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How the Internet of Things and People can help improve our health, well-being and quality of life


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How the Internet of Things and People can help improve our health, well-being and quality of life

  1. 1. Maged N. Kamel Boulos, MBBCh, PhD, SMIEEE Professor and Chair of Digital Health The Alexander Graham Bell Centre for Digital Health University of the Highlands and Islands, Scotland, UK twitter: @mnkboulos From smart cities and regions to smart, healthy individuals: how the Internet of Things and People can help improve our health, well-being and quality of life
  2. 2. About this lecture • I thought I would share with you some key highlights of the European experience (including that of some European cities in WHO Euro Healthy Cities Network) in this domain. • I will also include some highlights of related past and present research projects I worked/am working on. All video excerpts in this presentation are either public domain or used under the 'fair use' principle. In its most general sense, a fair use is any copying of copyrighted material done for a limited and “transformative” purpose, such as to comment upon, criticize, parody, or highlight (for research and scholarship) a copyrighted work. Such uses can be done without permission from the copyright owner.
  3. 3. Agenda – October 2017 update • The Internet of Things (and People) (IoT): a primer with examples • IoT standards and protocols • IoT big data and analytics • IoT and connected health / smart lifestyle and nutrition • IoT-powered cities and regions: towards self-aware, smart and potentially healthier cities and regions • Case study: Barcelona and Sant Cugat (a suburb north of Barcelona) • Linking people to people – social inclusion in the digital age • The 'distributed city model' or 'smart countryside' for sparsely populate regions (as in Finland and North of Scotland) • Concerns: IoT data and device privacy and security • Metrics: a note on measuring happiness • Conclusions / Where and how can smart-cities-to-be begin
  4. 4. The Internet of Things (and People) • The Universe, our bodies and the physical animate and inanimate objects around us have always generated enormous amounts of data, but we were not able to fully capture and make sense of those data until recently. • Today, the Internet of Things (IoT) enables almost everything (people and objects on our planet and the Universe) to be automatically identified and located, e.g., using RFID or Radio-Frequency IDentification tags, instrumented using a very wide array of specialised sensors or detectors to capture data, and connected / interconnected to cloud servers for storage, processing and 'in context' / 'intelligent' analysis of captured data. By 2020, 50 billion things and devices will be equipped with unique identifiers. Image source: 'Internet of Things' was added to Oxford Dictionaries in 2013: definition/english/Internet-of-things
  5. 5. The Internet of Things (and People) • The results are smarter 'things' and smarter environments in which people and objects interact and cooperate with each other in better and new ways that can vastly improve our quality of life. • A 'quantified self' is now possible, thanks to a growing range of wireless sensors in gadgets / wearables (e.g., smartwatches and smart garments), ingestibles and implantables that can continuously monitor and track in real time various aspects of a person's daily life and clinical status. • Internet-connected wireless health sensors and sensors around the home are key to modern telehealthcare services (also known as 'connected health/care'), particularly those aimed at prolonging the independent living or 'ageing well' of older people (Ambient Assisted Living—AAL). The 'smart garment' used in the eCAALYX EU-funded AAL project:
  6. 6. The Internet of Things (and People) • Connected 'things' can also have remotely- controlled actuators or other mechanisms to trigger or modify actions carried out by those objects according to needs measured by sensors (or user-initiated), e.g., in home automation (domotics) scenarios. • Public engagement / citizen sensing / crowdsourced efforts: the 'Air Quality Egg' example - Source (Kamel Boulos, 2013): and-participation-in-health-geography
  7. 7. A citizen science network to reduce earthquake damage
  8. 8. How to convert an object to a connected 'smart thing' • Suppose we have a chair. We want to know (using an Internet- connected smartphone / tablet or computer) from anywhere in the world if it is occupied, and who is currently sitting in it. • To convert the chair into a smart one, we first need to give it a unique identity (IPv6) to uniquely identify it and connect to it specifically (as opposed to all other / similar chairs in the same room or elsewhere). • We then need to give it the ability to communicate (wirelessly) and equip it with the ability to 'sense' its own status and its environment via sensors. • A pressure sensor on the seat can detect whether the chair is occupied or not. An RFID tag reader attached to the seat can identify any tagged person sitting in it. • We can even think of ways to control that chair, e.g., move it, from anywhere in the world, using a remotely-controlled actuator / motor (though this does not make useful sense with the chair example). Image and example source: (Dr John Barrett, Cork Institute of Technology)
