Smart Cities and Health: the new concept of Smart-Health

What are smart cities?

In recent years, we have incorporated the term "Smart" into everyday objects or realities such as a watch, a telephone or even an entire city, and so the use of the term"Smart Cities" has become increasingly common. But do we really know what Smart Cities are?

These cities are based on sustainable development and the use of innovation and technology to manage and deliver different services. Using these technologies allows all areas linked to the organisation of a city to be connected, resulting in more efficiency and improved service delivery.

This innovation is based on the use of software and hardware, which allow the exchange of information or data, resulting in a centralisation of the city. Smart city systems also include technologies such as:

• IoT
• Artificial Intelligence
• Big Data
• Cloud
• Blockchain
• Sensorization

In addition to providing a whole series of advantages for administration and for companies, it also presents a series of benefits for citizens as it increases the quality of public services, the ease and transparency of dealings with the public administration, as well as the agility of all bureaucratic procedures.

In addition to these technological innovations being implemented by the public administration, more and more companies and organisations are joining in to offer complementary services that are integrated with the public ones, resulting in public-private partnerships that are highly beneficial for both sectors.

Smartest cities in the world

Some of the cities that can be considered "top" Smart Cities are the following:

• New York: they use cutting-edge technology to make the Internet of Things and personal devices perform at their best; they also have numerous digital transformation projects in both the public and private sectors that will make city management more efficient.
  
  
• London: has a development plan that includes driverless cars, free WIFI hotspots and green buildings.
  
  
• Singapore: they started their Smart Nation programme back in 2014. There are a large number of sensors installed around the city that monitor practically everything its inhabitants do.
  
  
• Barcelona: the local administration has developed apps that inform about what is happening in the city or about important events.
  
  
• Oslo: Of all the smart cities, Oslo is the one that stands out the most for taking special care of the sustainable and ecological environment. It has more than 600,000 LED bulbs that adjust the light output to the needs of the moment. It is also developing a new transport network.
  
  
• Toronto: is a city that is testing the smart city technologies being developed by Google through its company Alphabet, which operates Sidewalk Labs. They are looking for technology development, but seeking solutions for climate change, efficiency or urban sprawl.
  
  
• Tokyo: focused above all on being energy smart. To this end, they store energy locally and use electric vehicles.

In Spain, in addition to Barcelona, we can also highlight Madrid, Vitoria and Pamplona as cities that are seeking to develop these technologies to improve the quality of life of their inhabitants.

Information technology in the service of healthcare

The COVID-19 pandemic brought with it a whole series of changes that meant, that almost overnight, we had to think about new ways of living our lives.

The healthcare sector saw that as well as tackling disease, it needed to accelerate its digital transformation to enable, among other things, virtual care.

Thus, one of the fields where the implementation of these tools has had and is having the greatest impact is healthcare. Electronic medical records are already familiar to us and there are more and more new medical services that we can access even from our mobile phones, this series of innovations is what we know as e-health.

This concept is currently being developed in parallel to that of Smart cities, as part of the idea of improving the quality of life of their inhabitants through different parameters, including, without a doubt, health.

As we have explained, smart cities have sensors of all kinds that provide data on temperature, humidity, pollution, traffic conditions and a long etcetera of information that make it possible to configure what is considered to be the context of the city in which each person carries out different tasks and types of life.

If this data is used in the right way, highly personalised health applications can be created, as they are adapted to the context of each person in each city. In other words, if we combine e-health applications with the data provided by a Smart city, we will obtain what is known as Smart-health, which involves handling and managing Big Data in healthcare companies.

Smart health therefore refers to the use and application of various tools and infrastructures in such a way that, by combining ICT (Information and Communication Technologies), information and patients' mobile phones or devices, patients can have better control over their health.

In a society like ours, in which the population is dying later and later and our life expectancy is longer, the concept of Smart health would help to improve the public and private healthcare system because it would allow, among other things, fewer face-to-face consultations and more prevention, all of which would reduce healthcare costs. Being able to tailor treatments to each individual would not only help to treat illnesses but also prevent them, which is essential to minimise healthcare costs.

There are many examples that can be given. For example, if a person suffering from allergies receives information on the concentration of pollen or other elements on their mobile phone, they can prevent possible allergic reactions or be aware of the nearest pharmacy or health centre, as well as avoid areas with the highest concentration of these allergens. On the other hand, for people with cognitive impairment, there are applications that detect if they have wandered away from their area and call the person who is looking after them.

IoT, Big Data and 5G Connectivity

The technological progress to be made by the healthcare sector also posed the challenge of achieving efficient equipment that could deliver these new services to patients.

