The Methods and Challenges of Managing a Smart Health Program during the COVID-19 Pandemic in Thailand

Abstract

A smart health city creates a healthy environment. Since the end of 2019, the coronavirus pandemic has increased the number of sick patients around the world, and many government services have been enacted to treat patients with distance therapy. Therefore, many countries are using smart health technology as one tool to address coronavirus. In this article, we present how cities can implement and manage smart health technology in response to the coronavirus. In addition, we present the challenges in implementing smart health technology as a tool for solving the coronavirus problem. We found that the Internet of Things is a concept to drive smart health programs, and governments and municipalities should develop innovative strategies for deploying emerging technologies in health information technology (health IT) to enhance the quality, accuracy, efficiency, and availability of health care while reducing costs. However, some of the challenges of smart health cities are that medical staff must change the work culture by using more technology, the cost of providing accessibility to emerging technologies in aspects of government investment, and equal opportunities to access technology.

Full text

The International Journal of Interdisciplinary Global Studies
ISSN: 2324-755X (Print), ISSN: 2324-7568 (Online)
Volume 18, Issue 2, 2023
https://doi.org/10.18848/2324-755X/CGP/v18i02/99-114 The Methods and Challenges of Managing a
Smart Health Program during the COVID-19
Pandemic in Thailand
Akkakorn Chaiyapong, Suratthani Rajabhat University, Thailand
Sakda Wattatham, Office of the Chief Justice, Region I, Thailand
Thongphon Promsaka Na Sakolnakorn, Silpakorn University, Thailand
Received:
01/16/2023;
Accepted:
05/19/2023;
Published:
07/18/2023Abstract: A smart health city creates a healthy environment. Since the end of 2019, the coronavirus
pandemic has increased the number of sick patients around the world, and many government services have
been enacted to treat patients with distance therapy. Therefore, many countries are using smart health
technology as one tool to address coronavirus. In this article, we present how cities can implement and
manage smart health technology in response to the coronavirus. In addition, we present the challenges in
implementing smart health technology as a tool for solving the coronavirus problem. We found that the
Internet of Things is a concept to drive smart health programs, and governments and municipalities should
develop innovative strategies for deploying emerging technologies in health information technology
(health IT) to enhance the quality, accuracy, efficiency, and availability of health care while reducing costs.
However, some of the challenges of smart health cities are that medical staff must change the work culture
by using more technology, the cost of providing accessibility to emerging technologies in aspects of
government investment, and equal opportunities to access technology.
Keywords: Management, Challenges, COVID-19, Pandemic, Smart Healthy
Introduction
A healthy city means one that facilitates the creation of a state of happiness among the
population in both aspects of physical and mental health; in addition, urban populations are
physically and mentally happy in the context of their well-being. Healthy cities are those that
continually create and improve the physical and social environment and strengthen the
community’s resources, enabling people to support each other in the fulfillment of all the
functions of life and to achieve their maximum potential (Turnwald and Crum 2018;
Ruenpakpoj, Aim-Im-Tham, and Promsaka Na Sakolnakorn 2020). In addition, healthy cities
must emphasize the need to address inequality in health and urban poverty; the needs of
vulnerable groups; participatory governance; planning and healthy urban design; and the
social, economic, and environmental determinants of health (Kickbusch and Behrendt 2013).
In addition, as healthy cities become important to urban development around the world,
they aim to create a health-supportive environment, to achieve a good quality of life, to
provide basic sanitation and hygiene needs, and to supply access to health care. In addition,
healthy cities foster health and well-being through governance, empowerment, and
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participation, creating urban places for equity and community prosperity and investing in
people for a peaceful planet (WHO 2018).
Many cities in the world face major challenges in creating healthier urban environments,
with major obstacles including more pollution, road traffic, and health inequalities (Smith
2019). To create healthy cities, information and communication technologies (ICT) have
been widely adopted in the healthcare environment to make healthcare access and delivery
easier and more cost-effective (Haluza and Jungwirth 2014; Zeadally et al. 2019). A smart
healthy city aims to cover human health, the well-being of the physical, economic, and social
environment, and to provide happiness, good health, and well-being for the people. Smart
healthy is a concept outside the traditional healthcare system that encourages disease
prevention and full well-being in the city (Ruenpakpoj, Aim-Im-Tham, and Promsaka Na
Sakolnakorn 2020), by increasing the technology and data for governments to manage
citizens’ health proactively, thereby changing the way health care is delivered (Jagota 2018).
