In Part One, we took a look at one of the major challenges of today’s reigning approach to designing Smart Cities: That the discussion and development veers towards surface level technology opportunities, rather than deeper, more systemic urban challenges, like the social determinants of health (SDOH). When left under-addressed, SDOH reinforce the so-called “urban health penalty,” which winds up costing us more in the short term, and reinforcing the intergenerational inequities that undermine our collective prosperity over time.
Not all is well in the Smart City.
As a health innovation junkie, I began researching Smart Cities last summer, and I was dismayed to find a glaring absence of discussion related to healthcare payment and delivery, public health, or urban health equity.
An excellent report by the Center for Health Care Strategies breaks down how six such communities around the country have done just that as part of multi-site program funded by the Robert Wood Johnson Foundation.What follows is a summary analysis of the report, and some added color commentary on how the worlds of public health, healthcare, and health IT are rapidly converging as we move further into 2018.
hile Amazon and Apple have captured most of the public interest in the “big tech company enters healthcare” race this year, perhaps the more important development of the year happened without nearly as much fanfare. Sidewalk Labs, the urban innovation arm of Alphabet (aka Google) quietly spun its healthcare project into a new startup called CityBlock.
CityBlock aspires to be a socially integrated direct primary care-style model for underserved urban Medicaid populations, starting in New York City. At the simplest level, they’re betting they can build a partnership-enabled, utility-style approach to care delivery that will break even.
Originally published on Tincture.
Imagine a Smart Health City. A city where health is ‘ built into the OS.’
This conceptual metropolis doesn’t exist all in one place— not just yet. For now it’s a patchwise place, a de-aggregated lab where emerging urban health innovations can be grafted onto digital and physical infrastructure, and multi-sector collaborators conspire to bring a growing evidence base to life.
A smart health city treats its resources — human, environmental, financial, and data — with respect and rationale; it stewards public funds efficiently and innovatively, and convenes private partnerships that pay for success. It learns from its peers. It’s a place where taxes and tax credits alike bolster the health of the community.
It understands and measures how city living shapes our behaviors and impacts our health, and the health of our children. It’s a place where nutrition strategy reflects real-world resources and the needs of the community. A smart health city harnesses tech to keep its air and water clean and safe for all.
It’s also a city that treats violence like a disease; that approaches family planning like a win-win opportunity; that drinks responsibly, smokes up sensibly, and fights the opioid epidemic with a mix of data, leadership, and compassion.
It’s a city that’s smart about the where and the how of building new officesand homes. It optimizes our public infrastructure for health and wellness, from sidewalks to highways. It invests in trees, for their benefits on our stress and anxiety as well protection from fire, heat, flooding, and pollution. It’s equipped to respond to storms, wet or wintry.
A smart health city is one where the healthcare systems are self-aware of their limitations and opportunities, as well as the local impact of their business behavior on the access, price, and quality of care in the community; where payers reach beyond their membership to improve the public’s health; where hospitals play well with one another, and with those outside the system. It’s a city with progressive primary health options for all of its citizens.
It’s the type of city that cares for the elderly, the disabled, and the vulnerable, treating them with respect and compassion. That harnesses state-level creativity and innovations to fund the social safety net, and enhances the daily lives of its people through smarter policymaking. It changes up the game when things don’t appear to be working.
It’s a city that understands that the ways it interfaces with citizens and businesses alike are too often a bottleneck to progress, instead of an opportunity to use human-centered design to unlock double or triple bottom lines.
Smart Health City is not a real place— but it’s happening, right now — in countless corners of the US, and all around the world.
What else might we imagine it doing?
What else should we push it to become?