  9. 9. The Internet of Things (and People) • Boundaries between 'digital' (bits/data) and 'physical' (atoms/things) are getting blurred: Internet-connected smartphones, phablets* and similar can also sense and 'recognise' where we are (location awareness) and the persons, places, things and objects around us (via camera/cloud-powered image recognition, QR [Quick Response] code scanning, etc.), and link them to relevant information (e.g., 'Layar' augmented reality app, ESRI 'My Place History' geomedicine app, Amazon Fire Phone [failed] and Google Glass [is now back]), or even use them as elements of a digital game (or exergame) taking place in the real world! * Phone-tablet
  10. 10. Below: A WeChat Pay system is demonstrated at a canteen in Guangzhou, China, 9 May 2017. REUTERS/Bobby Yip Above: Amazon Go: Futuristic supermarkets with no checkouts Amazon's technologies will automatically know which products you've left the supermarket with. Customers can walk in, take what they want and walk straight out. Video:
  11. 11. Video: IoT-powered (connected) pillbox • Length: 0:38 - (also locally embedded on next slide)
  12. 12. Video station
  13. 13. Connected vehicles • The emerging EU 'connected cars' vision and standards (see have the potential of reducing traffic bottlenecks and road traffic accidents, in addition to improving ambulance response times. Image source:
  14. 14. Video: IoT-powered vehicles • Length: 0:38 - (also locally embedded on next slide)
  15. 15. Video station
  16. 16. IoT in criminal justice • Law enforcement entities are increasingly turning to Fitbits and similar internet- connected devices for time- and location-stamped information regarding criminal investigations
  17. 17. Standards & protocols • In IoT, everything has an IP address. Internet Protocol version 6 (IPv6) uses 128-bit addresses, allowing 2128, or ~3.4×1038 addresses, i.e., >7.9×1028 times as many as IPv4, which uses 32-bit addresses and provides ~4.3 billion addresses. • There are very many other protocols and standards required to make IoT work, e.g., 'data plumbing' standards, IEEE 802.15.4 standard for low-rate Image source: Adjuvi LLC HAN: Home Area Network HVAC: Heating, Ventilating and Air Conditioning MEMS: MicroElectroMechanical Systems RFID: Radio-Frequency Identification wireless personal area networks (LR-WPANs) and ISO/IEC 18092 standard for Near Field Communication (NFC), Continua Version 2015 (compilation of standards and specs for connected health / personal telehealth), among many others.
  18. 18. IoT generates (and consumes) big data • IoT-driven sensors, devices, systems and services generate big amounts of real-time data (not all of which are trustworthy and reliable). • Much of the IoT-generated 'big data' are geo-tagged or geo-located. Location gives important context ('where'), as well as being an essential piece of information to know when responding to events and deploying appropriate actions (but also has some individual privacy implications). • Big data and their context are key to gaining new insights that can inform better decision making in various scenarios. The importance of having robust, intelligent analytics systems in place to process and make sense of such data in real time cannot, thus, be overestimated. The 4Vs of big data: According to Gartner (2012), "big data are high Volume, high Velocity, and/or high Variety information assets that require new forms of processing to enable enhanced decision making, insight discovery and process optimisation". A fourth V for 'Veracity' can be added to the definition to emphasise the importance of establishing data trustworthiness and accuracy.
  19. 19. IoT big data examples • Farmers can now use sensors to continuously monitor cows' health and track their movements, ensuring better milk supply for human consumption. • On average, each cow generates 200MB of data/year! • 'Quantified self' data from the growing number of personal clinical and health & fitness wearables / sensors available today can easily exceed the above figure (per person). Image sources: CISCO, Apple and Fitbit
  20. 20. ^ Above (left): The types of physiological data points and the wearable sensors under development or on the market to monitor them. Illustration by PureTech. From: Defining digital medicine, Nature Biotechnology 33, 456–461 (2015) doi:10.1038/nbt.3222 (not a comprehensive/complete list) Connected health and lifestyle sensors and gadgets 'Smart toilets' that would recognise its user and carry out biomarker and microbiota analysis to inform and help formulate highly-individualised lifestyle and diet recommendations
  21. 21. Connected health: an 'Internet of Food' for smart nutrition and lifestyle (Kamel Boulos, 2014 – present) • Problem / application to China: China is ranked the world's second for obesity, after the United States, particularly in larger cities where fast food culture and unhealthy lifestyles prevail. China's most recent child and adolescent obesity figures are also very alarming. Overweight and obesity are a documented leading risk factor of major non-communicable diseases (not just in the EU, but worldwide; e.g., China now has the world's largest and fastest growing diabetes epidemic). • Problems of current solutions: poor compliance and adherence; lack of accuracy and precision; lack of true personalisation; not taking individual factors such as metabolism, gut flora, gut hormone levels, genetic profile, etc. into consideration; no proper prediction of clinical risks; inflexible and non-negotiable diet and lifestyle recommendations no true ecosystem/expandability.
  22. 22. Well-tailored P5-Health-compliant smart nutrition and lifestyle e- interventions (Precision, Predictive, Preventive, Personalised and Participatory Health).