In addition, the healthcare industry has to adapt to the digital world due to the influence
of global change. In particular, the COVID-19 pandemic has been an important turning point
driving consumers and organizations to adapt and learn different technologies in order to
adhere to medical treatment and comply with social distancing measures. The medical
community must be at the forefront of robotics and automation remote operations
(telemedicine), including online counseling (video conferencing), the inevitable fight against
COVID-19, and so on. With the development of these technologies, the result will be a more
effective treatment of diseases. The COVID-19 pandemic has been rapidly spreading and
affecting many people around the world and has been the most violent and phenomenal
outbreak in recent years. Therefore, many countries are eager to apply new technologies or
cutting-edge innovations in medicine to enhance their capabilities and solve the crisis. As
mentioned earlier, in this article, we aim to present smart health cities as well as their
management and challenges in Thailand during the 2019 coronavirus crisis.
Smart Healthy Cities
“Healthy cities” refers to the use of innovations and technological resources in urban
infrastructure and local services to solve urban health problems based on the principles of
primary health care, health promotion, and health for all (Alves 2019). Electronic health (e-
health) is the contribution of ICT implementation in the healthcare industry, and the e-health
concept helps increase efficiency and reduce medical costs (Mamra et al. 2017). In addition, the
convergence of technology creates a vast range of opportunities in the healthcare sector,
particularly for those affected by chronic conditions who could access medical information, be
constantly connected with a network of formal and informal caregivers, and benefit from
clinical monitoring tools (Nollo et al. 2015). With emerging technologies such as artificial
intelligence, Generation 5 data networks (5G), and smart cameras, innovative strategies and
designs can address healthcare problems. The data also allows city services to respond promptly
to urgent health needs and to make decisions to avoid situations of poor health. The
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combination of intelligent solutions and real-time data access is proving to be a significant force
for healthcare professionals. Patient care will improve, and residents will stay out of hospitals,
living healthier lives. In addition, virtual health enables easy access to a doctor for diagnosis,
remote monitoring, care coordination, and occupational health (Burton 2020).
The key role for smart technology in smart healthy cities is to provide support and
incentives for various stakeholders to collaborate in the provision of integrated care. There
are many factors or parts to this role, including the following: data protection and regulatory
compliance guidelines in line with technological innovation; leveraging of existing
information technology (IT) capabilities and good practices in the IT ecosystem;
collaboration in the IT ecosystem to improve usability, data interoperability, standardization
of information, and IT competency in the new technologies; involvement of health- and
social care professionals and informed citizens in the organizational change and service
design; planned interventions and production of services based on health, environmental,
and social data; and a multidisciplinary system, involving a wide range of social sectors and
actors that have in common the aim of preventing disease and frailty (Nollo et al. 2015).
To create a healthy city, the five most important steps in the implementation process are
as follows: (1) Make a city greener, more eco-friendly, and sustainable by using clean energy
and/or renewable energy such as solar, wind, and electric transportation. (2) Improve mass
transit with energy-efficient public transit, and upgrade mass transit and infrastructure, as
well as public transportation, thereby reducing traffic on the roads and the pollution that
transportation creates. (3) Invest in digital health to provide people with the opportunity to
take active roles in their health care through digital applications by having the option to
monitor their health at home with digital monitoring devices, thereby reducing the time
spent at the hospital. (4) Implement the Internet of Things (IoT) to encompass the many
elements that comprise a smart city; IoT can link all the necessary elements of a smart city
through technology into a unique platform, thereby improving efficiency and breaking silo
behavior. (5) Monitor air pollution by analyzing it and distributing and sharing that data;
this will be a large part of the challenge, but we emphasize that accurate monitoring of air
pollution is another key element for a healthy, smart city, and we encourage at the
community level the formulation of a plan to implement and manage hundreds of air-quality
sensors (Korber 2016).
In addition, a smart healthy city must use IoT as a tool for urban development.
Furthermore, to develop a clean and green city concept, we must implement an efficient
waste management system, using a circular economy to help with solid waste management.
