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Towards more Elderly-friendly
Ambient Assisted Cities
The 2nd China-Europe Forum on Smart Healthy Aging and Privacy Protection
(Share2018), June 28th 2018, Beijing, China,
http://www.cybermatics.org/CF2018/Service/program.html
Dr. Diego López-de-Ipiña González-de-Artaza
dipina@deusto.es
http://paginaspersonales.deusto.es/dipina
http://www.morelab.deusto.es
@dipina

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Abstract
Two of the main current challenges faced by society are the growing urbanization and ageing of population.
ICTs play a key role helping us addressing these socioeconomic problems which are paramount for our future
progress. Firstly, this talk will overview the opportunities and strengths brought forward by ICT
democratization in all societal sectors to make cities more age-friendly, sustainable, productive and satisfying
environments. On the other hand, it will also review the weaknesses and threats associated to the increasing
adoption of ICT to face these societal challenges. For instance, it will review the need to capture and process
personal information to offer assistance services and ease decision making in cities, together with the threats
to privacy that personal data management may cause. Several European projects facing the challenges of
Sustainable and Inclusive Cities will be described in order to illustrate the high potential of this idea. Both their
scientific-technological contributions and their economic potential will be overviewed, highlighting the
potential of the Silver Economy – the new market opened to address the progressive societal ageing. Secondly,
this talk will give further details about three core pillars to make reality this idea of more elderly-friendly
ambient assisted cities, namely Internet of Things, Big Data and higher stakeholder participation and
collaboration. Through use cases extracted from European projects, examples of novel personal health devices
connected to Internet, new ways to correlate and process information in order to enhance decision-making and
emerging approaches to make elderly people to have a higher involvement and engagement in aspects
related to personal autonomy and their higher societal involvement will be provided. Finally, the talk will
conclude exemplifying how Spanish administrations are addressing ageing problems through smart healthcare
technologies.

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Context (I)
• Two of the biggest challenges faced by
current society are:
–continuous urbanisation process
–progressive population ageing
• In Spain, 70% population lives in urban
centres, where 18,4% > 65 years

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Context (II)
• Cities are responsible for 70% world’s GDP and 80% of CO2
emissions
– Cities are more efficient environments urbanisation process
• Public spending associated to ageing in Europe (pensions,
health systems, long life caring and learning) is about 20% of
GDP
• Important to conceive and adopt solutions to counter-back
the social and economic effects of urbanisation and ageing in
society
– Solution: technology + social innovation

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Smarter Cities to fight back
Urbanisation & Ageing processes
• Smart City is a place where urban services are
improved in efficiency by applying ICT, for the
benefit of its inhabitants and economic
development
• Smart Territories innovative geographic areas,
able to build their own competitive advantages
taking into account their context
• Smart Places balance among economic
competitiveness, social cohesion, innovative
creativity, democratic governance and
environmental sustainability
– Satisfying the basic and self-fulfilment needs in
the Maslow pyramid

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Challenges for Smarter Cities
• Enable life, work and leisure
environments which allow our self-
fulfilment without disregarding basic
needs and their development in
welfare society
• Answer to the urbanization
demands in a economically feasible,
socially inclusive and sustainable
manner
– BUT… apply traditional solutions to
the needs of urban development 
unsustainable urban ecology
footprint
• Generate more electricity or new
water resources not addressing
inefficiencies in distribution

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ICT as levers of Smarter Cities (I)
• ICTs will help in the urbanization process only if the following
three premises are fulfilled:
1. Social equity
2. Economic feasibility and
3. Environmental sustainability
• ICTs are key to leverage the existing infrastructure and
maximize the socioeconomic throughput
• A more rational and extensive usage of ICT in cities a quicker and
more economic fulfilment of urban challenges

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• Some interesting examples:
– smart meters for water and electricity which, through
technology, reduce leakage and waste and improve
transparency and reliability
– telehealth systems which connect hospitals with remote
facilities for monitoring, diagnosis or training
– smart transport solutions which help to improve efficiency
and usage of air, road, train or sea transport resources
– public security solutions to help preventing, detecting and
answering to security requirements
ICT as levers of Smarter Cities (II)

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ICT as levers of Smarter Cities (III): Big |
Open | Personal Data
• Big potential for enterprises, social entities and governments
if there is a better usage of infrastructure and information
(IoT + Open + Personal data) in urban environments:
– Big Data: extensive analysis of heterogeneous urban data to offer
answers, indicators and visualizations to help improving the decision
criteria upon the challenges of cities and territory management
• It will allow us to progress towards more disruptive
approaches
– All agents should benefit from a more efficient usage of data
processing technology to give place to Urban Analytics
• Great potential but huge difficulty associated!

