nanomaterials and graphene [38, 39]. As a result of
designing advanced ecosystems of IoT, wearables have been
enrolled in even cancer diagnosis applications recently [40-
42]. It seems that wearables have been widely discussed and
reviewed in terms of healthcare applications [43-46].
Since wearables allow tracking for the wearer’s actions,
location and instant characteristic states, they have been often
discussed in the context of tourism studies. Although use of
wearables directly for tourism tracking has been not studies
widely so far, studies so far focused on the relation of
wearables and virtual or augmented reality applications to
improve tourists’ experiences [47-49]. Since reality
applications have a remarkable role for interactive touristic
visits and user-based interactions, wearables seem to be
effective tool for supporting instant interaction better. On the
other hand, the required interaction for users can be extended
to the ones in remote places and such a mechanism can ensure
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effective outcomes in rapidly arising areas such as health
tourism. Because wearables have relations with touristic
applications and been already effectively used in healthcare
applications, the health tourism has the great potential for
meeting purposes of both healthcare and tourism in
innovative IoT-based solutions. Considering the today’s
conditions in terms of massive user and service interactions
over Web environments, there are many potentials to apply
wearables in health tourism.
2.1. Potentials of wearables for health tourism
It is important to indicate that the key mechanisms by
wearables are associated with instant data collection and
flexible localization over the body. Because of these
mechanisms, wearables are supported by special sensors to
collect different body data. In addition to the hardware
components to accomplish data collecting, specific software
background is developed to process the data for user
interfaces. All these user-oriented features make wearables
easily adaptable to health tourism applications. Because
health tourism has a global coverage, wearables already
provide the requirement ICT infrastructure. In addition to the
established ICT tools, agencies may use specially developed
software environment for connecting to inside of health
tourism ecosystem they are running. In order to do that,
necessary data using strategies should be organized
accordingly. Eventually, there are some technical and
organizational steps to take but these do not affect the fact
that potentials of wearables will be able to advance the way
of health tourism.
For better understanding, major potentials of wearables
can be explained from the standpoint of health tourism as
follows (Figure 2):
• Instant Tracking Capabilities: Since wearables are
able to feed the ICT instantly, it is an advantage for
health tourism actors to track the updates and instant
flow inside the ecosystem. That gives many advantages
such as starting emergent interactions for health
services, performing instant communications and
sharing time-sensitive promotional components.
• Data Level Transformation: When wearables are used,
it is possible to define the whole ecosystem in the
context of data world. This will allow including
advanced information management features and
providing simpler interaction ways for remote users.
Furthermore, this allows advanced technologies such as
Artificial Intelligence to process data for further
inferencing outputs.
• Adaptive Interaction Ways: As a result of using
advanced algorithms inside the health tourism
ecosystem, all actors are able to interact each other
according to adaptive matching that may be done
automatically by the software system. In this way,
efficiency of the interaction, which is a golden
component in health tourism activities, can be improved
greatly.
• Close Data Collection: Since wearables are the closest
technological tools for collecting data from health
tourists, it allows accurate and efficient processing of
user states or actions. This improves the quality of health
tourism services, communication and interaction.
• Scalable Services: Wearables benefit from technical
capabilities of the IoT. Among these, scalability allows
adaptive changes in terms of communication, data
storing or service adaptation. This is applicable for
health tourism applications since wearables will trigger
scalability mechanisms. In this way, services by
agencies will be improved effectively.
Figure 2. Factors pointing potentials of wearables for
health tourism.
3. A Model Suggestion
By considering the potentials and the pointed current state of
the art, this study suggests a model in which wearables, health
tourism actors, and the supportive technology components
are combined together to build a digital ecosystem. Although
the suggestion is a high-level overview, it is possible to
develop such ecosystem in terms of current conditions. Such
a model may trigger also policy makers and national or
international associations, ministries to establish agreements
for a common platform. Figure 3 represents the general
scheme of the model. It generally points the interaction
among all components of an ecosystem. The ecosystem
supports all actors to benefit from data and support the
general purposes of the health tourism applications, by
focusing on all actors’ needs. It is critical that necessary ICT
should be designed for the organization of all tasks performed
inside the ecosystem. As moving from the general model
scheme, a general working flow may be explained as under
the next sub-section.
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Wearables for Health Tourism: Perspectives and Model Suggestion
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Figure 3. The suggested model of health tourism ecosystem with wearables.
3.1. General working flow
In the model, there are different kinds of wearables mostly
associated with health tourists. Currently, it is possible to
see that people around the world have great interest in
smart watches. There are also people having other types of
wearables such as shoes, clothes, bands…etc. Eventually,
such wearables are able to measure a person’s efforts,
calories, sport activities, movements, locations, heart beats,
oxygen rate and many more data depending on the sensors.
