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Design and implementation
of IT services as part of the “Smart City” concept
Aleksandr Lepekhin1,*,
Abstract.
The concept of “Smart City” is evolving and increasingly becoming
important for modern urban society. The state structures, business and
institutions increasingly rely on information technology (IT) in its
architectural representation. Such transformation of cities is connected with
the growing use of software, server infrastructure and client devices in all
the most important municipal services. The construction of infrastructure for
these municipal services is a complex task, being solved both at the level of
the whole city and at the level of individual directions. “Smart healthcare” is
an important part of the “Smart City” concept. It is built on scalable storage
systems and a communications platform. With this type of IT support, patient
records are stored electronically and distributed where they are needed.
Construction of “Smart health” ecosystem has to be addressed steadily and on
different levels in order to design an infrastructure integrated in the
whole-city concept. This research paper discusses the IT services that underlie
the concept of “Smart Healthcare”, and describes a project for developing
software and designing a technology infrastructure for the implementation of
these services by major medical centers within the framework of the general
concept of “Smart City”. The research represents a step-wise analysis of
society needs and development of IT-services and application, which are
designed to connect the urban infrastructure with inner ecosystem of hospitals.
The results of the work can be used as a basis for the design of IT services
for e-health and the construction of the “Smart Healthcare” system.
1 Introduction
The concept of “Smart City”
is an emerging paradigm nowadays. Based on the previous studies, the Smart
cities are defined by strong foundation on information and communication technologies
(ICT) that invest in human and social capital to improve the quality of life of
their citizens [1]. A major challenge of “Smart City” concept realization is
implementation of e-health system and “Smart healthcare” as a whole on many
different levels of urban life of citizens to build a system of healthcare
services, influencing the overall wealth level and quality of life. *
A major challenge in
healthcare is the lack of availability from patient/physician for frequently
health monitoring [2]. This includes indoor and outdoor monitoring of vital
signs of any patient in order to react rapidly or even prevent different health
problems and their outcomes. Wireless and mobile networks offer an adequate and
powerful solution to overcome a variety of barriers and provide qualified
monitoring and treatments services for citizens. A vast variety of applications
are developed in attempts to evolve the paradigm of e-health, m-health and
Smart healthcare in big cities [3]. One of those examples is the StepUp
application. This is a step counter application, which uses sensor-enabled
mobile phones to automatically count the number of steps the user walked. The
application returns to the user the measured quantity of his/her daily
activities and create a healthy competition. The key goal of this solution is
to increase awareness and understanding the importance of physical activities
and facilitate the integration of regular exercise into their daily life [4].
Another example of an application, which fits the Smart Healthcare concept,
could be A Mobile Personal Trainer (MOPET). MOPET is a wearable system that supervises
physical activity alternating jogging and fitness exercises in outdoor
environments. The main goal of this software is to motivate the user to do
sports. It also provides safety and health advices, adapted to the user and
his/her context [5]. Another application is iWander. Its main goal is an
attempt to partially alleviate stress, financial burden, and offer easier
remote monitoring to caregivers by using the user’s social network as a
monitoring service. The application runs in the background and collects data
from the device’s sensors such as GPS, time of day, weather condition, stage of
dementia, and user feedback. This data is then analyzed to determine the
probability the person is wandering. The application then automatically takes
actions that help navigate the patient to a safe location, notify caregivers,
provide the current location of the patient and call 911 [6]. The solution,
which is presented in current research, is WorldWideCare complex system. It
gathered contributions from the above described applications and also from
number of personal healthcare solutions from different vendors and was
developed by Design Thinking approach, targeting citizens and large medical
centers. The core concept of WorldWideCare is building the bridge between
hospitals infrastructure and urban area by means of ICT in order to increase
the quality of life of citizens. This is approach, which has not been discussed
yet in current researches and practices, because its main focus is considerably
wider than inner healthcare services of medical centers. The solutions aims to
provide healthcare services continuously and ubiquitously in “Smart City”.
2 Materials and methods
The common problems that
involve both issues related with the monitoring of personal health and
organizational processes in providing healthcare assistance are addressed by
means of the current research. These problems were gathered by means of
interviewing, shadowing, storyboarding and other Design Thinking techniques.
All these techniques were applied in one of the largest Medical Centers of the
city [7]. Finally, the diagram, which shows how potentially could the
application react on different cases faced by user, was developed and presented
in the figure 1.3
Fig. 1. Application
concept.
This Solution is aiming to
overcome several problems, which were gathered and analyzed: • Languages
barriers: One of the main difficulties concerns the communication between
doctor/nurse and patient. Often happens that the language differences lead to a
huge time loss and even to an erroneous diagnosis. • Mistakes at the reception
desk: A very important factor to prevent the loss of valuable time is
addressing the patient at the right hospital sector and room. • Double data
storage system: Hospitals are facing the problem of a dual storage system, both
in paper and electronic form. • Faster reaction to critical emergency: When
someone suddenly has health issues and is in need of immediate help very often
suffers from the slow process of recovery. The concept of potential solution
was adapted from [2] and addresses the M-Health paradigm, which allows to
provide a set of services, required to solve the designed problem. Moreover,
the peculiarities of telecommunications projects were taken into account [8].
The concept is presented in the figure 2.
Fig. 2. M-Health
services framework.