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ICT as levers of Smarter Cities (IV): Open
Collaboration + Social Innovation
• Smarter environments cannot only be reached through
technological solutions
– We have to take advantage of the huge potential of collective
intelligence and citizenship capacity to generate knowledge through
crowdsourcing techniques (or open distributed collaboration)
• Social Innovation: collaboration of citizenship through new
technologies to co-create knowledge and solutions addressed
to an ample range of social needs through Internet, e.g.:
– Social networks for those that suffer chronic diseases
– Platforms for citizen collaboration
– Open data for transparency and good government linked to public
expenditure

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ICT as levers of Smarter Cities (V):
Ethical Implications
• Personal data are the “new petrol” of XXI century, being exploited by big
corporations such as Google, Apple (publicity + marketing) BUT …
– There are multiple distributed personal data silos among different Internet
providers and institutions which have to be interoperable
– There is a need for individuals to have a greater control of their own personal data
• Governments must:
– Regulate, protect, legislate to guarantee the rights and opportunities of such data
providers (we)
– Legislate and manage non-functional aspects (accessibility – technological
inclusion, privacy, data protection and ethics to achieve responsible technological
solutions  GDPR in Europe
• (Open) Knowledge management is a key to undertake innovation in the
public sector and achieve the implication of private agents for a more fruitful
public-private partnership

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Personal Data
• Defined as "any information
relating to an identified or
identifiable natural person
("data subject")”

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Ageing forecast in Europe for 2060

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• By 2060, 30% of European population will be older than 65
– Negative  smaller active population share will pay taxes to support an
increasing volume of elderly people
– Positive older people want, can and should play a key role in society
• The “Young old” (65-74 years) undertake caring activities (other elderly, children),
take part in family businesses or collaborate in NGOs
– Imperative to use the capabilities and knowledge of elderly people (bigger professional
involvement):
» Promote their desire to improve the community and social services
» Put them in contact with professional associations which demand their knowledge and
contacts to sustain industrial and business processes
– GDP of those countries with strong family links (south of Europe), could be improved if
their non-remunerated voluntary work would be taken into account
• Offer to companies an opportunity to access a growing and lucrative market which
has been termed as Silver Economy
Smarter Cities aware of Elderly
People (I)

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Smarter Cities aware of Elderly
People (II): Silver Economy
• Economic opportunities resulting from public and private expenditure (users+
consumers) associated to population ageing (> 50 years)
– Imperative to promote the innovation for an active and healthy ageing, helped by a network
– Needed promotion of innovation for active and healthy ageing, helped by European Innovation
Partnership on Active and Healthy Ageing (EIP on AHA) or the Active and Assistive Living program
• Some examples of the market opportunities for products and services are:
– Smart houses for independent living
– Devices to monitor personal health
– E-senior tourism
– Autonomous vehicles and assistive robotics
• Digital Social Innovation applied to ageing challenge, brings forward:
– Improve the quality of life for elderly citizens and their carers
– Promotes care systems which are more efficient and sustainable
– Generates new business opportunities and economic growth

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Silver Economy

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Ambient Assisted Cities: Age-
friendly Smart Cities (I)
• WHO (World Health Organization) has acknowledged the convergence of
urbanisation and ageing, coining the concept of “Age-friendly cities”
– promote active ageing optimizing the opportunities for health, participation and
security so that quality of life is improved whilst people age
• ICT, a key factor to ensure ageing in place, within the city, offering solutions in
aspects like:
– Simplified communication and involvement through ICT to be in contact with members
of family and community
– Security systems giving answer to personalised mobile emergencies and fall monitoring
systems to provide confidence to elderly and caregivers.
– Health and welfare through ICT to help elderly people to maintain active and manage
chronic diseases, like diabetes and hearth problems.
– Learning and contributing with innovations to allow that elderly people can keep
reading, learning and keep active in society.

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Ambient Assisted Cities: Age-
friendly Smart Cities (II)
• An Age-friendly city is an inclusive and accessible
urban environment that promotes active ageing
• The main attributes of an Ambient Assisted
(Smarter) City are:
– Livable
– Accessible
– Healthy
– Inclusive
– Participative
[WHO Global Network of Age-friendly Cities]

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What is an Ambient Assisted City?
• A city aware of the special needs of ALL its citizens,
particularly those with disabilities or about to lose
their autonomy:
– Elderly people
• The "Young Old" 65-74
• The "Old" 75-84
• The "Oldest-Old" 85+
– People with disabilities
• Physical
• Sensory (visual, hearing)
• Intellectual

