Smart City and Crisis Management: Lessons for the COVID-19 Pandemic

The Clinical Resource Hub Telehealth Program and Use of Primary Care, Emergency, and Inpatient Care During the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic disrupted delivery of health care services worldwide. We examined the impact of the pandemic on clinics participating in the Veterans Affairs (VA) Clinical Resource Hub (CRH) program, rolled out nationally in October 2019, to improve access to care at under-resourced VA clinics or "spoke" sites through telehealth services delivered by regional "hub" sites.

OBJECTIVE

To assess whether the CRH program was associated with increased access to primary care, we compared use of primary, emergency, and inpatient care at sites that adopted CRH for primary care (CRH-PC) with sites that did not adopt CRH-PC, pre-post pandemic onset.

DESIGN

Difference-in-difference and event study analyses, adjusting for site characteristics.

STUDY COHORT

A total of 1050 sites (254 CRH-PC sites; 796 comparison sites), fiscal years (FY) 2019-2021.

INTERVENTION

CRH Program for Primary Care.

MAIN MEASURES

Quarterly number of VA visits per site for primary care (across all and by modality, in-person, video, and phone), emergency care, and inpatient care.

RESULTS

In adjusted analyses, CRH-PC sites, compared with non-CRH-PC sites, had on average 221 additional primary care visits (a volume increase of 3.4% compared to pre-pandemic). By modality, CRH-PC sites had 643 fewer in-person visits post-pandemic (- 14.4%) but 723 and 128 more phone and video visits (+ 39.9% and + 159.5%), respectively. CRH-PC sites, compared with non-CRH-PC sites, had fewer VA ED visits (- 4.2%) and hospital stays (- 5.1%) in VA medical centers. Examining visits per patient, we found that CRH-PC sites had 48 additional telephone primary care visits per 1000 primary care patients (an increase of 9.8%), compared to non-program sites.

CONCLUSIONS

VA's pre-pandemic rollout of a new primary care telehealth program intended to improve access facilitated primary care visits during the pandemic, a period fraught with care disruptions, and limited in-person health care delivery, indicating the potential for the program to offer health system resilience.

Smart city healthcare delivery innovations: a systematic review of essential technologies and indicators for developing nations

BACKGROUND

In recent times, the concept of smart cities has gained remarkable traction globally, driven by the increasing interest in employing technology to address various urban challenges, particularly in the healthcare domain. Smart cities are proving to be transformative, utilizing an extensive array of technological tools and processes to improve healthcare accessibility, optimize patient outcomes, reduce costs, and enhance overall efficiency.

METHODS

This article delves into the profound impact of smart cities on the healthcare landscape and discusses its potential implications for the future of healthcare delivery. Moreover, the study explores the necessary infrastructure required for developing countries to establish smart cities capable of providing intelligent health and care services. To ensure a comprehensive analysis, we employed a well-structured search strategy across esteemed databases, including PubMed, OVID, EMBASE, Web of Science, and Scopus. The search scope encompassed articles published up to November 2022, resulting in a meticulous review of 22 relevant articles.

RESULTS

Our findings provide compelling evidence of the pivotal role that smart city technology plays in elevating healthcare delivery, forging a path towards improved accessibility, efficiency, and quality of care for communities worldwide. By harnessing the power of data analytics, Internet of Things (IoT) sensors, and mobile applications, smart cities are driving real-time health monitoring, early disease detection, and personalized treatment approaches.

CONCLUSION

Smart cities possess the transformative potential to reshape healthcare practices, providing developing nations with invaluable opportunities to establish intelligent and adaptable healthcare systems customized to their distinct requirements and limitations. Moreover, the implementation of smart healthcare systems in developing nations can lead to enhanced healthcare accessibility and affordability, as the integration of technology can optimize resource allocation and improve the overall efficiency of healthcare services. It also may help alleviate the burden on overburdened healthcare facilities by streamlining patient care processes and reducing wait times, ensuring that medical attention reaches those in need more swiftly.

