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April 28, 2017 1:57 PMCategory: Health Equity

Creating Healthier and Smarter Cities: Connecting Cities and Healthcare through Patient Engagement

This article was published in APA’s Technology Division newsletter.

We present a novel collaborative strategy for rethinking citizen engagement at the intersection of planning and healthcare.

Citizen engagement has been always challenging for planning organizations due to various considerations, including the organizations’ limited resources or the citizens’ lack of interest in participation. This challenge still exist even in the era of smart cities when organizations and citizens are commonly using new technologies to facilitate collaboration (Afzalan & Evans-Cowley, 2015).

New communication technologies (e.g. online participatory tools and social media) can greatly help the planning organizations by providing more accessible engagement opportunities for citizens and ready-to-use data for planners. On the other hand, they may create challenges. For example, cities and planning organizations may not be ready for big data analysis or may not be fully aware of ethical and privacy issues of engaging citizens through online technologies (Afzalan, 2015).

To deal with this complexity, cities need to find partners to help them with this challenging and time consuming process through inter-organizational collaborations. In this essay, we suggest a framework for connecting ideas of citizen engagement and patient engagement to discuss how cities and healthcare organizations can collaborate on a joint mission: creating healthier communities.

We suggest the development of a participatory GIS application to facilitate the communication between healthcare organizations and cities. The web-GIS application would allow patients to share their ideas, likes, and dislikes about their neighborhood by creating comments on a map, when they are waiting for their doctor visit.

The application could also display other place-based information for the doctor, such as neighborhood walkability, crime rate, pollution, noise level, or demography.

The comments gathered from patients could be used by their primary care doctor to explore whether and how the environmental factors may be related to patients’ health.

For example, air pollution may be the culprit that frequently sends a patient with asthma to the emergency room even if they take their medication. Understanding this geographic based information is important for a physician in order to provide more targeted advice. Ultimately the physician and patient would like to move upstream and mitigate this air pollution in the first place. That is generally beyond the scope of what the healthcare organization can do and requires going to the city or county. A web-GIS tool would allow information gathered from patients to be shared in a de-identified way with the city to incorporate into their decision making process.

If many residents of a particular neighborhood are affected by asthma, the city can use this information to come up with feasible strategies to respond to the issue. The webGIS application helps the doctors, the hospital administrators, and the planners make decisions that will positively impact community health. While the hospitals will benefit from this process by learning more about patients’ living environment (Macintyre et al., 2002), they will be a great collaborator in helping cities create healthier neighborhoods.


Afzalan, N. 2015. “Participatory Plan Making: Whether and How Online Participatory Tools Are Useful.” Doctoral thesis.

Afzalan, N., & Evans-Cowley, J. 2015. “Planning and Social Media: Facebook for Planning at the Neighbourhood Scale.” Planning Practice & Research 30(3), 270–285.

Macintyre, S., Ellaway, A., & Cummins, S. 2002. “Place effects on health: how can we conceptualise, operationalise and measure them?” Social Science & Medicine 55(1), 125-139.

Nader Afzalan, PhD, Chair, American Planning Association-Technology Division, Visiting Assistant Professor, University of Redlands

Chethan Sarabu, MD, Clinical Informatics Fellow, Stanford Medicine, Pediatrician


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