  23. 23. Big data analytics • There are three main analytics levels: • Descriptive analytics: what has happened and where (smart location) / the 'big picture'; • Prescriptive analytics: choices currently available; and • Anticipatory / predictive analytics: what could happen next and how to be prepared / take action. • Health is geospatial, and if we can see trends spatially (the 'where' / smart location component), we can monitor and improve population and individuals' health. • But do not go beyond the actual statistical strength of the (big) data; accommodate sound 'error bars' around all inferred predictions. • Also 'big data' methods can only be truly useful if they are paired with traditional forms of information collection, or what some researchers call 'small data'. Image source: IBM -
  24. 24. Big data analytics: artificial intelligence • A major way to keep up with the IoT-generated medical/health data and gain the hidden insights it holds is by using specialised AI, machine learning and cognitive computing (e.g., IBM Watson Health and Google DeepMind Health). • See Kamel Boulos (2016): watson-health-how-cognitive-technologies-have-begun-transforming-clinical- medicine-and-healthcare
  25. 25. Machine learning / deep learning (AI comeback) are not a panacea • Human learning remains unmatched by any machine. • That big data 'AI bubble' we are witnessing today will burst again! (cf. the 1980s) • A highly-recommended article by Rodney Brooks: sins-of-ai-predictions/ The "sponge-like learning that humans engage in, making rapid progress in a new domain without having to be surgically altered or purpose-built" is unparalleled.
  26. 26.  Wall M: Ebola: Can big data analytics help contain its spread? BBC News 2014 Oct 15, Online at  Lazer D et al.: The parable of Google Flu: traps in big data analysis. Science 2014, 343(6176):1203-1205.  Gomes L: Interview with IEEE Fellow Michael I. Jordan on 'Why (or when) big data could be a big fail'. IEEE Spectrum 2014 Oct 20, Online at maestro-michael-jordan-on-the-delusions-of-big-data-and-other-huge-engineering-efforts#qaTopicThree Cities and regions should avoid being lost in a costly flood of big data, by starting with (the right) questions, not with data, and by using the right-sized data and analytics ('big data diet' and 'light analytics') to answer those questions.
  27. 27. Dashboards and real-time visualisation Smart traffic management in Hamburg, Germany Image source:
  28. 28. IoT-powered cities • "The cities of the future will be self-aware, much like a being. These cities will be able to reconfigure themselves, based on what’s happening, and what might happen, in the immediate future. • "You have two versions of cities. One is made of atoms. You and me, and cars, and all this sort of thing. We are atoms. Then you have another version which is a mirror city, which is made of bits. And the two are connected to one another. If you have sensors in the one, it can connect to the other." --Roberto Saracco, Chair of IEEE's (Institute of Electrical and Electronics Engineers) Future Directions Committee and EIT ICT Labs Italian Node Director
  29. 29. Diagram source: Roscia et al., 2013 - DOI:10.1109/ICRERA.2013.6749783 Smart Health or sHealth Reactive mHealth --> Proactive (P4) sHealth
  30. 30. Barcelona: an IoT-powered smart city • A 500-Km-long underground fibre network is being installed progressively as the city carries out routine maintenance to its roads and other underground services, which helps reduce installation costs significantly. • Solar-panel-powered smart bus stops are connected to the city's fibre network. They display real-time bus information and times, tourist information and digital advertising, offer USB (Universal Serial Bus) charging sockets for mobile devices such as smartphones and tablets, and act as free WiFi (Wireless Fidelity) hotspots, allowing people to connect to the Internet using their mobile devices while waiting for a bus. Image source: city-internet-of-things/
  31. 31. Barcelona: an IoT-powered smart city • The city's smart parking spots are also connected to Barcelona's WiFi network. They detect the presence of cars through a combination of light and metal detectors. • Online searching and payment for the smart parking spots is possible using dedicated smartphone apps. Image source: city-internet-of-things/ Icon of apparkB app for Android and iOS • Reduce traffic congestion • Lower air and noise pollution
  32. 32. Barcelona: an IoT-powered smart city • A city-wide network of sensors provides real-time information on the flow of citizens, noise and other forms of environmental pollution, as well as traffic and weather conditions, enabling local authorities to streamline city operations for better environmental management, reduction of costs, and improvement of socioeconomic and environmental sustainability. • Barcelona's highly-energy-efficient LED (Light-Emitting Diode) streetlights are fitted with CCTV (Closed-Circuit TeleVision), environmental monitoring sensors (humidity, temperature, air quality / pollution and noise) and WiFi. • The streetlights are capable of dynamically managing the level of lighting depending on surrounding conditions to save energy, e.g., dim lights when no motion or pedestrians are detected in the street. Image source: internet-of-things/
  33. 33. Barcelona: an IoT-powered smart city • Barcelona's smart grid developments include rolling out one million new smart electricity meters in the city, providing customers with higher energy usage awareness and optimisation tools, and helping them better plan and adapt their consumption for greater savings and reduction of greenhouse gas emissions such as CO2 and NOx. • Barcelona is also a strong supporter of electric vehicles and created Spain's first electric vehicle fast recharge point. An innovative solar-powered building in Barcelona Image sources: s/Barcelona_Smartcity.aspx and