We must develop more green spaces such as public parks, including the development of more
areas for exercise in the city. The city must be developed following a friendly design concept,
including the development of bike lanes for people to use bikes as their mode of transport in
their everyday lives. We must ensure food quality and the safety of agricultural products to
supply the city. The city must have medical applications on smartphones for health checks,
connected to hospitals to book medical service, and we must develop an online tool that
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facilitates the collection and sharing of medical information between residents and hospitals
or medical doctors (Ruenpakpoj, Aim-Im-Tham, and Promsaka Na Sakolnakorn 2020). In
addition, the use of ICT is a key concept for improving today’s health care as it will improve
access to quality care and will make the health sector more efficient. This efficiency will
include data sharing between patients and health service providers, hospitals, health
professionals, and health information networks through the use of electronic health records,
telemedicine services, portable patient monitoring devices, operating room scheduling
software, robotized surgery, and blue-sky research on the virtual physiological human
(ActiveAdvice 2017).
One of the challenges of smart health care is telecommunication because wireless and
internet networking technologies are used to provide connectivity in various types of medical
devices and sensors (Zeadally and Bello 2021). In addition, healthcare providers with limited
finances and resources face challenges in providing ICT systems for potential smart health
care, and lack of finances hampers the quality of security system services (Sligo et al. 2017).
Numerous studies have shown that the challenges in IT are maintaining people’s privacy and
security and protecting the database from unauthorized access (Tissaoui and Saidi 2020;
Jitsupa, Nilsook, and Piriyasurawong 2012; Atiyah and Al-Mejibli 2022). In addition, people
cannot access technology due to economic problems, such as the lack of money to buy a
smartphone for billions of people around the world. Smartphones remain too expensive for
many people in low- and middle-income countries (Woodhouse 2020). With the gap between
the people who can benefit from the digital world and people without the internet or modern
ICT, people without internet access or smartphones cannot access news, buy products, use
online services, or access smart healthcare services.
Management of Smart Healthy Cities to Improve the Quality of Life
for Citizens
Smart healthy cities can improve the health and wellness of citizens by increasing the
adoption of telemedicine, which allows on-demand specialist resources to expand the scope
of their care to underserved populations and communities (Satyam 2019). An integrated
healthcare solution can be of great benefit when implemented on a large scale in smart cities.
The increase in technology and data will provide more opportunities for governments to
manage citizens’ health proactively and to change the way health care is delivered. It will
integrate stakeholders through a robust, technology-based smart healthcare structure. This
technology will enable the provision of affordable, accessible, efficient, quality care to all
when they need it, and where they need it. Moreover, a holistic view of a city’s health data
including disease profiles, disease patterns and trends, or seasonal disease cycles will be
available to the government, through which the authorities can plan their healthcare
initiatives and programs and allocate funding (Jagota 2018). Thus, in Table 1, we summarize
the environmental and development issues for the management of smart healthy technology
in cities.
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Table 1: The Management of Smart Healthy Cities
Issue
Management
Smart Infrastructure
▪ Free Wi-Fi internet access in public places
▪ 5G systems enabled
▪ Low cost of internet
▪ High-speed internet and 5G coverage of both urban and
rural areas
▪ Transformative power of the Internet of Things (IoT) and
its core and complementary technologies for ICT
management
▪ Municipal management with smart healthy city
innovations to create platforms for citizen engagement
▪ City to promote environmentally friendly transport
systems in the near future
Smart Institution
▪ Building a smart nation and digital government
▪ R&D investment (research and development)
▪ Local government collaboration with universities
▪ Proximity to universities
Smart People
▪ Improved open data/big data initiatives
▪ Increased job opportunities
▪ A healthy city initiative to create robust economic value
▪ Knowledge sharing
▪ Training programs and internet training programs
targeting older and disadvantaged people to become a
necessity in mitigating the digital divide in the
community (Kamel Boulos, Tsouros, and Holopainen
2015)
Urban Environment
▪ Design of the urban environment following the clean
and green city concept through the growth of trees and
valuing, nurturing, and protection of urban forests. This
will lead to a low-carbon city with green transport and
increasing use of electric vehicles (EV), improvement in
waste management. Such a city will be the cleanest, using
green energy and a friendly design to improve and
renovate downtown areas. It will create a universal,
friendly design and a sustainable environment with
renovated walkways and roads for everyone. Urban form
and city growth will be connected to natural areas to
protect their rich biodiversity (Promsaka Na Sakolnakorn
2018).