In the model, these measurements are collected by data
gathering algorithms, which feed processing components.
The processing components adjust the data for the
Artificial Intelligence algorithms. Artificial Intelligence
algorithms work for giving predictive and descriptive
outputs, which are useful for understanding present state of
massive health tourists and producing predictive action
plans for them. Also, the model already has the instant
tracking mechanisms and to support tourism agencies
mainly. Of course, outputs from the mentioned components
are connected to also health staff including doctors and
other people in the same group. From a general perspective,
combination of algorithms is for building a decision-
support environment, which is effective for all actors.
As typical IoT components, wearables are working
inside the system to feed all actors by activating the
following features:
• Wearables connected to health tourists measure their
health states and allow system algorithms to predict
probability of future visits. These data are also stored
to have past health state record, which is used by
predictive algorithms of the ecosystem.
• Visits for health tourists are determined and planned
in terms of needed healthcare services, target
countries, locations, and agencies. Like health state
data, these visit-planning data are stored to ensure past
health tourism activities.
• Storage of health state and visit data are used by
specific algorithms to create outputs, which are for
adapting the whole ecosystem for potential service
interests, active resources and the general state (of
health tourism activities) globally.
• Health tourists are able to feed the system with not
only their states but also feedback they give over
special software systems. These systems are
developed also to inform health tourists about
promotions, their membership states (if applied),
recommendations on contacting with other users, and
reaching out to the tourism agencies or health staff.
These systems are critical to ensure connections
among health tourists, tourism agencies, and health
staff.
• Tourism agencies are able to track state of health
tourists instantly. The concept of state here is not
related to detailed medical information (like tracked
by a doctor) but general information, which is useful
to detect potentials of health tourism contact and also
any emergent health state. The agencies are also
provided with decision support tools, which reveal
predictive and descriptive outcomes (e.g., current
distribution of health tourist intensity, positive /
negative distribution by past health tourists, potential
health tourists matched with planned promotions)
associated with health tourists. The system also runs
recommendation systems for giving suggestions to
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agencies about potential health tourists, optimum
touristic routes, and healthcare services that will have
more interest in the future.
• Tourism agencies can be connected to healthcare
services through ICT. In this way, they are able to see
status of active health services in hospitals. The
ecosystem matches health tourists with corresponding
cities as well as hospitals, by considering their current
state, past healthcare service experiences, and
touristic / cultural interests.
• Except from wearables and the IoT infrastructure,
tourism agencies are able to manage the whole
ecosystem in terms of their costs, incomes and any
other managerial activities.
• Health staff is most likely to track the health tourists
for their medical states. Especially doctors inside the
ecosystem are able to collaborate with tourism
agencies to track health tourists instantly in the
context of as a matter of their professional
responsibility. Along with the rest of health staff, they
are able to track the status of hospital as well as
medical resources (e.g., equipment, service
availability). Also, doctors are able to be in touch with
tourism agencies to plan automated service plans.
• The ecosystem already supports all actors in terms of
instant communication (through direct messaging or
video conferencing). Additionally, the ecosystem may
include software applications (over Web and mobile
venues) specifically designed as social media-oriented
health tourism environments where users interact and
share information / ideas.
• In terms of data storage and operations, the ecosystem
is built on a cloud-based approach where cloud
services are employed for scalable and robust enough
infrastructure, which is necessary for running the
software environment of the suggested model. Such a
cloud-based system is supported with also advanced
computers working inside cyber security and privacy
sensitive methodologies.
• Inside the suggested model, there are also other IoT
devices including sensors, computer vision-based
cameras, smart medical tools, smart mobile
technologies to improve the variety and scope of the
data. Depending on the components owned by health
tourists or located in hospitals and tourism agencies,
it is possible to use multi-modal data (e.g., medical
images, voice data, photos by health tourists, camera
recordings) to improve the interaction capabilities.
These capabilities may include visual tracking,
detailed medical image analysis, remote diagnosis by
doctors, remote pre-meetings with agencies to plan
activities or promotional content enabling health
tourists to see target countries and hospitals before
they plan and approve their services.
The suggested model provides a wide ecosystem for
expanding the health tourism capabilities according to
needs for global communication. At this point, advantages
of wearables and IoT components are used accordingly for
real-time data flow and enhanced interaction as well user
experience. As the model considers the human factor and
healthcare services mainly, it is important to have some
feedback by potential / active health tourists, health staff,
and agent staff (tourism agencies). So, the model was
evaluated through a survey work as explained under the
next section.