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Smart Health
• Combination of intelligent & networked technologies for
improved health provision
– remedy to rising ageing and per capita healthcare expenditure
• Cure, care and prevent more effectively!!!
• DIAGNOSIS >> MANAGEMENT >> PREDICTION >> PREVENTION
– includes eHealth & mHealth services, electronic record management,
smart home services and intelligent and connected medical devices
• Disruptive technologies like; IoT, Cloud, Big Data Analytics and
Sensing can take us from a reactive illness-driven HealthCare
System to a proactive wellness-driven system
– healthcare services need to be:
• predictive and proactive
• individualized
• decentralized from hospitals to the community and the home

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Smart Health

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Enablers (I): Data Intelligence / Analytics
• Broad Data aggregates data from heterogeneous sources:
– Open Government Data repositories
– User-supplied data through social networks or apps
– Public private sector data or
– End-user private data
• Humongous potential on correlating and analysing Broad
Data in the city context:
– Leverage digital traces left by citizens in their daily interactions with
the city to gain insights about why, how and when they do things
– We can progress from Open City Data to Open Data Knowledge
• Energy saving, improve health monitoring, optimized transport system,
filtering and recommendation of contents and services

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From Open Data to Open Knowledge

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Enablers (II): Internet of Things …
connecting information, people and things

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Trends
in Smart
Personal
Health

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Personal data: SmartWatch & Health-
promoting Data Devices

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Quantified Self & Life
Logging
• Quantified self is self-knowledge through self-tracking with technology
– Movement to incorporate technology into data acquisition on aspects of a
person's daily life in terms of inputs (e.g. food consumed, quality of
surrounding air), states (e.g. mood, arousal, blood oxygen levels), and
performance (mental and physical)
• Self-monitoring and self-sensing through wearable sensors (EEG, ECG, video, etc.)
and wearable computing  lifelogging
• Application areas:
– Health and wellness improvement
– Improve personal or professional productivity
• Products and companies:
– Apple Watch, Fitbit trackers, Withings scale

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EU funded R&D on “8. Health,
demographic change and wellbeing”
• Three types of projects are being funded:
1. Managing your health and care : These projects help patients and
healthcare professionals to manage a certain condition. Or they
preventively help people to stay healthy.
2. Innovate the health and care system and the way it works. This
includes projects which are related to interoperability - meaning the
ability of systems and organizations to work together ('inter-
operate').
3. ICT solutions supporting for active and healthy ageing; this includes
projects funded through the Active and Assisted Living Programme
• Report available at: https://ec.europa.eu/digital-single-
market/en/news/eu-funded-research-and-innovation-field-
ict-health-wellbeing-and-ageing-overview

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EU funded
R&D on “8.
Health,
demographic
change and
wellbeing”

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Managing your health and care projects
• BigO (Big data against childhood Obesity)
– Aims to redefine the way existing obesity-related policy strategies are designed and deployed in
the European societies. It is an Open Platform for:
• The collection of Big Data (e.g., accelerometry, geolocation, food pictures) from school aged children about
their behavioural patterns.
– The BigO data pool will be analysed and combined with various online data (e.g., maps, registries and GIS) in order to
extract information on the local environment of the children.
• The creation of comprehensive models of the obesity prevalence dependence matrix through the
association of the local environment, community behavioural patterns and local obesity prevalences.
• The real-time visualisation of the system outcomes allowing evaluation of behavioural risk factor profiles
and comparison with other individuals and populations.
• The Public Health Authorities to evaluate their communities based on their stratified obesity prevalence
risk, to plan health policies against obesity, to predict their efficiency in specific communities
H2020 project
12/2016 -
11/2020
https://bigoprogram.eu/about-bigo/

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ICT solutions supporting active and
healthy ageing
• City4Age: Elderly-friendly City services for active and healthy ageing
– Aims to act as a bridge between the European Innovation Partnerships (EIP) on
Smart Cities and Communities & Active and Healthy Ageing (EIP AHA)
– Demonstrate that Cities play a pivotal role in the unobtrusive collection of “more
data”and with “increased frequency” for comprehending individual behaviours
and improving the early detection of risks
H2020 project
2016-2018, PHC 21
http://www.city4ageproject.eu/

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eHealth in the Basque Country,
SPAIN
• In Spain, healthcare professionals cannot
access or share EPR on a national level, each
region uses a different system
• In the Basque Country:
– Osabide Basque EPR model used across 21
hospitals and 300 health facilities
– Apps to enable physicians and patients to access
medical records
– Devices for Teleassistance

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Towards more Elderly-friendly
Ambient Assisted Cities
The 2nd China-Europe Forum on Smart Healthy Aging and Privacy Protection
(Share2018), June 28th 2018, Beijing, China,
http://www.cybermatics.org/CF2018/Service/program.html
Dr. Diego López-de-Ipiña González-de-Artaza
dipina@deusto.es
http://paginaspersonales.deusto.es/dipina
http://www.morelab.deusto.es
@dipina