CHAPTER 1

 
 
 
 
 
 
INTRODUCTION
1.1 Aim
The aim will identify and analysis the Impact of Artificial Intelligence on Smart Cities for Smart Decision-Making for Healthcare sector.
 
1.2. General Introduction
Artificial intelligence technology is becoming more popular and is widely used by the majority of health care facilities around the world. However, the adoption of this technology has been slow and gradual and has only picked momentum in recent years. Artificial intelligence was first introduced in health care in the late 1950s (Greenhill and Edmunds, 2020). During that time, there were many limitations and hence, the AI technology was not as effective as it is today. Some of the challenges were; lack of proper training programs on how the AI systems work; the high cost of installing the AI systems; limited technology that could help the health care providers to properly incorporate the AI systems in their services. In recent years, the majority of health facilities have overcome these challenges. Today, more than 50% of health care facilities in the world have adopted AI systems which have helped to improve operational efficiency, enhanced precise medication, predict clinical outcomes and also reduce the workload among the health care providers (Park et al., 2019). However, AI systems are more common in European countries than in African countries. As it stands, the majority of hospitals in Africa have poor infrastructure that does not permit the full implementation of artificial intelligence systems.
 
This project aims to analyse how the impact of artificial intelligence systems on smart cities for smart decision making in health cares. However, the main emphasis will be on countries in the Gulf Co-operation Council (GCC). As Yeasmin (2019) states, the majority of countries in the Gulf Co-operation Council (GCC) including Dubai, Saudi Arabia, the United Arab Emirates, Oman, and Kuwait have started to develop smart cities. These countries are using data and technology to create economic development, improve sustainability and enhance the quality of life for their people. Therefore, this research will evaluate how the GCC members can implement artificial development in their health care systems to increase the quality of treatment, diagnose diseases and improve clinical decision making. The main motivation of this research is that AI systems can be used in health care systems to obtain insights into clinical practice, improve feedback of clinical practices and also reduce therapeutic errors in medical delivery.
1.3. Research Questions
the research questions are one of the main pieces of your exploration venture, theory or exposition. It’s critical to invest some energy surveying and refining your inquiry before you begin. The specific type of your inquiry will rely upon the length of your venture, the sort of examination, the subject, and the exploration issue. Be that as it may, all exploration questions should be engaged, explicit, suitably mind boggling, and applicable to a social or academic issue.
The examination inquiries for this study are:

• Explain how artificial intelligence in smart cities will lead to improved decision-making in the health care sector.
• What role can AI play in transforming current Healthcare to the Smart-Healthcare status?
• What are the roles of AI in the creation of smart cities?
• What will be the impact of introducing AI systems in GCC health systems?
• How will patients benefit from AI services in GCC countries?
• How will AI systems help to improve health care services in GCC countries?

1.4. Research Objectives
Artificial intelligence and some of its related technologies have become very prevalent, especially in the business sector, and their application in the health care sector has also started to increase. Artificial intelligence technologies have a great potential of changing different features and techniques of patient care and the health care facility management process. For instance, these technologies can be to establish a smarter health care framework that has powerful deep learning algorithms that are able to analyze the massive amount of health data provided by the health care sector. In this research, I will explain how artificial intelligence in smart cities will lead to improved decision-making in the health care sector as well as evaluate if artificial intelligence in smart cities has any benefits to the health care sector. Establishing the smart health care sector within the smart cities in the GCC will enable big data analytics using intelligent health care servers that will enable the care practitioners to have access to an enhanced sustainable health care system.
This research has two main objectives, which are:

• To determine the exact impact of introducing AI in GCC health systems.
• To analyze how patients will benefit from AI in GCC countries
• To examine how the AI will improve health care services in GCC countries
• Identify the impact of Artificial Intelligence on Smart Cities