4. Evaluation
The suggested model was evaluated by using the feedback
by a total of 30 people within the groups of health tourists
(10 people), health staff (10 people), and agency staff (10
people). 5 people were active health tourists with the ages
of 28, 37, 25, 67, and 72 respectively. The rest of health
tourists were chosen as potential health tourists, who are
interested in taking part health tourism activities in the
future. Active health tourists were associated with hair
implant (28, and 37), wellness and dental operations (25),
physical rehabilitation (67), and eye operation (72). Health
staff were a total of 6 doctors and 4 assistive health staff.
Finally, the agency staff were a total of 7 agency owners,
and 3 agency support staff.
Among the related survey respondents, 17 people (3
potential health tourists, 2 active health tourists, 4 doctors,
2 assistive staff, 4 agency owners, 2 agency support staff)
were from Mexico while 13 people (2 potential health
tourists, 3 active health tourists, 2 doctors, 2 assistive
health staff, 3 agency owners, 1 agency support staff) were
from Turkey. Each survey respondent-group was asked to
give feedback for 10 statements, as based on the Likert
Scale (1: Totally Disagree, 2: Disagree, 3: No Opinion, 4:
Agree, 5: Totally Agree). In this context, Table 1, 2, and 3
respectively provides the findings for the feedback by
health tourists, health staff, and agency staff.
Table 1. Survey statements and findings for health
tourists.
No. Statement Feedback
1 2 3 4 5 Avg.
1
“This model will be
effectiv e in the area of
health tourism.”
0 0 1 1 8 4,7
2
“This model may have
risks in data privacy.”
4 2 1 2 1 2,4
3
“This model may detect
different tourism
interests.”
0 0 1 1 8 4,7
4
“I can get effective
treatment thanks to this
model.”
0 1 1 1 7 4,4
5
“This model will improve
communication and
interaction in health
tourism.”
0 0 0 2 8 4,8
6
“I do not want to take
part in such a model /
system of health
tourism.”
7 1 2 0 0 1,5
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Wearables for Health Tourism: Perspectives and Model Suggestion
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7
“Wearables in this
model will make the
health tourism
enhanced.”
0 0 1 1 8 4,7
8
“I can get good health
service experience
thanks to this model.”
0 0 1 3 6 4,5
9
“I believe this model will
improve my tourism
experiences.”
0 1 1 1 7 4,4
10
“This model can be
used effectively for all
kinds of health tourism.”
0 0 1 1 8 4,7
It can be seen from Table 1 that health tourists generally
think positive about the suggested model in terms of the
using features and the innovative mechanisms that are
provided through the general ICT structure and especially
wearables.
Table 2. Survey statements and findings for health
staff.
No. Statement Feedback
1 2 3 4 5 Avg.
1
“This model will be
effectiv e in the area of
health tourism.”
0 0 0 1 9 4,9
2
“This model will be
effective to track health
tourists’ instant medical
states.”
0 0 1 2 7 4,6
3
“I would like to take part
in a health tourism
application in which this
model is used.”
0 0 0 1 9 4,9
4
“This model will support
my decision support.”
0 0 1 1 8 4,7
5
“This model will improve
communication and
interaction in health
tourism.”
0 0 0 1 9 4,9
6
“I find this model
innovative in terms of
improving health
tourism.”
0 0 0 3 7 4,7
7
“I do not think that
wearables in such a
model will be effective
to improve health
tourism experiences.”
7 1 1 1 0 1,6
8
“This model will improve
my performance in
tasks.”
0 0 1 1 8 4,7
9
“I believe this model is
good to track state of
healthcare resources.”
0 1 1 2 6 4,3
10
“This model will improve
my health tourism
experiences.”
0 0 1 2 7 4,6
As like the health tourist, the health staff also thinks
positive about the suggested model. As it can be
understood from Table 2, people from health sector finds
the technological background of the model effective. They
also think that the model will be a solution to improve their
performance and tracking capabilities. They also think that
the suggested model will have advantages in terms of
health tourism applications.
Table 3. Survey statements and findings for tourism
agency staff.
No. Statement Feedback
1 2 3 4 5 Avg.
1
“I find this model
effective for tourism
agencies.”
0 0 0 2 8 4,8
2
“This model can be
used to increase
income in terms of
health tourism
business.”
0 0 1 1 8 4,7
3
“This model may take
different health tourists’
interests.”
0 0 0 1 9 4,9
4
“Thanks to this model, I
can have good health
staff in health tourism
applications.”
0 0 1 1 8 4,7
5
“This model will improve
communication and
interaction in health
tourism.”