Tokyo's COVID-19: An urban perspective on factors influencing infection rates in a global city

This research investigates the relationship between COVID-19 and urban factors in Tokyo. To understand the spread dynamics of COVID-19, the study examined 53 urban variables (including population density, socio-economic status, housing conditions, transportation, and land use) in 53 municipalities of Tokyo prefecture. Using spatial models, the study analysed the patterns and predictors of COVID-19 infection rates. The findings revealed that COVID-19 cases were concentrated in central Tokyo, with clustering levels decreasing after the outbreaks. COVID-19 infection rates were higher in areas with a greater density of retail stores, restaurants, health facilities, workers in those sectors, public transit use, and telecommuting. However, household crowding was negatively associated. The study also found that telecommuting rate and housing crowding were the strongest predictors of COVID-19 infection rates in Tokyo, according to the regression model with time-fixed effects, which had the best validation and stability. This study's results could be useful for researchers and policymakers, particularly because Japan and Tokyo have unique circumstances, as there was no mandatory lockdown during the pandemic.

An agent-based secure privacy-preserving decentralized protocol for sharing and managing digital health passport information during crises

The aim of this article is to identify a range of changes and challenges that present-day technologies often present to contemporary societies, particularly in the context of smart city logistics, especially during crises. For example, the long-term consequences of the COVID-19 pandemic, such as life losses, economic damages, and privacy and security violations, demonstrate the extent to which the existing designs and deployments of technological means are inadequate. The article proposes a privacy-preserving, decentralized, secure protocol to safeguard individual boundaries and supply governments and public health organizations with cost-effective information, particularly regarding vaccination. The contribution of this article is threefold: (i) conducting a systematic review of most of the privacy-preserving apps and their protocols created during pandemics, and we found that most apps pose security and privacy violations. (ii) Proposing an agent-based, decentralized private set intersection (PSI) protocol for securely sharing individual digital personal and health passport information. The proposed scheme is called secure mobile digital passport agent (SMDPA). (iii) Providing a simulation measurement of the proposed protocol to assess performance. The performance result proves that SMDPA is a practical solution and better than the proposed active data bundles using secure multi-party computation (ADB-SMC), as the average CPU load for SMDPA is approximately 775 milliseconds (ms) compared to about 900 ms for ADB-SMC.

Municipal Pathways in Response to COVID-19: A Strategic Management Perspective on Local Public Administration Resilience

This paper aims to understand the different resilience pathways local governments may take during moments of crisis, specifically focusing on the COVID-19 pandemic. Through survey responses from local administrations in Wallonia, Belgium, we consider how varied contexts led to different strategic resilience pathways. These pathways range from static (i.e., no strategy) to innovative change. Our findings highlight that digital technology solutions may play a role in supporting resilience across the different pathways. Therefore, we adapt strategic public management literature to suggest propositions for future research to test the specific role that digital technologies play in supporting resilience within local administrations.

Effects of the built environment and human factors on the spread of COVID-19: A systematic literature review

Soon after its emergence, COVID-19 became a global problem. While different types of vaccines and treatments are now available, still non-pharmacological policies play a critical role in managing the pandemic. The literature is enriched enough to provide comprehensive, practical, and scientific insights to better deal with the pandemic. This research aims to find out how the built environment and human factors have affected the transmission of COVID-19 on different scales, including country, state, county, city, and urban district. This is done through a systematic literature review of papers indexed on the Web of Science and Scopus. Initially, these databases returned 4264 papers, and after different stages of screening, we found 166 relevant papers and reviewed them. The empirical papers that had at least one case study and analyzed the effects of at least one built environment factor on the spread of COVID-19 were selected. Results showed that the driving forces can be divided into seven main categories: density, land use, transportation and mobility, housing conditions, demographic factors, socio-economic factors, and health-related factors. We found that among other things, overcrowding, public transport use, proximity to public spaces, the share of health and services workers, levels of poverty, and the share of minorities and vulnerable populations are major predictors of the spread of the pandemic. As the most studied factor, density was associated with mixed results on different scales, but about 58 % of the papers reported that it is linked with a higher number of cases. This study provides insights for policymakers and academics to better understand the dynamic roles of the non-pharmacological driving forces of COVID-19 at different levels.

