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Over recent years, there has been a lot of interest in the potential impact of ideas contained within digital concepts including smart community. A utopian discourse has emerged that outline digital technology solutions to a host of twenty first century economic and social challenges (Tapscott and Williams 2008; Broy, Cengarle and Geisberger, 2012; Mesko 2013). Tapscott and Williams claim that mass collaboration changes how we do everything. Broy et al focus their optimism on cyber physical systems stating that they could be as revolutionary as the internet. Mesko’s utopian stance is specifically about healthcare, he describes a future where patients will soon be able to measure any health parameter at home, something he argues will disrupt healthcare.
This literature review article engages with one corner of this wider discourse, the potential contribution of the smart community concept to improving healthcare efficiency. The paper has two aims. The first is to create a current definition for the concept of smart community in the context of healthcare efficiency. The second is to apply this definition to discourse about improving healthcare efficiency.
By efficiency I mean costs in relation to the quality of service provision. This definition is informed by healthcare research (Palmer and Torgerson, 1999). Palmer and Torgersen state that efficiency is concerned with the relation between resource inputs and outputs, with outputs including both quality of life and life expectancy. The criteria is similar to the notion of QALY (quality, adjusted, life year) often used in health economics research. In terms of healthcare, I am looking at the wider system that includes prevention and mental health as well as treatment in hospitals. Specific technologies considered in this paper are artificial intelligence, monitoring devices and internet forums. The core focus of this article is however not on technologies but how changes related to smart community might be able to improve efficiency by changing the relationship between patients, other community members and healthcare professionals. In later sections I will explain how smart community ideas may change these relationships and what impact these changes might have.
Contribution to Theory
The academic contribution of this article is to map the evolution of the concept of smart community and by doing so to create a contemporary definition for it in the context of healthcare efficiency. This is needed due the paucity of academic smart community literature applied to healthcare efficiency, there is no clear current definition of the smart community concept in this context. By creating a new definition based on the evolution of the smart community concept I have made a contribution to theory.
My assertion that there is a paucity of smart community literature is supported by research (Xia & Ma, 2011; Granier &Kudo 2016; Michelucci & De Marco 2016; Grotherr et al 2020). Xia and Ma make this point directly when they state that further research is needed into the lifecycle of a smart community. Grotherr et al connect this to practice when they argue that knowledge of how to build smart communities is scarce.
One of the complications of mapping the evolution of smart communities is that it is a concept that is intertwined with similar terms that all have inconsistent definitions. Smart city for example is a term often associated with smart community. Like the concept of smart community, smart city is nebulous and has undefined theory (Harrison & Donnelly, 2011; Chourabi et al, 2012; Goodspeed, 2014; Tok et al, 2014; Albino et al 2015).
Goodspeed (2014, p89) argues that:
scholarly literature on smart cities contains a confusing jumble of theory and a lack of historical perspective.
Because of the interconnectedness of concepts, this review goes beyond simply looking at literature that uses the term smart community. For clarity, most of the discussion about connected terminology is given in the related concepts section, due to the porous nature of digital terms however it was not possible to confine all references to them in that section. As smart cities is the most directly connected concept it is the one that emerges most frequently. Zhang et al (2019) state that studying smart communities will enrich our understanding of smart city projects, their assertion implies the two concepts cannot be studied entirely in isolation.