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Smart Healthy Cities
▪ Use of ICT as the key concept for improving a city’s
healthcare systems
▪ Telehealth innovations in remote healthcare services
delivery
▪ Health intelligence can be characterized as applications
of artificial intelligence (AI) to improve health at the
population level and at the individual level, using IoT in
several disciplines within public health and precision
medicine and generating and consuming large amounts
of big data on health and the environment (Kamel
Boulos, Peng, and VoPham 2019)
▪ To create mobile applications for promoting public
health such as through the disciplines of environmental
health, epidemiology, genetics, social and behavioral
sciences, and infectious diseases (Kamel Boulos, Peng,
and VoPham 2019)
▪ Adopt applications of the Virtual Reality Geographic
Information System (VRGIS) for healthcare systems. In
addition, VRGIS technology is a combination of virtual
reality (VR) and GIS technologies, integrating three-
dimensional GIS (3D GIS) and internet-oriented GIS
(Web GIS) (Kamel Boulos et al. 2017)
Smart health means putting the patient at the heart of the health services design and
reimagining models of care to realize personalized health at scale by interconnecting people,
the environment, and infrastructure as a unified, intelligent, data-optimized system of care.
That is the point at which health becomes smart (Mcbride, n.d.). In addition, during the
coronavirus outbreak of 2019 (COVID-19), technology has become a tool for COVID-19
management as it assists in the sharing of knowledge and the use of technology for the control
of the virus. For example, developers have created more efficient mobile health applications
for COVID-19 such as information about the nearest health centers and essential services.
These applications allow for self-symptom checks, the tracking of infected individuals, and
government announcements (Davalbhakta et al. 2020). For example, technology can be
implemented to support COVID-19 management, such as pulse oximetry sensors, which
serve as an indicator of respiratory malfunction and can help in COVID-19 diagnostics and
monitoring for a person’s oxygen saturation, as well as indirectly monitoring the oxygen
saturation of a patient’s blood. In addition, body temperature sensors can be used to measure
temperature, including skin probes and rectal thermometers (Ennafiri and Mazri 2020).
Furthermore, mobile application-based prototype smart home healthcare systems can be used
for efficient and effective health monitoring to ensure patients’ convenient and independent
living while at home. Patients can use the mobile application system to remotely upload or
capture essential health symptom information during a pandemic, such as the ongoing
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COVID-19 pandemic, for their doctor’s assisted diagnosis, especially when patients are
observing self-isolation at home or government obligatory quarantine. In addition, the smart
healthcare support system measures and records specific health parameters such as weight,
pulse, blood pressure, glucose level, and body temperature; this system is also designed to
send a reminder to patients on the use of certain medications, with input supplied by the user
(Taiwo and Ezugwu 2020).
Methods
In this study, we used secondary data related to smart health care and/or health cities. We
collected data from published research reports, websites, and previously conducted surveys.
In addition, we collected data on how to manage the smart health program during the
COVID-19 pandemic in Thailand from the news and the internet. We followed the five
research steps: identify the research topic, identify the data source, collect data, combine and
compare the data, and analyze the data using content and descriptive analysis. One limitation
of this study is that we collected all data from secondary sources and used existing data, which
is not representative of all phenomena; however, the study’s results can help other countries
determine and develop smart health cities in the future.
Results
We divided the results of this study into two phases: managing the smart health program
during the COVID-19 pandemic and the challenges in Thailand in managing the smart health
program.
Managing the Smart Health Program during the COVID-19 Pandemic
The IoT comprises technology-enabled linked devices/applications that can be utilized to
lower the spread of COVID-19 via early diagnosis, patient monitoring, and the practice of
protocols after patient recovery (Nasajpour et al. 2020). In addition, the IoT allows for
integrating physical devices that connect to the internet to provide patients’ real-time health
statuses to doctors. Chronic diseases such as diabetes, heart, blood pressure are prevalent in
the world as economic and social problems (Kumar, Kumar, and Shah 2020). The highlight
of smart healthy cities is their emerging technologies for improved healthcare services.
