Orignal article can be viewed here.

 
The annual WEF meeting in Davos provides a great opportunity to “take the pulse” of global businesses, governments and civil societies on issues that are gaining their attention.

Last year, the theme was the Fourth Industrial Revolution – a convergence of advances in bio-technologies, material sciences and digitization that is fundamentally changing lives, work, and relationships. This year’s theme was Responsive and Responsible Leadership – dealing with the impacts of this revolution and other global issues.

At the geo-political level, the main concerns were:

  • Changes from a unipolar world (with one superpower) to a multipolar one; regional conflicts and re-alignments; and rising inequality in developed nations are generating societal resentment, population movements and business uncertainty.
  • Uncertainties and (on balance) pessimism regarding the future of work. In the early stages of the Fourth Industrial Revolution, technology-related job losses appear to be outweighing new jobs associated with new opportunities. The pessimists cited research from WEF (2016), OECD (2016), Oxford University (2013) and McKinsey (2017). The optimists did not present research findings or modelling.

One thing that stood out to me during this annual meeting was the absolute pervasion of information and technologies. Every session I attended, whether relating to health, humanitarian issues, geo-politics or anything else, featured the use of information and technologies at their centres. While these have been dominant influences for many years, their escalation to “centre stage” was noticeable.

Health, Health Informatics and Davos.

Four issues that stood out to me from the health and informatics sessions I attended were the progress of blockchain, advances in AI and robotics, the current state of precision and personalized health, and techno-ethics.

1.      Blockchain

Blockchain is gaining considerable momentum, particularly in the financial world. Many mainstream players such as central bankers are now actively pursuing blockchain-based financial transaction systems. Blockchain is proving scalable, and the key questions are moving from “whether” and “why”, to “when” and “how”?

However, the number and potential of blockchain-based applications for healthcare are growing. These include identity and authentication management (e.g. for electronic records and mHealth), linkages between clinical and financial transactions, management of the Internet of Health Things and its integration into the health information system, and health financing.

As always, health needs to move carefully and balance innovation with safety-criticality, but we will be hearing a lot more about blockchain in health.

See also: http://bit.ly/2jRR2Va

2.      AI and robotics

Until relatively recently, the main focus of technology substitution for humans has been manual labour and data processing. However, recent developments include:

  • The replacement of health information staff by cognitive technologies in Japan (BBC News, 2017).
  • Trialing of a AI-powered chatbot triage service as an alternative to the NHS’s 111 health telephone helpline (O’Hear, 2017).
  • An autonomous robot that is more adept at soft-tissue surgery than both expert surgeons performing the same task, and robot-assisted surgery using the Da Vinci system.

The impacts of AI and robotics on highly-skilled healthcare and health informatics roles may be nearer than previously thought.

3.      Precision and personalized health

Strong investments have been made in precision and personalized health, assisted by the Obama administration’s Precision Medicine Initiative. Though the impacts of administration change in the US is as yet unknown, the trend is strong.

Indications of this strength include that governments and health systems are now beginning to take stock of requirements for scaling and systematizing precision and personalized health, including ascertaining the implications for:

  • Health information infrastructure and records.
  • Health funding and insurance, including dealing with a potential cost “hump” and deferred system-level payback.
  • Regulation.
  • Systematic measurement.

4.      Techno-ethics

Techno-ethical questions stood out to me at many, disparate sessions. These ranged from questions of access (will new health approaches be available to all, or will they exacerbate digital and health literacy divides?); governance (who decides? how are clinical governance and patient/carer choices embedded in cognitive technologies?); data protection in the hyper-digital era; the visibility of clinical choice-making, etc. The list is large.

Ethical questions are far from new in health, but the scale and pace of techno-social change is, and ethical questions can easily be lost in the rush, surfacing ultimately through misadventure.

I believe this is an area where great vigilance is required.

References

BBC News. (2017, January 5). Japanese insurance firm replaces 34 staff with AI. Retrieved from http://www.bbc.com/news/world-asia-38521403.

McKinsey & Co. (2017). Harnessing automation for a future that works. James Manyika, Michael Chui, Mehdi Miremadi, Jacques Bughin, Katy George, Paul Willmott, and Martin Dewhurst. Retrieved from http://destination-emea-prod.mckinsey.com/global-themes/digital-disruption/harnessing-automation-for-a-future-that-works.

O’Hear, S. (2017, January 4). Babylon Health partners with UK’s NHS to replace telephone helpline with AI-powered chatbot. TechCrunch. Retrieved from https://techcrunch.com/2017/01/04/babylon-health-partners-with-uks-nhs-to-replace-telephone-helpline-with-ai-powered-chatbot/.

Organization for Economic Cooperation and Development (OECD). (2016). Automation and Task-based change in OECD countries. Retrieved from https://oecdskillsandwork.wordpress.com/2016/05/19/automation-and-task-based-change-in-oecd-countries/.

University of Oxford, Oxford Martin School. (2013). The Future of Employment: How Susceptible are Jobs to Computerisation? Carl Benedikt Frey and Michael A. Osborne. Retrieved from http://www.oxfordmartin.ox.ac.uk/downloads/academic/The_Future_of_Employment.pdf.

World Economic Forum (WEF). (2016). The Future of Jobs. Global Challenge Insight Report. Retrieved from http://www3.weforum.org/docs/WEF_Future_of_Jobs.pdf.