1.5. Significance of the Study
Despite artificial intelligence being a popular concept, most health care professionals including nurses and doctors have little knowledge of the AI systems and their applicability in health care environments. Therefore, this research will build on the existing knowledge about AI and help health care professionals to understand its importance, use, and how it can be used to improve medical services. On the other hand, patients also have very little knowledge about artificial intelligence. To make matters worse, most patients in different health organizations have little knowledge about this technology. Therefore, this research aims to shed light on the effectiveness of AI in enhancing patient care. This will help the patients to embrace its usability in health organizations. Lastly, this research will also help contribute towards GCC’s goal of establishing smart cities. It will provide knowledge and insight to the doctors on they can improve medical services in their cities and create sustainable societies through effective and efficient medical services.
1.5.1. Managerial Relevance
This research is also effective for managers. First, the study of artificial intelligence helps managers to understand the effectiveness of interoperability in their operations. Artificial intelligence facilitates interoperability since the medical personnel can share the patients’ information, analyze it and provide the best medical decision that will help the patient (s) to recover. Similarly, managers can also use this insight to promote interoperability in their operations by allowing their employees to share ideas and thoughts that would improve the services of their companies. On the other hand, artificial intelligence also facilitates doctor-patient conversations. Through technologies such as electronic health, health care providers can communicate with their patients and discuss the health of their patients. Similarly, managers can use this knowledge to enhance or improve their interaction with their employees to help them either improve their performance or minimize their weaknesses.
1.5.2. Scientific Relevance / Scientific implications
Various researches have been undertaken regarding the effectiveness of artificial intelligence in various sectors including health. Therefore, this research will provide additional information that will build on the current knowledge of AI applicability in health care. It will provide knowledge and information on how AI is used to benefit patients, improve medical decisions and also support the health of patients. Therefore, the research will be useful for people that have limited knowledge about the usefulness of AI in health care.
 
 

CHAPTER 2

 
 
REVIEW OF LITERATURE

2. This chapter present and define theories relevant to the thesis’ research problem. The presented literature has the intent to form a literature review for the thesis topic, and to be able to conduct this research the author has focused the study on theories surrounding the areas of technology and Smart Cities. The thesis includes, more specifically, (1) AI, (2) Smart Cities and (3) the Smart Decision-Making and (4) Smart Healthcare.

The order of the subchapters has also been specifically decided by the authors. To be able to answer the research questions, there first needs to be an understanding of the technology used. This is to grasp its areas of use, its potential, and the opportunities that arise with its introduction. An understanding of Smart cities, and Smart Decision-Making and (4) Smart Healthcare. Combining the knowledge gained from these subchapters should be sufficient to give the reader the necessary tools to reflect over the results reached in the thesis and also enable them to draw their own conclusions.
2.1. Artificial intelligence
Artificial intelligence can be characterized in numerous ways. As “the hypothesis and improvement of PC frameworks ready to perform assignments typically requiring human knowledge” as well as Merriam-Websters (2018) definition represented “the ability of a machine to emulate shrewd human conduct”. In view of these definitions, the idea of AI alludes to the prologue to making machines think and go about as people, making it feasible for the machines to perform human undertakings and adjust to or associate with its general climate. Nonetheless, it is essential to take note of that what we call AI changes with time as innovation propels. At the point when certain AI advances become profoundly available to us, it is underestimated and not called AI any longer. This is on the grounds that the term AI is seen as a future innovation. A portion of the objectives of AI is picking up, thinking and discernment. Utilizing these qualities empowers AI to justify and make moves towards the most elevated likelihood of accomplishing its objective (Frankenfield, 2020). The previously mentioned qualities gives AI gigantic potential with respect to critical thinking. With the capacity to think and go about as people, tackling issues that individuals do becomes available to AI. A portion of the benefits of AI taking care of issues rather than people, could be the end of human blunder, yet in addition the mind boggling speed at which it can work. While our organic neurons work at around 200 Hz, current chip can work at a ludicrous speed of 2,000,000,000 Hz, or to place as such, 10 million times quicker than our natural neurons (Paasschen, 2017). To comprehend the power and potential in critical thinking by AI contrasted with people, a correlation between AI’s capacities to individuals’ capacities in regards to complex prepackaged games is fascinating to do. A genuine model is the Chinese prepackaged game ‘Go’. Go is accepted to be over 2500 years of age and gets going with two players who take turn putting stones on a board, one player has white stones while different has dark stones and the target of the game is to cover bigger regions with your stones to gather focuses. Albeit the standards of the game are fundamental, it’s a very mind-boggling game because of the quantity of potential moves that can be performed. In chess for example, the player taking the initial action has the chance of taking 20 different opening actions. In Go, the comparing number of moves is 361 (Britgo.org, 2019). Google have fostered an AI program ready to play the game Go, called AlphaGo. AlphaGo concentrated on the playbook of Go and shown itself how to play the game. In the fall of 2015, AlphaGo confronted the current European boss of Go in a progression of five games. This brought about AlphaGo winning each of the five out of five games. About a year after the fact, a changed version of AlphaGo, called AlphaGo Master, played 60 games against various expert Go players. This came about in a surprising 60 out of 60 successes. This shows obviously the tremendous capability of AI contrasted with people with regards to tackling complex issues, prompting the contention that the execution of AI can be utilized to perform human assignments, yet additionally improving (DeepMind, 2019). To totally get a handle on how AI empowers PCs and machines to think like people and perform various kinds of errands, there are two terms that we want to get to know. Those are AI and profound realizing, which are subsets of AI, as shown by figure 1 underneath. The two ideas are introduced in the forthcoming subchapter.
Figure 1: Venn diagram representing the relation between AI, machine learning and deep learning (Mateis, 2018, pp.1).
 