Governments and municipalities should develop innovative strategies for deploying
emerging technologies in health information technology (health IT) in order to advance the
quality, accuracy, efficiency, and availability of healthcare delivery while reducing costs
(Taiwo and Ezugwu 2020). In addition, IoT-powered smart cities will rely on a growing
number of subtechnologies and subsystems (devices, appliances, buildings, vehicles,
component services, etc.) that need to be seamlessly interconnected and interfaced with one
another in real time (Agbali et al. 2017). For the smart management of health during the
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COVID-19 crisis, the government should adopt new working practices using smart
technology and the IoT to fight COVID-19:
1. In developing countries such as Thailand, many citizens still do not have a smartphone.
Data from the National Statistical Office Thailand (2021) showed that, based on the results
of the 2019 Household Information and Communication Technology Survey of the National
Statistical Office, Thailand has 56.7 million mobile phone users, accounting for 89.6 percent
of the population. Specifically, 86.4 percent of mobile phone users use smartphones, and 12.7
percent use feature phones.
Thus, the government should collaborate with mobile and telecom companies to allow
citizens without a smartphone to exchange their non-smart mobile phone for a smartphone.
The government should subsidize the mobile phone companies. For example, from 2020 to
2021, the Thai government only gives money to citizens and subsidizes the travel economy,
including internal travel, hotel subsidies, and more.
2. Governments should develop smartphone applications for COVID-19. Countries
should have only one application for COVID-19 statistics, monitoring, registration for social
welfare, checking in at public areas, and discovering [incorrect word choice – please revise]
symptoms. It should also offer an anonymous and safe medical application for self-diagnosis
and focus on safeguarding access and information for citizens and marginalized groups. The
crisis response could offer the capacity for building sustainability to tackle future crises.
Thailand has many mobile applications for COVID-19 developed by many government
agencies, who tried to force Thai citizens to use all applications. For this issue, why did Thai
government agencies not integrate mobile applications during development?
3. Sensors and the application network should be used to avoid COVID-19 disease,
including using infrared thermometers for thermal imaging and body temperature
measurement. Infrared reflection sensors could also be used for door and window operation,
lift operation, power switch operation, water supply in toilets, and heart rate detection via
smartwatches. Optical cameras could be used for facial recognition of patients, and smart
internet cameras could be used for virtual conferences, meetings, and news broadcasting
(Kamel Boulos and Al-Shorbaji 2014).
4. Smart medical devices that use IoT wireless technology are revolutionizing health care.
For example, wearables now link patients to doctors and transmit critical medical data in real
time from hospital beds and private homes. Mobile equipment is also used at emergency sites
and in transport vehicles, and smart monitoring facilitates vaccine delivery and storage by
using mobile technology and the IoT to transmit accurate information of conditions
throughout the vaccine supply chain (production, transportation, vaccine storage, and
delivery to patients).
5. Telemedicine or telehealth technology is an alternative method in the COVID-19 era.
The doctor and patient can communicate via an online application or telephone, and patients
can receive advice from their doctor via internet systems. In addition, the doctor and patient
can communicate via digital cameras for virtual treatment.
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6. A case study was conducted in Thailand using smart health and technology as tools for
COVID-19 management by creating mobile applications connected to the healthcare
database for COVID-19 prevention, as follows:
6.1. Thai Chana mobile application: Thai Chana means “Thailand Wins.” This
application is used for people to check in when they have been to a public area, which is
useful for COVID-19 disease investigation. It reminds people when an infected person has
been in the same area and the period during which the infected person spent time in the
public area.
6.2. Mor Chana mobile application: Mor Chana means “Doctor Wins.” It is the second
mobile application used in Thailand. People open the application when they go out to public
areas, and the application records the locations they visit. If people have been infected with
COVID-19, this application will show the timeline and then a health officer will announce
to the public, and people who have been to the same place and are at risk for COVID-19 will
get tested. However, the Mor Chana mobile application is not popular in Thailand because
it uses a lot of mobile battery power, and people feel it is a duplicate of the Thai Chana mobile
application.
6.3. Mor Prom mobile application: This application was developed in 2021. Mor Prom
means “Doctor Ready.” This mobile application is concerned with the COVID-19 vaccine
and is used to promote people to register for the vaccine and make a vaccine appointment,
and it collects users’ vaccination history, COVID-19 vaccine certificate, COVID-19 lab
certificate, and travel health certificate.