The Recovery of China's Industrial Parks in the First Wave of COVID-19

Industrial parks are functional urban areas that carry the capacity to support highly concentrated production activities. The robustness and anti-interference ability of these areas are of great importance to maintaining economic vitality of a country. Focusing on the rate of production recovery (RPR), this paper examines the recovery of 436 major industrial parks in mainland China during the first wave of COVID-19. Leveraging spatio-temporal big data, we measured 14 attributes pertaining to industrial parks, covering four categories, namely spatial location, central city, park development, and public service. We focused on the spatial association and heterogeneity of the recovery patterns and identified the factors that truly affected the recovery of industrial parks with quantitative evaluation of their effects. The results reveal that: (1) RPR of industrial parks are significantly spatially clustered, with an obvious "cold spot" in the early outbreak area of Hubei Province and a prominent "center-periphery" pattern in developed areas, which is highly correlated with the spread of the epidemic. (2) The mechanisms driving the resumption of industrial parks are complex and versatile. All four categories in the variable matrix are related to RPR, including up to eight effective influencing factors. The effect of influencing factors is spatially heterogeneous, and its intensity varies significantly across regions. What is more interesting is that some impact factors show positive effects in some industrial parks while inhibiting the recovery in others. On the basis of the discussion of those findings with practical experiences, the planning and construction strategies of industrial park are suggested to mitigate the impact of similar external shocks.

Knowledge Trajectories on Public Crisis Management Research from Massive Literature Text Using Topic-Clustered Evolution Extraction

Current research has ignored the hiddenness and the stochasticity of the evolution of public crisis management research, making the knowledge trajectories still unclear. This paper introduces a combined approach, LDA-HMM, to mine the hidden topics, present the evolutionary trajectories of the topics, and predict the future trends in the coming years to fill the research gaps. We reviewed 8543 articles in WOS from 1997 to 2021, extracted 39 hidden topics from the text using the LDA; 33 remained by manual labeling. The development of the topics over the years verifies that the topics are co-evolving with the public crisis events. The confusion and transition features indicate that most topics are confused or transferred to the others. The transition network and the direction of the topics show that six main transfer paths exist, and in the evolution process, the topics have become more focused. By training the HMM, we predict the trends in the next five years; the results show that the heat of the topic that focuses on traditional crisis issues will decrease while the focus on non-traditional issues will increase. We take the average error to test this model’s prediction effect by comparing it with the other approaches, concluding that it is better than the others. This study has practical implications for preventing crisis events, optimizing related policies, and grasping key research areas in the future.

Use of Toxic Substance Release Modelling as a Tool for Prevention Planning in Border Areas

The paper deals with the protection of the population and the environment in crisis management and emergency planning. It includes a proposal for an auxiliary tool for crisis managers and commanders to increase the safety of the population and the environment in the evaluated area. The proposal was developed thanks to a detailed analysis of the border area in selected regions of Slovakia, where extraordinary events may occur during the cross-border transport of hazardous substances. The actual outputs are maps of area-border crossings, including the places of transport of hazardous substances specifying a range of possible adverse effects on the endangered area. The modelling process was based on real conditions in the given area. Various scenarios of the possible occurrence of the release of hazardous substances were developed. The scenarios were applied in the ALOHA CAMEO software. Using the software output, it was possible to draw the most probable emergency scenarios with a cross-border effect. Cross-border impacts are crucial challenges in dealing with an emergency, as there is a need to ensure cooperation and coordination of emergency services in two different countries. The outputs proposed by the authors are a tool suitable not only for taking preventive measures but also as an aid in repressive activities. It is, therefore, suitable both for reducing the probability of the occurrence of given emergencies and minimizing its consequences.

Spatializing Social Networking Analysis to Capture Local Innovation Flows towards Inclusive Transition

The location of the local network of firms impacts, positively or negatively, their economic performance. The interactions between different sectors in a territory are still not easily observable. We test the complexity of the economic structure at a local level, given the availability of data at a very granular scale. This could greatly assist in observing sectors or/and locations that play a dominant role in the regional economy. Thus, in order to interpret the economic structure of a territory, we used cluster-based analysis. The analysis helps in evaluating the interconnections among sectors that constitute a cluster. A novel method of describing the territorial economic structure is presented by applying Social Network Analysis (SNA) within cluster-based analysis to characterize the importance of both location and economic interconnections. In this study, we focus on the industrial agglomerations in Calabria, Italy, to underpin the potential of the region’s industries by using social networking analysis metrics. This research put forward new interpretations of SNA metrics that describe regional economic compositions. Our findings reveal that territorial social networks are a potential instrument for understanding interactions in regional systems and economic clusters and might help in highlighting local industrial potentials. We believe that this study’s results could be considered as the initial steps for a pioneer data-driven place-based structural analysis model.