  34. 34. Barcelona: an IoT-powered smart city • Barcelona's wirelessly-connected garbage bins are fitted with sensors that monitor trash levels. • The data reach the city council's team in charge, enabling the team to plan the optimal routes for garbage collection, update garbage truck drivers in real time regarding which routes to take, and in this way optimise productivity and reduce waste management service costs, as well as pollution caused by garbage trucks. • Other compact drop-off street containers connect through pipes to a subterranean vacuum network sucking up trash below the ground, thus decreasing noise and air pollution caused by garbage trucks. Image sources: internet-of-things/ and reasons-why-barcelona-is-smart-city.html
  35. 35. Barcelona: an IoT-powered smart city • Smart parks at Sant Cugat (a suburb 20 Km north of Barcelona) are watered only when necessary, thanks to sensors capturing the degree of soil humidity and air temperature in order to determine the exact amounts of water needed. Image source:
  36. 36. Video: Sant Cugat (a suburb of Barcelona) smart city pilot • Length: 04:05 - (also locally embedded on next slide) See also: Barcelona embraces IoT to create a smart city (03:50) - watch?v=TCbvxb5t5_8
  37. 37. Video station
  38. 38. Barcelona: benefits of being an IoT-powered smart city • An economic growth opportunity: Thanks to IoT, the city was able to make big savings in areas such as smart water (savings of €42.5 million a year) and lighting and parking management (increased revenues of parking fees by 33% or €36.5 million), besides creating 47,000 new jobs related to the smart city developments in Barcelona (source: • Better quality of life for citizens and visitors: According to Antoni Vives, Barcelona's Deputy Mayor for Urban Habitat, the main rationale behind his city's embracement of IoT is to improve the quality of life of people. Antoni Vives describes his ultimate vision of a smarter Barcelona by 2023 as "a city of culture, creativity, knowledge but mainly fairness and well- being; a place where people live near where they work; a city self- sufficient in energy; a zero emission city and a city hyperconnected to the world".
  39. 39. Barcelona IoT: not everything worked quite as expected • What other cities can learn from Barcelona's smart city experiment: • "There is a need to focus on what IoT can do to serve the people, instead of a technology push agenda, and to encourage citizens to participate in smart city planning policies. • "Some of the technological innovations have produced benefits different to those originally planned. Others didn't prove useful. In one project, electromagnetic sensors were placed under street parking bays to indicate whether they were free or occupied. Whenever a subway train stopped beneath, however, its mass of metal tripped the sensors to read 'occupied' until the train moved on. Moreover, since parking places are typically filled within 30 seconds of becoming available, it became apparent there was little point developing a system to direct drivers to free spaces. • "City Hall ended up with a lot of data, with a lot of dashboards, and yet without any capacity to really use data and information to take better decisions for the public good, or give ownership of the data to citizens. • "There are a lot of different silos, a lot of sensor vendors, a lot of different applications, and the first thing we need is a common layer. The main lesson learnt in Barcelona is that the first thing needed to become a successful smart city is to start deploying a common platform, to create an open-source sensor network, with common standards, connected to a computer platform managed by the city itself."
  40. 40. • Video: Nice, France: an IoT-powered smart city Length: 3:41 - • Video: Hamburg, Germany: an IoT-powered smart city Length: 3:28 - • Video: Milton Keynes, England, UK - MK:Smart Length: 2:58 - • Video: OPEN Glasgow, Scotland, UK Length: 6:52 (and • Singapore: smart-nation-smart-city/ • And many more cities… • Related video: Internet of Things World Barcelona 2013 Keynote Demo: additional creative IoT application examples for cities (CISCO) Length: 13:31 – There are many more smart city examples around the world
  41. 41. Linking people to people "How accepted and supported we feel affects the biological pathways that skew the genetic expression of a disease, while feeling isolated leaves a loneliness imprint on every cell." --American social neuroscientist John T Cacioppo (University of Chicago) • Social inclusion, the feeling of belonging and connectedness to a cohesive group of family, friends and neighbours, is key to healthy ageing (and healthy living for all age groups). Training older people in social media carries the potential of improving well-being and combatting social isolation. • Various studies have shown that people with better social support suffer less heart attacks, have more protection from serious complications following stroke, greater tissue repair, faster recovery from illness, fight cancer better, can keep memories for longer, and live a longer healthier life. • Research evidence shows that Internet use and social engagement can also protect against health literacy decline during ageing, independent of cognitive decline. • Also, there is evidence that helping and supporting others can make people of all ages happier and healthier.