0 0 0 1 9 4,9
6
“I do not want to take
part in such a model /
system of health
tourism.”
8 1 1 0 0 1,3
7
“Wearables in this
model will make the
health tourism an
automated global
platform.”
0 0 1 1 8 4,7
8
“I can decrease health
tourism costs better,
thanks to this model.”
0 0 1 2 7 4,6
9
“I do not believe this
model will improve my
tourism experiences.”
7 1 2 0 0 1,5
10
“This model can be
used effectively for all
kinds of health tourism.”
0 0 2 1 7 4,5
As based on the findings in Table 3, the model was
found positive by tourism agencies, too. As different from
the other groups of respondents, tourism agency staff
believes that the model will be an effective solution in
terms of their business considering income and cost
balance.
4.1. Discussion
In addition to the model suggestion, short surveys have
been useful to have better idea about how such a model
could be accepted from the view of actors. They allowed to
understand perspectives by different actors inside the
health tourism. As based on the evaluation findings, the
following discussions can be made briefly:
• Health tourists find use of wearables in health tourism
effective. They believe that the suggested model will
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| Volume 10 | 2024 |

G. Kose et al.
8
improve their healthcare service and ensure better
communication with agencies.
• Health tourists believe that their interests in different
types of touristic visits can be effectively detected as
a result of wearables, which will track also their
actions and feedback. They feel a little anxious about
data privacy, but it seems the current technological
trend and advantages with the wearables enhanced
health tourism successfully lowers them.
• It is remarkable that health staff believes the model
will be innovative to improve health tourism from the
point of tracking patients and healthcare resources.
This is because technological advancements have
been always effective to improve healthcare
applications. Health staff thinks that wearables will
provide more accurate patient data for them.
Additionally, they believe that use of data and
advanced algorithms will ensure decision support and
improve their performance. So, as an innovative tool
of IoT applications, wearables are accepted greatly by
health staff inside the health tourism scope.
• When the responses by all actors are evaluated in the
communication perspective, it is believed that
wearables will improve the capabilities for instant
communication and tracking. This is too critical that
global way of health tourism needs instant interaction,
so wearables seem a supportive component to achieve
this in an ecosystem.
• The suggested model is highly accepted by health
tourism agencies. Use of wearables and IoT
mechanisms can improve features of current software
systems, which are not synchronic enough to track
immediate changes in terms of health tourists,
resources, health staff and any other factors connected
to the built ecosystem. So, a system with wearables is
found by agencies as an effective environment to run
an automated global platform. As general, this may be
because agencies want to provide quality health
tourism services and improved income as well as
reputation.
• Although investment is needed for using wearables
and the associated IoT infrastructure in health tourism,
agencies believe that it will optimize applications and
increase incomes while decreasing costs in longer
terms.
• Health tourism is widely open for technological
innovations. Since it is a global business, improved
ICT is a necessity for the existence of health tourism
in the future. The suggested model promises this
accordingly. The findings for the surveys approve the
high interest from the health tourism sector for
technological developments. In this context,
wearables have an essential place in the
developments.
5. Conclusions
This paper generally examined the role of wearables in
health tourism and ensured a recent perspective to
understand how use of wearables is acceptable from the
health tourism scope. After explaining some about why IoT
and wearables (as IoT components) have remarkable
potential in innovative health tourism solutions, the paper
suggested a model of wearables-based health tourism
ecosystem and had some feedback for the model. In terms
of feedback by health tourists, health staff and agencies, it
seems that use of wearables with IoT perspective would
improve the health tourism experiences greatly. Although
there is currently a high level of digital transformation
inside health tourism, employment of the suggested model
may need time to become a global tradition. However, the
authors believe that such advancements will happen in the
near future. Actually, rapid developments in ICT already
covered all fields to make digital transformation alive in
almost all types of daily life tasks. Similarly, advanced
technology finds the way easier when it comes to data
usage and processing for desired objectives. Because of
this, different fields are interested in employing advanced
technology in their applications. Healthcare and tourism
are located under the umbrella of health tourism, which has
relations with ICT. Because of the relations with ICT, the
health tourism is sensitive to technological potentials and
changes. As based on this, the study in this paper pointed
the current interest for wearables and high potential in
health tourism accordingly.
Outcomes from the study are reference for further
studies. It is suggested to perform further evaluations and
perform some pilot studies to see how health tourism
scenarios are improved accordingly with the relation
between wearables and health tourism. Such studies may
be done in different locations of the world so that an
average overview for the global state can be obtained. It is
also required to have interdisciplinary studies to go further
about technological developments along with user,
healthcare and business-based evaluations.
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