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Why Do We Need Being Smart in Healthcare?

by Can Uludag

Ultimate purpose of Smart Cities is to improve living areas while minimizing costs, reinforcing smart infrastructure systems, encouraging innovation in different sectors and improving quality of life for citizens. However, what about smart healthcare? Can smart cities provide significant contributions to the health of their citizens?

Smart healthcare is generally known as the use of eHealth* and mHealth (Mobile Health) systems through intelligent & connected medical systems. As opposed to the treatment, it focuses on the implementation of health policies encouraging a broader point of view of wellness management and healthy living by using monitoring and diagnostic systems.

Smart health concept has a tremendous potential to support the emerging concept of P-4 medicine referring to “preventive, participatory, predictive and personalized” and it is a new model of health management.

As you know, technology plays a significant role in smart cities and data is the main fuel of the whole concept. All of these technological approaches along with big data has been turning the medical sciences into a data-intensive science and new digital-physical ecosystems as well. In such systems, doctors and patients are digitally assisted by data. Smart health puts the correct data in the hands of correct people at the correct time. It consolidates information from many aspects of a person’s life and presents a more complete picture of his/her health. This information might have a wide range from biological, genetic, medical records to lifestyle, mental state, sleep patterns, blood pressure, body fat, physical data and so forth. In this way, it allows decision-makers and patients to make better decisions.

Traditional approaches are not capable of keeping pace with this rising flood of data at an exponential order.

Improving only traditional user experience is not sufficient anymore and we need more interactive systems between humans and computers to handle the complexity of the world providing both of opportunities and limitations at the same time.

Therefore, we need smart approaches to deliver meaningful results refined from that multi-dimensional, weakly-structured, noisy, dirty and complex big data world.

Fortunately, the advent of smart phones, powerful ubiquitous smart sensors, decreasing cost of data storage, low-power integrated circuits, wireless communication systems and recent technological advances come to the help to cope with challenges, track our well-being in real time and create a smart environment. Furthermore, they provide mobility, invisibility (smart devices embedded in our daily objects such as watch, clothes etc.), adaptability and context awareness (people, place, objects etc.) to be able to react to all abnormal and exceptional situations in a flexible way.

As for a city eco-system, all of those mean less waiting time in hospitals, less hospitalization rates, giving the patients more control of their own health and well-being, evidence-based public health campaigns, more accurate communications between the patient & health professionals, increasing patient contact, saving more lives, saving more money, ensuring a better quality of life and so on.

Nevertheless, being smart is not only related to data mining or enabling more people to manage their own health, but also has many moral sides because health data is highly personal and sensitive information. Hence, it might raise many questions in people’s minds.

The more we understand all opportunities and all concerns in advance, the more we can achieve a sustainable success over time.

Five important smart-up elements of health

According to the Healthcare 3.0 report of Deloitte, smart health will remain as one of the most sensitive areas in any government’s agenda in the new normal. Therefore, it is not only about fulfilling the needs of citizens, but also a critical strategic piece in defining a nation’s agenda in support of the social compact.

To sum up, smart health eco-system is summarized in an integrated framework in the report which composes of five important smart-up elements;

(i) Use of insights from behavioral studies (psychology and economics) to increase individual engagement in health matters,

(ii) Integration of behavioral changes as a core component within new healthcare delivery models,

(iii) Leveraging the power of influencers and social networks to support and drive health behavior change,

(iv) Adopting remote monitoring and self-care technologies to support and empower individuals and establish linkages to clinicians and influencers,

(v) Encouraging multi-stakeholder involvement which includes public and private sector partnerships across the healthcare ecosystem.

Next Jump – Behavioral Case Study

Next Jump is an ecommerce company headquartered in New York. Company CEO Charlie Kim wanted to motivate his employees to keep them more energized and engaged through regular gym exercises because only 12% of employees was doing exercise regularly. So, the company installed gyms in their offices and created an app to reward employees for ‘checking in’ at the gyms with various perks. However, ultimate motivator has become a constant office-wide fitness competition. Subsequently, the app was upgraded to include elements of gamification. In this way, staff has started to form regional teams to compete with each other on a digital board and the team working-out most wins $1,000 each week.

According to a recent study on workplace wellness of RAND Corporation, just 20% of employees took advantage of their companies’ wellness programs. However, that performance, today, has reached to more than 80% including work-outs at least twice a week.

Future visions for smart health – RWTH AACHEN University Case Study

E-health group of Rwth Aachen University developed a new approach called future care lab a few year ago. The project aims at novel and integrative user-centered healthcare systems to assist people within their home environment. It is a new form of technology integrated research space and living environment for older and frail persons.

The vision includes electronic monitoring systems, various biosensors to monitor vital parameters, smart floors, multi-touch walls, emergency systems, and virtual space experiences such as making you feel like in a natural forest ambiance.

All data can be stored at an online medium in real time and can be supervised by personnel physician. Accordingly, the person may get further assistance for medication, nutrition or exercise to optimize their rehabilitation and overall well-being. Moreover, these data can also serve as a means of immediate diagnosis in case of emergency situations.

Aachen UniversitySmart Health India – Prevention Case Study for Poor Areas

In 2014, the George Institute for Global Health India launched a pilot smart health project in Andhra Pradesh, main purpose of which was to decrease cardio-vascular disease risk (CVD) in poor areas. In this regard, the institute developed an android based application with the support of Institute of Bio-Medical Engineering at Oxford University.

The app customized for the use of non-physician health care workers in 54 villages records blood pressure, cholesterol levels and other heart disease risk factors like age, sex, smoking status etc. Accordingly, it analyzes the data to indicate the risk level of CVD and evaluates the need of further consultation.

Sappide Kannaro is a 49-year-old farmer in rural India. His monthly income is about $80 and solely breadwinner of his family including his wife and three children. In case of any unfortunate event happened to Sappide, entire family would be destitute. Using the back-end software solution and analyzing of a simple serious of question, it was diagnosed that Sappide was at the edge of clinically high risk of CVD. Following the treatment, he started to get treatment and go to screening regularly. It could be a total catastrophy for the whole family in such a poor area, but he was one of the lucky persons who could benefit from smart health services at early stages.


(*) Note that eHealth does not only stand for electronic health. According to the issues published in the Journal of Medicine Internet Researches, it implies a number of other “e’s” such as efficiency, enhancing quality, evidence based, empowerment, encouragement, education, enabling, extending, ethics and so on. 

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