  42. 42. Linking people to people • IoT can help users form a variety of communities of practice (smart communities) for enhancing the quality of life and curating available expertise in the community; for example: • a smart home community-based service to allow collective baby and child care among neighbours; • a ‘car sharing service’ that combines social interactions (people offering to help each other, driver ratings, incentives, etc.) and IoT technology (location services, ride advertising and matching services, etc.) under one platform; • refranchising older (and younger unemployed) people via e-labour exchange services, further helped by the connected European Digital Single Market initiative; and
  43. 43. Linking people to people • 'Vincles BCN', a mobile app by the Spanish city of Barcelona aimed at helping Barcelona's older people develop and maintain stronger social ties and networks with trusted and secure circles of social workers, volunteers, neighbours, friends and family. The app allows older users to engage in activities with their trusted networks, such as making calls, sending and receiving multimedia content, sharing a calendar and transferring money easily and safely, so that they no longer feel isolated or lonely, and can more easily find help when they need it, while at the same time continuing to live independently.
  44. 44. Video: Vincles BCN
  45. 45. Video station
  46. 46. • Samsung Tunisia's app for helping people with Alzheimer's disease utilises a device's Bluetooth connectivity to discover other nearby devices running the same app. A connection to those devices is then made, if they are in a 10-meter (33 feet) range. Backup Memory then pulls information (memories and photos) regarding the nearby person (e.g., a family member) and presents it to the patient to stimulate his/her memory and help him/her recognise the nearby person.
  47. 47. Research direction: Data-driven incentives for citizen cooperation in smart communities Source: ^ Gamified ‘connected garbage bin’ (TetraBIN)
  48. 48. Rural populations are shrinking worldwide (1950 [70%] – 2030 [40%]) 2015 = 46%
  49. 49. The 'distributed city' model (smart countryside) • While acknowledging that there is 'no-one-size-fits-all' IoT-driven smart city solution for cities of different sizes, needs and settings, the 'economies of scale', determined by the size of the population to be served by a given IoT service, usually play an important and decisive role when deploying sustainable smart services that are cost-efficient and cost-effective, and thus good value for taxpayers' money. • Smaller towns and villages tend to be left at a disadvantage because of their much smaller population sizes and modest local capacities and resources, all of which make the deployment of some IoT-driven smart services prohibitively expensive and non-viable at such limited scales. • However, there is no reason why the populations of smaller and rural settlements should be left lagging behind, especially when one considers the negative consequences in terms of the difficulty these regions have in retaining their best local skills and stopping the eventual 'brain drain' of young professionals to the surrounding larger, more attractive and more opportunity- filled cities.
  50. 50. The 'distributed city' model (smart countryside) • It has been said there is 'power in unity', and this cannot be truer than in the case of small neighbouring towns and villages (e.g., the Scottish Highlands and Islands, as well as sparsely populated regions in Nordic countries such as Finland) uniting together to reach the required economies of scale when their local populations and resources are pooled together under some suitable single administrative umbrella to form a larger 'distributed city'. • But for this pooling and the subsequent deployment of smart services to occur and succeed, the smaller settlements within a distributed city will need to be well connected with each other and the rest of the country by a good network of physical roads and/or highways and most importantly by reliable, high-speed cable and mobile Internet (cf. a metropolis and its suburbs consisting of multiple smaller cities and towns).
  51. 51. The 'distributed city' model (smart countryside) • A distributed city of this kind can potentially become a 'magnet' for young and skilled professionals, as the countryside and smaller towns are converted into more attractive and digitally connected settlements, with new economic growth and job opportunities and better services akin to those found in larger cities and metropolises, thus removing the negative connotations generally associated with rurality, while preserving the countryside's unique good character (e.g., the quiet and beautiful nature, fresh air and less crowded public spaces) that is still preferred by many.
  52. 52. IoT data and device privacy and security • As more of our personal 'quantified self' (health and other) data, and data originating from our devices, appliances, vehicles, offices and homes get stored, processed, interlinked and shared online on the 'cloud', questions and concerns arise about data privacy, misuse (e.g., unauthorised sharing / unwanted advertising) and security / hacking attacks. Image sources: and (Dr John Barrett, Cork Institute of Technology)
  53. 53.