6.4. In 2020, after the Thai government developed the Thai Chana mobile application,
many provincial governors also developed provincial mobile applications for local
management; however, it has appeared to be unsuccessful, giving people and local residents
a higher duty load.
6.5. After July 2021, COVID-19 spread throughout Thailand, and the number of patients
increased so that health systems and hospitals could no longer support all patients. Also,
many patients just stayed home or went to a COVID-19 quarantine facility that does not have
critical medical equipment such as ventilators. To solve this problem, medical associations
and volunteer doctors set up telemedicine for consultant and patient self-healing while
waiting for a hospital bed.
6.6. The uncertainty of Thai government policies on mobile applications for vaccine
registration made citizens uncomfortable or insecure; for example, government units and/or
some provinces have announced new mobile applications such as the “Thai Ruam Jai”
(“United Thai Heart”) mobile application, and the Thai government also allowed the
governor to develop his own provincial mobile application. Also, the Thai government
announced its support for that application while the other was still active. Then, the Thai
government changed its mind and allowed its people to use the old application (Mor Prom
mobile application). In conclusion, many government departments have developed mobile
applications, but only a few have been effective in the long term.
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6.7. At the end of years 2022 and 2023, Thailand declared COVID-19 to be an endemic,
and Thailand returned to an open society and economy. It also welcomed tourists from
around the world. However, the Ministry of Public Health is still using mobile applications
as tools for fighting COVID-19, especially the Mor Prom mobile application, and the Mor
Prom mobile application has also received more development and has become more useful
in comparison to 2021. Nowadays, this mobile application can be used for COVID-19
vaccination certificate, ATK (antigen test kit) results, searches for health service units,
registration for places that have strict COVID-19 rules, and health certificates.
The Challenges in Thailand in Managing the Smart Health Program
The challenges in Thailand in managing the smart health program during and after the
COVID-19 pandemic are as follows:
1. The costs for patients lead to public health inequality because poor people do not have
access to the technology they need to address, for example, the cost of mobile health (smart
phone, smart watch) and of internet access.
2. Medical technology is set up only in large hospitals, so people in rural areas do not
have access to high-quality medical services. Therefore, people in rural areas have to travel to
be treated in a large hospital, and in some cases, doctors in rural hospitals send patients to
receive treatment in major hospitals because the local hospital cannot treat complicated
diseases.
3. Applying technology for doctors and nurses is a basic problem in almost every hospital
because doctors and nurses face difficulties in using new technology, so they stick to the old
system.
4. Smart remedies that are not smart: smart health care in Thailand can only move
forward in terms of using technology to help take care of patients with follow-ups to monitor
them, but it is still impossible to conduct big data analysis to increase the efficiency of
treatment.
5. Linking databases between hospitals: in Thailand, hospital databases have not been
linked together, but the databases in private hospital groups have been connected.
6. Patient safety and cyber security: the regulations for disclosing patient information are
also an issue because patient information is confidential and can only be viewed by a licensed
physician. Therefore, there must be a high level of security to support and determine the right
to access the appropriate data and to prevent patient information leaks.
Conclusion
Smart health cities are meant to improve the physical and social environments and increase
the community’s resources, enabling people to support each other in the fulfillment of all
life functions and achieve their maximum potential (WHO 1997). The emergence of COVID-
19 has made technology more important in medical treatment and resulted in a paradigm
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shift in medicine and public health, but on the other hand, quite a few people still cannot
access technology due to lack of resources, poverty, knowledge, and physical readiness as well
as physical potential. In Thailand, various technologies have been developed to solve
problems during COVID-19; however, many technologies were developed too hastily,
making their design inefficient. Therefore, technology design requires systems and
mechanisms that are linked to practical use for each target group in the area. It must be
developed to address the needs of those who will actually use it to make technology more
equitable for all groups of people in society, and the government has a responsibility to
support systems and mechanisms.
