Health tech is an important Smart City functionality

In the FinEst Twins project there is no research stream for health. This posting is one more indication that perhaps it should be included in our portfolio of Smart City topics. The posting is based on a master thesis by Sara Klossner. With her supervisor Hadi Ghanbari from Aalto University School of Business, she is going to publish also a journal article based on this work. Link to that publication will be updated in this blog, also. The thesis is done in the research stream of Urban Analytics & Data. However, larger societal thoughts might arise in Smart City Governance stream, since the topic is linked also to privatisation - and individualisation - of health care. Is the responsibility of your good health becoming more and more on your own shoulders?


Sara Klossner writes:

The privacy paradox prevails in the use and adoption of m-health apps


The rapidly growing world population is concentrating increasingly in urban areas, putting pressure on the healthcare systems. Smart healthcare has emerged to help improve smart city citizens’ health at scale. In smart healthcare, Artificial Intelligence (AI) is of growing importance as it enables healthcare to be more personalized, as AI can collect and analyze vast amounts of data more effectively than a human physician is able to. AI-powered private mobile health (m-health) applications are a promising new area in smart healthcare, as they have the potential to lower healthcare costs by empowering individuals to take better care of their health in a preventive manner. For the m-health apps to reach their full potential, they need to gather and analyze the users’ health data, which enables the offering of highly personalized services. However, with the continuous data collection from users, the question of privacy and trust concerns arise.


In my thesis, I studied the privacy and trust concerns Finnish and Estonian users have towards m-health apps. The empirical part of the data collection was done by conducting an online survey distributed in through social networks in Finland and Estonia. 249 answers were anaysed quantitatively to better understand especially smart city citizens’ behaviors towards m-health apps.


The study confirmed that ease of use and usefulness have a strong positive impact on users’ behavioral intention. The privacy paradox (meaning that people might think data privacy is very important but act controversially) was also present, as privacy concerns were not found to have a negative effect on the behavioral intention of users to adopt and use the apps. Privacy concerns were not found to impact the user’s level of self-disclosure, i.e., sharing their health information with the m-health apps. The personalization-privacy paradox was partly present, as personalization did have a positive effect on trust, but surprisingly not on behavioral intention. Self-efficacy was found to have a significant impact on decreasing privacy concerns and increasing self-disclosure, while self-disclosure had a positive effect on behavioral intention. It was also found that the results varied between different demographic groups.




The findings indicate that cities and organizations should concentrate on creating easy-to-use, useful and trustworthy applications with strong privacy protection. On a societal level, it is important to achieve a high level of digital self-efficacy throughout the population to facilitate the adoption and use of m-health apps. Creating an environment of trust is also important to increase the level of self-disclosure of users, as it has a positive effect on the adoption of m-health apps. It is also necessary for the applications in order to maximize the benefits for the users and, through that, the entire society.


The research has been conducted by Sara Klossner, master’s student at the department of Information and Service Management, Aalto University School of Business. Assistant Professor Hadi Ghanbari has served as the thesis advisor, and Dr. Lill Sarv has helped with the data collection in Estonia.

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