  54. 54. IoT data and device privacy and security Investigation-reveals-personal-data-TV-sets-knows-you.html "Smart TV brands monitor the programmes you watch and the websites you browse to offer personalised recommendations for TV shows - but this information can be passed on to advertisers to target viewers more accurately"
  55. 55. Maker of Internet-connected robot vacuum Roomba 980 reveals controversial plan to sell 3D maps of your home to gadget firms privacy-and-tricky-question-data- ownershipV Could close deal to sell maps to Amazon, Apple or Google in the next few years vacuum-maker-iRobot-betting-big-smart-home.html <-Userconvenience---------Privacy->
  56. 56. • Data linking (often combined with rather simple AI) makes it very possible to "paint" and continually update a comprehensive and detailed 'life/lifestyle profile' of a given individual, as the person acquires more and more sensors/devices and/or visits interlinked Web sites (Facebook, cookies, etc.), all of which capture and send monitoring and usage pattern data about the individual. • These linkages can be used to offer highly personalised recommendations and experiences to the user, but there are real individual privacy and security risks involved (big brother tracking), if the process is left untamed in the hands of (unethical) commercial and other providers. • Linking different personal data sources should only be made when necessary and beneficial to the user and with the person's understanding and consent. If a user opts for 'do not track' (or similar settings), this should be honoured.
  57. 57. Big data meets Big Brother as China moves to rate its citizens The Chinese government plans to launch its Social Credit System in 2020. The aim? To judge the trustworthiness – or otherwise – of its 1.3 billion residents "Imagine a world where many of your daily activities were constantly monitored and evaluated: what you buy at the shops and online; where you are at any given time; who your friends are and how you interact with them; how many hours you spend watching content or playing video games; and what bills and taxes you pay (or not). It's not hard to picture, because most of that already happens, thanks to all those data-collecting behemoths like Google, Facebook and Instagram or health- tracking apps such as Fitbit. But now imagine a system where all these behaviours are rated as either positive or negative and distil- led into a single number, according to rules set by the government. That would create your Citizen Score and it would tell everyone whether or not you were trustworthy. Plus, your rating would be publicly ranked against that of the entire population and used to determine your eligibility for a mortgage or a job, where your children can go to school - or even just your chances of getting a date." Good or bad? Depends on process ethics, exact nature and extent of the implementation, scoring criteria, data protection safeguards, 'rehabilitation' and redress mechanisms (if any), etc.
  58. 58. • Length: 6:06 - (also locally embedded on next slide) Video excerpts from 'BBC Horizon 2014-2015 Episode 4: Inside the Dark Web' Image source:
  59. 59. Video station
  60. 60. IoT data and device privacy and security • Data ownership and 'right to be forgotten' issues: "[Consumers] may think we're in charge of our shopper cards and our mobile apps and our smart fridges— but … let's not fool ourselves. [The information] is not ours. It belongs to Google, and IBM, and Cisco Systems…and the global Mega-Corp that owns your local supermarket. If you don't believe us, just try removing 'your' data from their databases." --Katherine Albrecht and Katina Michael (2013) Image source:
  61. 61. IoT data and device privacy and security hacks-likely-to-spread/ /10hack.html hacks-likely-to-spread/ you-can-hack-a-pacemaker-and-other-medical-devices- too/
  62. 62. A hack that activated hurricane sirens in Dallas is a harmless warning about a far more serious problem m/s/604124/smart-cities-could- be-crippled-by-dumb-security/
  63. 63. Suggested reading: • Devices that cannot have their software, passwords, or firmware updated should never be implemented • Changing the default username and password should be mandatory for the installation of any device on the Internet • Passwords for IoT devices should be unique per device, especially when they are connected to the Internet • Always patch IoT devices with the latest software and firmware updates to mitigate vulnerabilities
  64. 64. Minimise security risks: Not everything needs to be 'smart' and 'Internet-connected'. Avoid 'gimmicky' products offering no real, practical value • A coffee maker with built-in, non-Internet-connected programmable timer (and high usability/ergonomics) would do almost the same tricks. • Users of some models of the so-called "smart" WiFi-connected coffee machines on the market today spent hours of frustration setting them up and troubleshooting the coffee machine's connection to the Internet/to the user's smartphone. • It is much cheaper and quicker (also possibly more relaxing) to manually prepare a cup of coffee or use a ‘dumb’ coffee maker, with no security risks involved ☺ Smart?
  65. 65. • waste_uk_573ca4d1e4b058ab71e628d1 • a-smart-tampon-that-tells-you-when-its-time-to-change.htm • must-be-stopped-1464198157 Users' fridge contents and menstrual cycle details The smart fridge could be well worth it if well implemented, but is a smart tampon really needed? ^ Smart hairbrush by Nokia i.Con: lets users know how good they are in bed, detects signs of STIs
  66. 66. IoT data and device privacy and security: some possible solutions • Individuals can be offered an option to 'opt out' of syncing their data with third-party or public cloud databases and services and become their own service providers. Using home (private) cloud-computing systems, individuals store their information privately instead of relying on companies, and choose what data leave their homes (or private cloud) and become part of the public cloud and what do not. However, by doing so, they might lose some features and functionality offered by third-party processing and interlinking* of their data (see • In its report "IoT Privacy, Data Protection, Information Security" published in January 2013, the European Union recommends the development of privacy-friendly default settings on IoT products and services that would give users more control over what information is shared with others. It also suggests that IoT networks give individuals the rights to their own data. * with additional own data and/or others' data, e.g., to answer the question: 'how do I compare to others'.