The healthcare industry is facing a variety of challenges, including inadequate medical
personnel, the number of elderly people is increasing every year, and new diseases are
emerging, the consequences of which are higher health costs for people in the country. After
the COVID-19 outbreak, Thailand adapted to what is known as the new normal. Medical and
public health professionals must be prepared for three key principles: (1) the safety of patients
and medical personnel is paramount; (2) the congestion of patients in a medical facility must
be reduced, and (3) there must be no disparity in receiving treatment. For example, the model
for new medical services was set up at Pattani Province. Patients were simulated, and they
were classified into three groups according to traffic lights: (1) green (low risk), (2) yellow
(moderate risk), and (3) red (high risk), which were determined based on the need for direct
care medical doctors and the risk of COVID-19 infection. Patients did not need to visit a
healthcare facility, and patients used the mobile application to consult remotely with a
doctor. Medicines and supplies will be delivered to the people at their homes with the help
from village volunteers. In addition, Thailand has other technologies, such as facial
recognition cameras, to measure temperature and warn people who do not wear masks.
Medical service robots are being used at Ramathibodi Hospital to help deliver food and
medicine, and they are ready to send equipment to measure the vital signs of the wilder at
Mahidol University. Also, the robot Westie (also known as Wastie) collects infectious waste
by using a mechanical arm to lift the waste bin to the storage pickup, thus reducing the risk
of infection for healthcare professionals (DEPA, n.d.).
To build smart healthy cities, the government should focus on designing and renovating
infrastructure as a friendly design, with city development that follows clean and green city
concepts to balance modern development and environmental friendliness. For smart
infrastructure, cities should collaborate with mobile network operators to develop low-cost,
high-speed internet and enable 5G systems to support software and mobile applications for
smart healthy cities, with the transformative power of the IoT at its core, along with
complementary technologies for ICT management. To implement smart health by using
technology during the COVID-19 pandemic, the government should develop only one (or a
few) mobile application to monitor COVID-19 disease investigation, to record the locations
people have visited, and for vaccine management, as well as using more information to
encourage people to use the mobile application. In addition, the government should encourage
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people who do not use a smartphone to do so or allow poor people to obtain a smartphone for
free or for a low price. Moreover, governments should seriously monitor the labor camps,
slums, and prisons for COVID-19 prevention, as well as control businesses such as nightclubs,
bars, pubs, and casinos. In these places, many people gather without wearing masks. A case
study in Thailand found that the spread of COVID-19 across Thailand in early 2021 occurred
via night activities, such as at nightclubs, pubs, buffet restaurants, and illegal casinos (in
Thailand, casinos are illegal). It also spread via illegal night entertainment where men paid
women for sex. In addition, in May 2021, COVID-19 occurred in prisons around Thailand, and
more than 10,000 prisoners were infected.
Finally, the COVID-19 crisis is an important turning point that has driven consumers
and organizations. It is important to be open to and learn how to use technology faster.
According to social distancing measures, such as remote work, the use of robots and
automation (robotics & automation), especially in the healthcare industry, has been at the
forefront of the fight against COVID-19. In addition, Thailand is facing the challenge of
becoming a fully aging society populated by an increasing number of patients with chronic
noncommunicable diseases; however, efficient communication system technology has
allowed Thailand to develop smart healthcare for patients. In addition, medical personnel
can communicate in real time, more patients’ data can be analyzed, more data can be
exchanged between medical doctors and the hospital, a more specific medical treatment
design has become suitable for personnel and patients, patients receive healthcare services
that are able to predict health problems, and patients can participate more through health
surveillance via mobile phones with various applications and wearable devices.
Informed Consent
We liaised with all coauthors to confirm agreement with the final statement.
Conflict of Interest
We have no conflict of interest to declare, and this article does not contain any studies with
human or animal subjects performed by any of the authors.
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ABOUT THE AUTHORS
Akkakorn Chaiyapong: Associate Professor, Faculty of Law, Suratthani Rajabhat
University, SuratthaniThailand
Email: akkakorn.law@gmail.com
Sakda Wattatham: Deputy Chief Justice of the Office of the Chief Justice, Region I,
Bangkok, Thailand
Email: sakdawattatham@gmail.com
Thongphon Promsaka Na Sakolnakorn: Professor of Public Administration, Faculty
of Management Science, Silpakorn University, Petchaburi, Thailand
Corresponding Author’s Email: thongphon.p@gmail.com; promsakanasakol_t@su.ac.th
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