2.2. Smart Cities
A Smart city is an innovatively present-day metropolitan region that utilizes various kinds of electronic techniques, voice actuation strategies and sensors to gather explicit information. Data acquired from that information is utilized to oversee resources, assets and administrations effectively; consequently, that information is utilized to further develop tasks across the city. This incorporates information gathered from residents, gadgets, structures and resources that is handled and dissected to screen and oversee traffic and transportation frameworks, power plants, utilities, water supply organizations, squander, wrongdoing recognition, information systems, schools, libraries, hospitals, and other community services. Smart cities are defined as smart both in the ways in which their governments harness technology as well as in how they monitor, analyze, plan, and govern the city (Susan Fourtané).
 
The Smart City idea coordinates data and correspondence innovation (‘ICT’), and different actual gadgets associated with the Internet of things (‘IoT’) organization to advance the effectiveness of city tasks and administrations and interface with citizens.  Smart City innovation permits city authorities to communicate straightforwardly with both local area and city framework and to screen what’s going on in the city and how the city is developing. ICT is utilized to improve quality, execution and intelligence of metropolitan administrations, to diminish expenses and asset utilization and to increment contact among residents and government. Smart City applications are created to oversee metropolitan streams and consider ongoing responses. A shrewd City may along these lines be readier to answer difficulties than one with a traditional “value-based” relationship with its citizens. Yet, the actual term stays muddled in its particulars and subsequently, open to numerous interpretations.
 
2.3. Smart Decision-Making
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2.4. The impact of introducing artificial intelligence in GCC healthcare systems
2.4.1. Enhancing interoperability
Interoperability is a crucial aspect in almost all sectors. However, it is more important in a health care organization because it helps the health care providers to share and discuss patients’ data and information with a view of providing a solution. In most health care organizations, Greenhill and Edmunds (2020) state that interoperability helps health care providers to analyze big data related to the patients. Nowadays, interoperability enables patients to access medical services from different health organizations with ease. In the Gulf Operation Council (GCC), there is a growing interest in fully implementing artificial intelligence in their health care systems. According to Ahuja (2019), 50% of their strategic initiatives are centered around AI and data analytics solutions. Therefore, if these initiatives are passed, they will have a positive impact on their health care systems. The first impact of AI in GCC health is to improve medical interoperability. As Gilvary et al. (2019) state, AI technologies like Electronic Health Records (EHR) and telehealth help medical providers to share and analyze big data in hospitals. It allows the doctors and the nurses to collect and share patient data and analyze it to provide the best medical decisions. If GCC countries implement artificial intelligence, it will be easy for doctors to collect real-time information from patients regardless of where they live. Electronic Health Record (EHR) is a medical technology that allows doctors to communicate with patients through a network. This will help the medical providers in GCC countries to collect medical data and statistics of their patients (Park et al., 2019). Therefore, it will be easy for doctors and nurses to share this information and make a decision about disease prevalence in the country. Countries in the GCC will then decide on how to set up initiatives to deal with diseases that may be prevalent such as cancer, diabetes, or blood pressure. However, this will depend on information collected from electronic health records intelligence systems. Information interoperability in GCC countries has been stagnant between 2015 to 2017 (Yeasmin, 2019). This trend has been limiting the ability of GCC countries to collect real-time data about disease prevalence in their countries and the initiatives that these countries could take to deal with disease prevalence. However, Becker (2019) states that AI enables medical facilities to share 75% of medical information, a key factor that will help to improve medical services in GCC countries.
2.5. How patients will benefit from AI implementation
2.5.1. Improved medical diagnostics
Patients in GCC countries will be the first beneficiaries of AI implementation. The first benefit will be through better medical facilities and procedures that will be available through AI systems. As Buch, Ahmed, and Maruthappu (2018) note, AI systems are crucial in medical diagnostics. With the full implementation of AI systems in GCC countries, it will be easy for health care professionals to scan the patients and determine the exact diseases they are suffering from. This will enable the medical providers to provide the exact treatment that the patients may need. Traditionally, health care providers performed almost all tasks including surgeries (Becker, 2019). But with AI implementation, surgical robots are used to perform 3% of surgical operations. Robots are fast, efficient, and effective and they have zero medical errors. Therefore, patients in GCC countries will experience improved medical care if AI is fully implemented in their health care systems. On the other hand, AI is used to provide real-time data that will help to improve the relationship between patients and doctors in GCC countries. By using AI systems such as EHR, doctors can get real-time data from their patients. Getting real-time data from the patients helps the health care providers to step up their preventive measures and saves the patients’ costs of directly traveling to their respective medical facilities (Ahuja, 2019). This means that AI introduction in GCC countries will directly improve the medical access to millions of patients in the country and will save them the expenses of traveling to their respective health facilities. On the other hand, AI intelligence can also help medical personnel to detect the level of seriousness of patients’ illnesses. The use of X-ray images can help medical providers to determine the extent of diseases such as cancer in patients’ bodies. Therefore, it improves medical services since such patients are placed in emergency medical units. In GCC countries, telehealth solutions will help to reduce patients’ death. As Kulkarni et al. (2020) note, telehealth helps to track the progress of the patients to determine if they are in dangerous situations. Therefore, it will help the health care providers to make a clinical decision regarding patients who may be discharged or those who may need specialized care. Therefore, it is clear that patients will benefit a lot of GCC countries will resolve to fully implement their health systems using the AI technology.
2.6. How the AI will improve health care services in GCC countries

