locally.” The different sources are “nitrogen oxides (NOx), total healthcare spending) puts the country above the average for nitrogen dioxide (NO), PM10 (particles less than 10 microns) and2 OECD countries (OECD website, 2020). PM2.5 (particles less than 2.5 microns).” The number of particles for urban background concentrations and street concentrations, Danes’ life expectancy increased from 77.9 years in 2005 to in Copenhagen, is dominated by local sources—that is, sources 80.6 years in 2015 (Denmark Ministry of Health Website, 2020). in the city and traffic sources in the streets. “Ozone pollution This increase can be explained by the fact that Denmark, [is] dominated by European sources,” and “particle pollution [is] one of the world’s leaders in healthcare technology, uses dominated by regional contribution” (Jensen, Brandt, Ketzel, and digitalized medical records, allowing optimization of processes Plejdrup (2013). www.dmu.dk/Pub/SR57.pdf) (Kierkegaard, 2013 & 2015). The three main strands of Copenhagen’s Climate Plan that are The Danish Ministry of Health and its agencies are the leading relevant to air pollution are: authority for overall coordination of healthcare services. The •Energy consumption; National eHealth Authority is responsible for developing the • Mobility; relevant common frameworks and standards within ehealth. •City administration. Denmark’s regions manage and develop ehealth projects for public hospitals to optimize patient care and emergency The plan embraces a very wide range of new technologies, from responses, where technology is used as a tool to save lives. wind farms and energy-efficient systems to carbon-free public transport (CPH Climate Plan 2025, 2019). Additionally, the city Denmark has a solid foundation for further digitalization of the wants to make its district heating and cooling capacities carbon healthcare system. The country is one of the most digitalized neutral, and it has opened the first district cooling plant, which economies and societies in the EU (see the Digital Economy uses seawater (CPH Climate Plan 2025, 2019). and Society Index (2020) by the European Commission) and the number one European country in the IMD World Digital The main objectives conveyed in the CPH Climate Plan are: Competitiveness Ranking (2020)). Denmark is also a world •Making all district heating and cooling carbon neutral by 2025; champion in digitalization (out of 193 states; see the 2020 •Lowering the energy consumption of commercial buildings United Nations E-Government Survey). The country’s goal in by 20 percent; this area is for citizens to experience the healthcare system as •Reducing household energy consumption by 10 percent; a coherent network based on a citizen-centric approach. •Lowering public buildings’ energy consumption by 40 percent; With a metropolitan population of 1.8 million people, •Making street lighting consume 50 percent less energy; Copenhagen is Denmark’s largest healthcare region. The •Using renewables to produce all the electricity consumed Emergency Medical Services (EMS) system has been created by the city; to ensure the appropriate level of care for citizens. •Increasing the number of journeys made in the city by bicycle, on foot, or by public transport so that they account 1.5.1Information exchange in the promotion of the eHealth for 75 percent of all journeys made in the city (with 50 system percent of trips to work or school to be made by bike). According to Kierkegaard (2013), the centralized aspects of Denmark’s health information system are organized as follows: All these objectives would contribute to reducing CO emissions2 • Sundered.dk, created in 2003 by the Danish regions in and therefore to increasing people’s quality of life and the city’s collaboration with the Ministry of Health and Prevention air quality. and the Danish Pharmacies Association, is the public health information portal. Its remit is to facilitate electronic 1.5 Danish medical services communication between care practitioners and patients, and citizens can use the portal to access information such as In Denmark, as in other countries in Europe, the healthcare medical records and medication histories; system is free of charge to citizens and aims to provide equal • Medcom has implemented the Danish National Health access for all. The country has invested massively in its healthcare Data Network. It aims to facilitate data communications, system; total government spending in this area is equivalent to 10 with standardized text-based clinical messages (including percent of Denmark’s GDP (The Danish Healthcare system, 2017). prescriptions) and seamless exchange of data; Also, spending on hospital facilities (representing 43 percent of • The National Prescription Service (Receptserveren) issues 119 Quélin and Smadja | HEC PARIS | SMART CITIES | The sustainable program of six leading cities | 2021