It is in this context that the Internet of Things (IoT) technology was seen as a key element for the development of Smart Health. This technology, which integrates devices and sensors connected to the network, allows data to be collected in real time, something which, as we have just pointed out, is fundamental to achieving the most effective smart health possible.

IoT devices can detect, visualise, collect and share data and connect or communicate with other devices via Bluetooth, ZigBee, Z-Wave, WiFi and RFID. The data collected is used for disease classification or patient monitoring as the sensors connected to the patient allow data to be collected that will help medical teams make decisions about a patient. Therefore, having high-speed 5G networks, either by Wi-Fi or high-speed satellite internet, will be one of the most important issues when implementing these smart health systems, as will cloud services, as they allow efficient and secure access to data, as well as efficient storage.

All this data that we have been referring to since the beginning is stored, documented or included in large lists scattered all over the world, this is what we know as Big Data. We put our tastes, our preferences or our fears in this immensity of data and this allows the decisions taken by an organisation, company or administration to be aimed at a specific sector, a specific public or a specific strategy.

In such a context, it is essential to know what to do with this data, which is why the figures of the data analyst and Business Intelligence are key. In this market, SAP solutions are the most widespread, so much so that SAP acquired a company dedicated to data analysis through artificial intelligence: Kausa.ai.

Artificial Intelligence is one of the drivers of change in the data analytics sector and this will undoubtedly also link to both cities and healthcare.

In short, the integration of IoT technologies together with 5G or Wi-Fi services is one of the fundamental pillars for the development of smart healthcare services, which will also increase the efficiency of their data analysis thanks to AI.

At Gigas we are aware of the importance of caring for people's quality of life and, consequently, we offer services that are aligned with these technologies and that ensure a smooth development process for both Smart Cities and Smart Health.

Mobile health applications

In this section, we should focus on what are known as Smart Health Cards, which are printed or digital versions of a person's medical history that also include test results or vaccinations that have been taken. These cards, which have been developed extensively in the United States, allow us to have a copy of our important medical records at hand and to share that information if we want or need to do so. These Smart Health Cards contain a secure QR code and can be stored digitally or printed on paper. For example, Apple has adopted them into its Health App to share data with whomever we choose, and California uses these health cards to keep track of vaccinations for COVID-19.

These cards, unlike other digital cards, are free of charge and are not linked to a specific organisation or government entity, but were created to make it easier for people to access their medical records.

Undoubtedly, one of the questions that may come to mind when reading and seeing these developments is: what about the security of my data? Is there a code that regulates the processing of data?

The first versions of the code of conduct for mobile health apps were prepared following the Green Paper consultation on mobile health in 2014 within the European Commission. This consultation already showed that a large proportion of people do not trust their mobile health apps because of privacy issues or the use of their data. The European Commission therefore called for the development of a privacy code, the key objective of which was to give users confidence while giving a competitive advantage to those who sign up to it.

It was in April 2015 that the development of the code text was started by a working team. The European Commission provided support and oversight for this work which included the App Association (ACT), App developer Alliance, Apple, COCIR, Digital Europe, ECHA, DHACA, EFPIA, Google, Intel, Microsoft, Qualcomm and Samsung.

After a first version of the work in June 2016, it was reworked and formally presented on 7 December 2017, but was not approved because it was considered that there were aspects linked to data protection that were not covered.

The current draft of the Code contains a kind of practical guide for developers of such applications on data protection principles. It covers issues such as user consent, purpose limitation and data minimisation, privacy by design and by default, data subjects' rights and information requirements, data retention, security measures, advertising in mobile health apps, use of personal data for secondary purposes, data transfers, personal data breaches and data collected from children.

Present and future of Smart Health

As we have seen, there are many innovations being implemented in Smart Health that are improving people's quality of life and health.

We would like to highlight the application launched by Data IQ Mexico, based on Gigas' Cloud Datacenter technology, which served to measure updated information on COVID19 cases in Mexico using data provided by the Mexican Ministry of Health.

This Gigas partner managed, in a short time, to develop this very useful tool in the worst moments of the pandemic. It was based on Qlik Sense technology, which made it possible to observe in real time the cases of infection, deaths and demographic data that allowed a map of what was happening to be drawn up.

The future, therefore, seems to hold many advances in this field, which also faces challenges such as the creation of an IoT system that can manage large amounts of data while taking care of all the basic aspects of security, such as data confidentiality, authorisation and authentication.

We will undoubtedly see how smart hospitals can become part of a wider, interconnected ecosystem that can help achieve both population health and preventive healthcare goals.

In the meantime, ... "Be careful out there".