2.6.1 AI will help to reduce medical costs

Currently, GCC countries spent almost $200 on health care (Briganti and Moine, 2020). This cost includes the daily expenses that patients incur when they travel to health facilities to receive medication. Additionally, not all people have the capacity to travel to medical facilities since some of them live in poverty. However, full implementation of AI services will help to resolve this situation. As Kulkarni et al. (2020) state, the AI telehealth solution with the help of Electronic Health Records (EHR) and electronic billing will help patients to access medical services without physically visiting health care centers in non-serious cases. Furthermore, it will also allow the GCC countries to de-conges health care facilities because less serious patients will receive medical support from their homes. Therefore, all these factors will help to improve the quality of services in GCC countries. Furthermore, Amisha, Pathania, and Rathaur (2019) also note that AI helps to reduce medical errors in health facilities. The majority of health care providers often make mistakes due to insufficient medical information. However, AI tools will help the medical personnel in GCC countries to get real-time data of what the patients will be suffering from. Furthermore, AI tools like robotics will also help in medical procedures, thereby reducing the likelihood of medical errors from health care personnel (Mintz and Brodie, 2019). Generally, AI will help patients to cut their budgets, and GCC countries will also reduce their expenditure in treating patients with serious medical cases since telehealth will have helped to diagnose such diseases before they occur.

2.6.2 AI will improve the security of patient records

The notion of creating ‘smart cities’ cannot exist without enhancing the security of patient records. Many health care facilities find it challenging to enhance the security of patients’ data due to constant attacks from hackers. The rate at which patient information is stolen or breached is high. In the US, almost 40% of patients’ data is usually hacked, and sensitive information was stolen by cybercriminals (Holzinger et al., 2019). Therefore, the majority of patients usually become reluctant to give their information due to the fear of cyber-attacks. Although, the majority of countries are boasting of creating or having ‘smart cities, the existence of cybercriminals derails the chance of creating sustainability in health care.
GCC countries are expected to see an increase in cyber-attack cases in the next few years. Since 2018, the rate of cybercrime among GCC countries has grown by more than 22.5% and various sectors such as health care are paying the heaviest price (Amisha, Pathania, and Rathaur, 2019). However, some of these attacks are state-sponsored and therefore, they are sometimes difficult to control. However, the use of AI can help to minimize the severity of cyber-attacks in the health care systems of GCC countries. Artificial intelligence systems help clinicians to monitor patients’ data in real-time and hence, reduce the chances of cyber-attacks. As Hamet and Tremblay (2017) state, AI helps to keep tabs on everything that happens in the health care systems and therefore, helps to identify and stop any malicious behavior. For GCC countries, AI systems will be crucial if the countries in this coalition are to achieve ‘smart health care’ goals. They will need to be vigilant with patients’ data and information. The use of AI will boost their chances of maintaining the integrity of patients’ information (Mintz and Brodie, 2019). The use of AI systems helps to neutralize all the threats from cyber-attacks by preventing phishing, an initial point where the cyber-attacks take place.
For the patients, this will be a welcomed opportunity as they will feel safe and will also trust the medical providers who will be handling their data.

