Rapid urbanisation, primarily due to economic migration in cities, such as Johannesburg, has placed additional strains on scarce resources, including healthcare services.
Johannesburg, in particular, struggles to meet demands for emergency medical care, especially when emergency departments have reached critical capacity and ambulances have to be diverted to nearby hospitals.
In such cases, the lack of connectivity between systems obstructs communication and can potentially result in an ambulance arriving at a hospital only to be told that the emergency department is temporarily closed (except for walk-ins). This can have devastating consequences for time-sensitive conditions, such as heart attacks and strokes.
This begs the question: Can a smart healthcare system inform all stakeholders of critical updates in real-time?
Less than 100 cities have been classified as smart cities globally, with only two of those cities (Accra and Cape Town) located in Africa. Johannesburg, one of the wealthiest cities in Africa, has not yet been classified as a smart city, though the Joburg 2040 plan intends changing this. Additionally, the Building a Smart Future plan intends uplifting Gauteng through digital innovation.
Smartness in healthcare calls for connectivity between healthcare systems and people.
From a healthcare perspective, a city can be considered as smart if it supports the health of its residents through the use of connected technologies. This concept exceeds that of smart device usage, such as smart watches, as noted by Healthbridge, which allows people to both produce and consume their own healthcare data. Smart healthcare is also about sharing official public healthcare information in real-time.
For Johannesburg to elevate itself to a smart city, connectivity that does not discriminate between those who have access to digital technology and those who do not, must be considered.
Johannesburg, like other major South African cities, however, provides an unfair distribution of services, such as internet connectivity, further increasing the digital divide. This calls for the optimisation of existing technology and infrastructure to provide real value to Johannesburg’s citizens without expending large amounts of resources.
Smartness in healthcare calls for connectivity between healthcare systems and people, combining healthcare information from disparate sources and communicating with the relevant stakeholders. Making the right information available to the right people at the right time can then support collaboration efforts between healthcare teams and the optimisation of scarce healthcare resources.
Reuse and repurpose
Gauteng’s freeway management system spans 185km and is equipped with 60 variable message signs (the electronic boards that inform road users of accidents and estimates on how long it would take them to reach the next offramp).+
This infrastructure, combined with the information being shared, is meant to form part of an intelligent transport system network for route optimisation and to provide contextualised information to road users.
These signboards are already perfectly positioned to provide road users with other types of real-time information, smart healthcare information. Healthcare systems could connect to these signboards to communicate real-time information at no cost to over three million road users per day.
People can be informed of relevant updates (without causing panic) to the healthcare system, such as whether there is a disaster at a hospital and whether they should reroute to a nearby healthcare facility. Or road users can simply be informed of how long it would take to reach the nearest hospital.
The Department of Health has taken significant steps through the (ongoing) implementation of the SAP Hospital Information System to connect healthcare information to healthcare providers.
Research has, however, demonstrated that less emphasis is being placed on management and optimisation information. Public hospitals, for example, do not digitally share all relevant datasets, such as ambulance diverts, with emergency medical services systems. This is surprising considering that these two entities work as an integrated team.
The term “public healthcare” does not seem to imply that the public are informed in real-time of changes to the public healthcare system, or even how the hospital systems work. The public are not always aware of which hospital to visit in the event of an illness or injury. Most people visit the nearest hospital, only to be referred to another (higher or lower level) hospital based on the patient’s condition.
Connect smart people with smart info
Joburg 2040 is just five years away and the National Health Insurance is meant to be phased in over the next few years. Smartness in healthcare, however, does not need to wait that long.
Returning to the original question, by effectively utilising smart city elements, it is possible to keep some of the population informed of critical updates within the healthcare system without increasing the digital divide or creating unnecessary panic.
Additionally, the freeway management system’s well-positioned infrastructure already provides a platform for sharing information. By reusing and repurposing existing systems, Johannesburg can therefore connect smart people with smart information, which strengthens its case for being branded as a smart city.
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