Evaluating the sustainability of smart technology applications in healthcare after the COVID-19 pandemic: A hybridising subjective and objective fuzzy group decision-making approach with explainable artificial intelligence

During the COVID-19 pandemic, some smart technology applications were more effective than had been expected, whereas some others did not achieve satisfactory performance. Consequently, whether smart technology applications in healthcare are sustainable is a question that warrants investigation. To address this question, a hybridising subjective and objective fuzzy group decision-making approach with explainable artificial intelligence was proposed in this study and then used to evaluate the sustainability of smart technology applications in healthcare. The contribution of this research is its subjective evaluation of the sustainability of smart technology applications followed by correction of the evaluation outcome on the basis of the applications' objective performance during the COVID-19 pandemic. To this end, a fuzzy nonlinear programming model was formulated and optimised. In addition, the impact of several major global events that occurred during the pandemic on the sustainability of smart technology applications was considered. The proposed methodology was applied to evaluate the sustainability levels of eight smart technology applications in healthcare. According to the experimental results, three applications-namely healthcare apps, smartwatches, and remote temperature scanners-are expected to be highly sustainable in healthcare, whereas one application, namely smart clothing, is not.

Conceptualizing Walking and Walkability in the Smart City through a Model Composite w2 Smart City Utility Index

This paper explores walking and walkability in the smart city and makes a case for their centrality in the debate on the resilience and sustainability of smart cities, as outlined in the United Nations’ (UN) Sustainable Development Goals (SDGs). It is argued that, while the human/inhabitant-centric paradigm of urban development consolidates, and research on walking, walkability, and pedestrian satisfaction flourishes, the inroads of ICT render it necessary to reflect on these issues in the conceptually- and geographically-delimited space of the smart city. More importantly, it becomes imperative to make respective findings useful and usable for policymakers. To this end, by approaching walking and walkability through the lens of utility, the objective of this paper is to develop a conceptual framework in which the relevance of walking and walkability, hereafter referred to as w2, as a distinct subject of research in the smart cities debate is validated. This framework is then employed to construct a model of a composite w2 smart city utility index. With the focus on the development of the conceptual framework, in which the w2 utility index is embedded, this paper constitutes the first conceptual step of the composite index development process. The value added of this paper is three-fold: First, the relevance of walking and walkability as a distinct subject of research in the realm of smart cities research is established. Second, a mismatch between end-users’ satisfaction derived from walking and their perception of walkability and the objective factors influencing walking and walkability is identified and conceptualized by referencing the concept of utility. Third, a model smart city w2 utility index is proposed as a diagnostic and prognostic tool that, in the subsequent stages of research and implementation, will prove useful for decisionmakers and other stakeholders involved in the process of managing smart cities.

The Favela as a Place for the Development of Smart Cities in Brazil: Local Needs and New Business Strategies

Smart cities are a natural evolution of the concept of sustainable cities. These cities can be analyzed by social, economic, environmental, and technological biases. For this work, we chose the social and economic vision, with a special focus on the poorest and most vulnerable territories of Brazilian cities. These territories in Brazil are called slums, places of poverty but with opportunities for the development of the creative economy with its own brand. Seen by many in a simplistic way, summed up to be geographic spaces of drug circulation dominated by trafficking, Brazilian favelas have been consolidating themselves as a storehouse of innovative minds, a creative territory with multiple and complex cultures. These places today are capable of producing a positive image with potential for market exploitation. Therefore, the objective was to draw a relationship between the creative economy, branding and favelas, considering the concept of smart cities that include products and services from the slums. The present study shows the results of a survey and a bibliographic analysis based on the methodology Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and with parameters that took into account the favela, branding and the creative economy. Thus, we expect that it will be possible to point out ways to accelerate entrepreneurial actions and foster the development of these locations.