  67. 67. ^ HP sells printers equipped with wireless (Internet-connected) sensors that monitor ink levels and automatically trigger online reorders before clients run out "Getting customers to agree to have their products monitored, which in turn means giving them something of value in return. (…) This is especially the case when a company's wireless sensors are transmitting sensitive customer data such as medical conditions. "Data must be processed and acted upon quickly (or else the service would be useless)." data-to-understand-how-your- products-perform <—Max. convenience——'Sweet spot'——Max. privacy—> Only send those data that are absolute- ly necessary for service delivery, as long as user wants the service; users have full control, know which data are being sent and how they are going to be used, and can fully turn off data sending when they want so Data sending on Data sending off Limited or no service IoT value exchange vs. privacy: Or consider the smart connected speakers on offer today: Amazon Echo, Apple HomePod, and Google Home
  68. 68. Give back control to IoT device owners/users • IoT device manufacturers can/should implement micro-client-side policies on IoT devices that users can control (e.g., to set bounding values such as temperature limits, so that deliberate attacks aimed at sending equipment out of limits can be prevented), as well as hardware switches to allow users to physically turn off features such as network and location functions. The latter (hardware switches) would afford a visible indication of the physical state of a connected device (with no need for a software user interface), besides enforcing a local, hardware-controlled form of security that cannot be easily overridden remotely. • Users should not be penalised because of their data sharing choices or to force them to opt-in/turn data sending on. Functions that do not rely on data not shared by users should never be blocked or disabled in any way. Smart connected plants surviving-the-iot-rodeo-helping-users-stay-in-control.html
  69. 69. Privacy and security at the concept (design) stage • While the research was successful at documenting and highlighting the risks associated with IoT deployments in health/care, the industry has somewhat failed to follow and tackle those issues, focusing more on rapid profit generation and usability (user convenience). • Device and service security and user privacy are often addressed as an afterthought, if at all, even though they should be given prominent priority from the very early concept and design stages. • As we rely more and more on the IoT, the above wisdom becomes imperative, not optional. Failing that could cost lives, e.g., self-driving connected cars that get remotely hacked killing passengers and pedestrians, etc. Are we ready?!
  70. 70. Metrics: Measuring and benchmarking smart cities and regions and their impact on happiness and well-being • European Parliament's 2014 report/comparisons: Mapping Smart Cities in the EU • European Smart City Model Version 3.0 (2014) by TU - Vienna University of Technology • OECD Better Life Index and Regional Well-Being: The ultimate outcomes of happiness and well-being can be tricky to measure, but the OECD's approach is quite notable with their Better Life Index, covering the 34 OECD member countries, and their related OECD Regional Well-Being--'How's life where you are?' tool, which covers 362 OECD regions (OECD defines regions as the first tier of sub-national government, e.g., the region of Catalonia in Spain, rather than the city of Barcelona).
  71. 71. Measuring happiness and well-being • OECD is focusing on outputs rather than on the conventional 'raw' system inputs, such as indicators of material wealth and deprivation. • Also focusing on what actually affects outputs. For example, education may help individuals live longer, participate more actively in civic life, commit fewer crimes, rely less on social assistance, and be less affected by unemployment trends. But it is the quality of education that really matters the most when considering the positive effects that education can have on people's lives. Rather than just measuring graduation rates, which while important, tell very little as to the quality of education received, the Better Life Index measures Education as a function of both educational attainment and student skills (the latter are computed from the results of OECD's Programme for International Student Assessment or PISA, and serve as a proxy to quality of education). See these metrics details in: Kamel Boulos MN, Tsouros AD, Holopainen A. 'Social, innovative and smart cities are happy and resilient': insights from the WHO EURO 2014 International Healthy Cities Conference. Int J Health Geogr. 2015 Jan 14; 14(1):3.
  72. 72. Conclusions • IoT-powered smart cities aim at improving the quality of life of their populations in a variety of ways, including through measures that promote eco- friendly, sustainable environments and the delivery of 'connected health/care' services to citizens at home and on the move. • Smart cities and regions stand better chances of becoming healthier cities and regions. The WHO and associated national Healthy Cities networks have hundreds of member cities around the world that could benefit from, and harness the power of, IoT to improve the health and well-being of their local populations. • IoT-powered smart cities rely on a growing number of sub-technologies and subsystems that need to be seamlessly interconnected and interfaced with one another in real time. This can only be achieved through the adoption of adequate standards and protocols for measurement, communication, integration, interoperability and control.