3 Results
3.1 User interface and Hardware
The WorldWideCare
application was designed with use of NinjaMock tool based on the design
problem, analyzed above. The application in total has the following modes:
Basic mode – the mode, which ensures Smart Healthcare concept integration in
the social life of citizens, providing continues healthcare services and
insurance; Hospital mode (upgraded version) – the mode, which can be
activated inside the hospital or any other healthcare organization to provide
higher quality treatment. The first interface of the application is presented
in the figure 3.
Fig. 3. First
screen of application.
The following functionality
is embedded in the application in the basic mode: • Registration / login /
logout – providing personal account in WorldWideCare system. • Change language
– the application is integrated with Google Translate API in order to be able
to set communication without any barriers [9]. • Check actual health parameters
– checking and updating the latest health indicators. • Edit profile – updating
person’s information. • Send a SOS (emergency) signal o Call ambulance (Share
data with ambulance/hospital) – ability to be integrated with ambulance system,
send location to be picked up, send data to the hospital, so that the personnel
can already be prepared. o Call emergency contacts (including Set up and
customize emergency contacts) – ability to reach people from emergency contacts
list automatically in critical case. • Make a self-diagnosis and choose the
hospital (doctor) nearby – ability to track and analyze personal healthcare
indicators and search for hospitals nearby to make an appointment. In the
Hospital mode the following functions are embedded:
• Ask for help –
provides assistance with asking for help, includes translation functions, helps
avoiding problems with misunderstanding between patient and personnel. • Check
timetable of procedures – tracks person’s own procedures, which are appointed
in scopes of the treatment process. When the prototype was analyzed critically,
it was decided that the Smart bracelet should also become a part of solution.
This would help to overcome different problems and improve the overall quality
of WorldWideCare system: • Precise and continuous data collection and analysis;
• An affordable and user-friendly solution for a wide audience; • Easily
customizable size of wearable. The bracelet design is presented in the figure
4. Fig.
4. Wearable prototype.
3.2 Market analysis
In order to assess the
value of the Solution on the modern IT market, a comparative analysis of
competitors was made. Since the proposed Solution is a complex system
consisting of an application, a portable device and their integration with the
hospital information system, the comparison was made with various applications
and wearables. The analysis is presented on the table 1.5
Table 1. Competitors’
analysis. Solution
Multilanguage Actual health parameters SOS button Connection with ambulances
Self-diagnosis Arrange an appointment with doctor Work without Smartphone WorldWideCare solution ✔ ✔ ✔ ✔ ✔ ✔ ✔ SOS button (iOS
application) ✘ ✘ ✔ ✘ ✘ ✘ ✘ iCare (iOS application) ✔ ✘ ✘ ✘ ✔ ✘ ✘ iWander (Android application) ✘ ✔ ✔ ✘ ✘ ✘ ✘ Xiaomi Mi Band 2
(wearable) ✔ ✔ ✔ ✘ ✘ ✘ ✔ Apple Watch Series 3 (wearable) ✔ ✔ ✔ ✘ ✘ ✘ ✔ Quardio (iOS
application) ✔ ✔ ✘ ✘ ✘ ✘ ✘ Analyzing the obtained
data, it can be concluded that WorldWideCare possesses a set of unique
functionality that is not represented in other solutions.
3.3 Implementation
opportunities
The solution was
analyzed and mapped within 2 key dimensions in scopes of implementation
opportunities – target market and functions. For the target market it was
decided to analyze the patients with heart diseases, who were divided into 3
categories: elderly people, patients of hospitals (or those, who are monitored)
and people with first symptoms. According to the category of patient, different
functionalities, solution’s variations and data transmission channels are
available. The analysis is presented in the figure 5, where building represents
a hospital, car – ambulance, “+” indicates the availability of function, “–”
signifies the absence of the function. Elements on the right represent the
primary device (wearable or Smartphone).
Fig. 5. Implementation
opportunities analysis.
Thus the first group of
patients – the elderly people – will have the following functions: • Continuous
data collection and analysis;
•Emergency alert for
person in conscious and unconscious state (button press or automatic signal); •
Location and data sharing in case of emergency. The patients of the medical
organizations will have access to the above functions, and the following: •
Social network for the communication among the people with the same disease; •
Channel for direct doctor-patient communication. For those users, who have only
first symptoms of serious diseases and who will actively use application the
following functions will be available: • Self-evaluation in application, where
they will be able to describe their problem, by clicking the model; • Arranging
visits to the doctor according to users' location.
4 Conclusions
To be able to work
properly, the following assumptions has to be taken into account when the
application is implemented in the urban area: the application has more
use-cases with bracelet but also together with any kind of wearable able to get
healthcare data and hospitals and ambulances, as well as citizens (users) are
registered in the application. These assumptions have to be overcome, so that
the application implementation would be able to address social understanding
and correction of real problems, targeting strong demand and big healthcare-technology
market. Social responsibility is a core objective of Smart Healthcare projects,
but another issue is security and privacy. The proposed application is
safety-critical solution, the failure would influence person's health. The
design of this application (in terms of its backend structure, critical
use-cases and other aspects) can be addressed on future researches. The
described system allows creating a network connecting people, medical
organizations and ambulances. Such solution increases the efficiency of
organizations and improves the quality of provided services. This system is the
step towards the digitalization of medicine, what is the basis for improving
various spheres of human life and developing the concept of “Smart City”.
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