2.6.3 AI will help to improve the clinical decision support

Traditionally, the majority of health care providers suffered from heavy workloads. They performed almost all health care operations. Nowadays, the issue of big data analysis still exists. Daily, health care facilities often receive millions of patients (Buch, Ahmed, and Maruthappu, 2018). Sometimes, it becomes difficult for health care providers to handle all the patients at a time. However, the implementation of AI systems has helped to reduce the workload on health care professionals. For example, the EHR systems always keep the patient information once. However, when they visit again, the nurses or doctors only need to enter the clients’ names and all the patients’ information appears. On the other hand, AI systems are also used to monitor important activities such as lab tests. They help the health care providers to determine if the patients are available or not. If they are not available, it becomes easier for health care providers to communicate directly with their clients (Gilvary et al., 2019). Therefore, AI has simplified operations in health care and they often help medical providers to make decisions. This allows the nurses or doctors to have lesser workloads and concentrate on the most important matters.
In GCC countries, AI systems will help nurses and doctors to make clinical decisions. The majority of health facilities in GCC countries are usually overloaded with patients and therefore, the implementation of the AI systems will help to reduce the workload on existing health care providers. Furthermore, the AI will help the doctors and nurses to make correct decisions regarding the patients’ medical schedules and their specific medication. Briganti and Moine (2020) note that AI technology will not only improve health care services but will also improve patients’ satisfaction rates. Therefore, GGCC countries should move fast and enact policies that will allow full implementation of AI in their health facilities.
2.7. Hypothesis

2.7.1 The use of AI systems will improve the quality of service in GCC countries

In this hypothesis, it is assumed that all the GCC countries will adopt the policy of AI implementation, and all the health care facilities in selected countries have the knowledge and expertise in using the AI tools. Therefore, it is expected that all the health care facilities will experience the same medical outcomes. First, it is assumed that the clinicians will be willing to use the AI tools to share the patients’ data and information and hence, facilitate the interoperability of patients’ data. On the other hand, it is also assumed that the health care providers will use the AI tools like the Electronic Health Record (EHR) to communicate with patients to get real-time data about their health conditions and help them to get proper medical procedures. Furthermore, it is also assumed that patients’ will be willing to co-operate with health care providers and also provide the correct information that would help medical providers to administer proper medication. Lastly, it is also assumed that health care providers will properly use the AI tools to improve the medical diagnostic and also ensure that the integrity and security of patients’ data are maintained.
 
 
 
 
 

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SAMPLE ANNEXURE

References

Ahuja, A. S. (2019). The impact of artificial intelligence in medicine on the future role of the physician. PeerJ, 7, e7702.
 
Amisha, P. M., Pathania, M., & Rathaur, V. K. (2019). Overview of artificial intelligence in medicine. Journal of family medicine and primary care, 8(7), 2328.
 
Becker, A. (2019). Artificial intelligence in medicine: What is it doing for us today?. Health Policy and Technology, 8(2), 198-205.
 
Briganti, G., & Le Moine, O. (2020). Artificial intelligence in medicine: today and tomorrow. Frontiers in medicine, 7, 27.
 
Buch, V. H., Ahmed, I., & Maruthappu, M. (2018). Artificial intelligence in medicine: current trends and future possibilities. British Journal of General Practice, 68(668), 143-144.
 
Gilvary, C., Madhukar, N., Elkhader, J., & Elemento, O. (2019). The missing pieces of artificial intelligence in medicine. Trends in pharmacological sciences, 40(8), 555-564.
 
Greenhill, A. T., & Edmunds, B. R. (2020). A primer of artificial intelligence in medicine. Techniques and Innovations in Gastrointestinal Endoscopy, 22(2), 85-89.
 
Hamet, P., & Tremblay, J. (2017). Artificial intelligence in medicine. Metabolism, 69, S36-S40.
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Mintz, Y., & Brodie, R. (2019). Introduction to artificial intelligence in medicine. Minimally Invasive Therapy & Allied Technologies, 28(2), 73-81.
 
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