  73. 73. Conclusions • IoT sensors, devices, systems and services generate big amounts of real-time data, much of which are geo-located. The main challenge facing smart cities and smart- cities-to-be is how to make sense and best use of such 'big data', while preserving citizens' privacy and data security. Cities can only be really 'smart' if they have in place the necessary intelligent, robust and reliable analytics functions to integrate and synthesise these big data, and filter out any unwanted 'noise' for the purposes of better planning and managing city operations and systems (including healthcare). • Innovation is key to avoiding collapse and promoting sustainability of large cities and their infrastructures. IoT for cities is a major innovation, able to stimulate other forms of innovation, and in doing so, generate economic value, growth and competitive advantage. • Rural regions should not be left behind! ('distributed city model'/smart countryside)
  74. 74. The fourth industrial revolution is here! Don't miss it H&I! • "The Internet of Things represents the fourth industrial revolution, opening up opportunities for a more enjoyable life and new and better ways of doing business. While IoT will create entirely new business models, innovations will have to come more quickly for companies to stay relevant. To do this, managers need to envision the valuable new opportunities that become possible when the physical world is merged with the virtual world and where potentially every physical object can be both intelligent and networked. Starting now, they must create the organisations and IoT-based business models that can turn these ideas into reality." Third Industrial Revolution (beginning from the late 1950s to the late 1970s): the change from analogue, mechanical and electronic technology to digital technology (start of the 'Information Age'). Second Industrial Revolution (2nd half of the 19th century until World War I): the period from the introduction of Bessemer steel in the 1860s to early factory electrification, mass production and the production line (Ford Model T car in 1908). First Industrial Revolution (2nd half of the 18th century until 1820-1840): the transition to new manufacturing processes, going from hand production methods to machines, with new chemical manufacturing and iron production processes, improved efficiency of water power, increasing use of steam power and the change from wood fuel to coal. --Matthew Jennings, Managing Director, Bosch Software Innovations (2014)
  75. 75. Practical notes: Where and how do we begin • IoT has been abused to "solve problems" that are not really problems, while posing serious security, individual privacy and 'infoglut' challenges, and fuelling rampant consumerism. From connected cars, smart (and camera-fitted) fridges and plants fitted with sensors to smart water bottles, tampons and umbrellas, everyday objects are becoming increasingly connected to the cloud and to apps running on our smartphones, with variable utility and impacts ranging from trivial or 'gimmicky' (no practical value or advantage) to truly transformative results that have the potential of improving the health, well-being and overall quality of life of individuals and whole populations. • To avoid the former and realise the latter, we should always begin with real world problems, exploring and harnessing suitable technologies to solve them, rather than start with the latest technologies, trying to create and enforce unneeded applications of these technologies.
  76. 76. Practical notes: Where and how do we begin • There is much more to (Digital) Health than GP care/acute care (hospitals), telehealthcare/homecare for older people and chronic conditions. There are many smart services that could engage and benefit our communities, while having a direct, positive effect on their health, well-being and overall quality of life, e.g., smart (green and sustainable) environment, smart transport, smart social support, etc. • Putting people first and foremost, and engaging people in the process as creators and decision makers and not as mere service users: Engaging WITH citizens/engaging citizens IN the WHOLE process (active citizen participation), from the design board to service running (even some aspects of service ownership); citizen- centred but also citizen-LED approach: for them and by them, making sure no one (or group) is excluded/left behind, e.g., because of (digital or other forms of) literacy, age, social status, etc. • The European Parliament's report entitled 'Mapping Smart Cities in the EU' analysed a sizeable sample of smart city projects and initiatives across 37 European cities, and identified three key factors for successful smart cities (vision, people and process). These are: (i) the presence of a vision of inclusion and participation to avoid polarisation between urban elite and low income areas; (ii) the presence of inspiring leaders or 'city champions' who are able to foster participative environments, bringing together businesses, the public sector and citizens, with a focus on empowering citizens through active participation to create a sense of ownership and commitment; and (iii) the presence of a sound process, including the creation of a central office acting as go-between diverse stakeholders, open data provision, and various level of coordination and integration mechanisms (central and local) across ideas, initiatives, projects and stakeholders. OECD BLI
  77. 77. Founder & Editor-in-Chief: Maged N. Kamel Boulos (UK) IMPACT FACTOR 3.28 • 2016 Impact Factor 3.282 • 2016 5-Year Impact Factor 3.199 • High-quality content • Covers a wide range of interdisciplinary geospatial topics smarthealthycities