Disruptive innovation in healthcare and well-being

One theme at Lift France 2011 is Care. It is introduced as follows:

From patient networks to personal genomics, from the quest for autonomy and well-being to do-it-yourself bio, new technologies and new business models are getting ready to transform the world of healthcare. Are the players ready?

First up is Paul Wicks a research scientist at PatiensLikeMe](http://www.patientslikeme.com/). His talk is titled Putting patients at the center of healthcare; disruption in medicine, research, business, and drug safety.

Initially we got things wrong on the Internet. We thought it was about information, but have now learned that it is about really easy group formation (Wicks must have gotten this from Clay Shirky’s Here Comes Everybody). This has been very disruptive for certain type of industries (e.g. the travel agent). One of the professions that has not been disintermediated yet is the medical profession. The point of PatientsLikeMe is to for patients to share their health information in order to learn from others like them and then use that information to discuss treatment options with their health care team.

One radical idea that they have is to give back the data in such a way that people can do their own data analysis (e.g. comparing effectiveness of certain types of medicine for a medical problem correlated with chance of side-effects). They try to be scientifically rigorous in the way that the data is used and make sure that all articles are open access. 23andMe is doing something similar with their 23andWe research.

This is not without problems, mainly around privacy. Wicks suggest we might need a phenotypic non-discrimination act for people who are willing to share their data for the greater good. Based on questions by the facilitor I now realize that PatientsLikeMe is actually quite a commercial venture and earns its money by selling the data to 3rd parties.

Jonathan Kuniholm lost an arm in a war, came back and started a PhD studying prosthetics. He created the open prosthetics project. He started his talk saying that he is wearing an arm that was patented in 1912 with a hook that was developed in the fifties and that the whole arm contains no motors. Imagine if the technology that we use would progress in a similarly slow pace: terrible. The problem is the small market size (only six other amputees are on PatientsLikeMe for example) leading to relatively small research budgets. We have a multiple market failures here. There is no lack of ideas, they are actually rampant. But very often they are design exercises without any practical purpose.

It would be great if prosthetics could use the innovative solutions that are developed in other industries. Unfortunately licensing agreements and patents often get in the way. Designing for larger markets also would not really work. Another option is using user participation and social collaboration. He then showed a lot of examples of “make” culture and 3D printing and how people are trying to use these type of technologies (not really successfully) for prosthetics. He is now starting a company, StumpWorks, owned by amputees to build the things they want to build.

A "chap watching his own body's performance"

Tobie Kerridge is based in the interaction research studio at Goldsmiths in London. His talk is titled Debating Biotechnology – Speculative Design as Public Engagement. He is doing a project called material beliefs. From the website of the project:

Material Beliefs takes emerging biomedical and cybernetic technology out of labs and into public spaces. The project focuses on technologies which blur the boundaries between our bodies and materials, and how design as a tool for public engagement can be used to stimulate discussion about the value of these forms of hybridity. [..] The lab becomes a site for collaboration between scientists and engineers, designers, social scientists and members of the public. Alongside existing research activity such as collecting experimental data, writing academic papers and funding proposals, the collaborations lead to a parallel set of outcomes including interviews, brainstorming, drawing, photography, filming and discussion.

Who needs to become “smart” in tomorrow’s cities?

Transforming abandoned oil platforms into ocean mini cities

The first true theme of the conference is Urban, who needs to become smart in tomorrow’s cities. From the introduction:

We want cities to become greener, safer, more competitive, more inclusive, more vibrant or easier to move in. To achieve that takes more than great engineering and determined leadership, yet this is what most models of “smart cities” are built around. It requires trust and collaboration, the deliberate sharing of urban (hardware, software, informational) resources, open innovation ecosystems, empowerment policies… How will we achieve smart and open cities that could be livable?

Saskia Sassen is talking about The future of smart cities. Her research question is how much of the new technologies are truly urbanised. The cities is not just the materialities, it also is the people, the practices, etc. This means that the city can “talk back” and there is a notion “cityness”.

What would it mean to do open source urbanism? What would it mean if we start to think of the city as the hacker? Incompleteness is her foundational image for the future of the city because the concepts of the user don’t align with the concepts of the engineer.

I thought it was unfortunate that Sassen did not develop her thoughts further than these large broad philosophical strokes. This was in stark contract with the next speaker: Adam Greenfield runs a shop in New York called Urbanscale. His talk is titled: On public objects: connected things and civic responsibilities in the networked city. He prefers the term “network city” over “smart city”).

He is inspired by Lefebvre’s concept of the right to the city. In our current networked city we have become an instrumented population. There is a strong spread of locative and declarative media. Increasingly we live among declarative objects (see Tom Armitage’s project of the talking Tower bridge).

We are surrounded by objects that can process information and “speak” to us leading to new modes of surveillance based on information gathering objects. What might it mean to speak of our right to the networked city. Maybe we need a new theory of public objects to help us think about them?

Greenberg show examples of a couple of technologies that are used in urban settings to get at a “taxonomy of effects” and a first start at thinking about the morality of objects:

Välkky traffic sensors are non objectionable: there is local collection with a local effect and a clear public good.
The Nikon advertisement that is “paparazzi billboard” is mildly disruptive: there is local collection and local effect, but there is no public good and slight disruption.
The Acure touchscreen vending unit is gathering information about you and tries to discern your age and your gender and then present you with the right proposition. This is a prescriptive and normative non-urban technology. This is local collection with global effect and no public good: the data is analysed and used to change the propositions.
Quividi (“he who watches”) VidiReports video analytics suite is a technology that records people as they pass by billboards and tracks their attention. Vidireports is leeching value of the cityscape. This technology is predictive and prospectively normative. Greenfield is actively trying to influence government to legislate against this type of technology.

Greenfield then gives a definition of the public objects. They should be designed in such a way that they are open and easily available. This has some problems: we are enormously increasing the “attack surface”. We also don’t have the etiquettes and protocols of precedence and deconfliction. But the aspirations are big though: among other things it could be a physical manifestation of the public sphere.

Next up was Alain Renk talking about Unlimited cities. He talked in French which was simultaneously translated. This setup made it very hard for me to both pay attention to the talk and blog. According to him we are confronted by a trend of standardisation of urban environment and it is very difficult to develop “urbadiversity”.

Robin Chase gave an incredibly inspiring talk about people-(em)powered platforms.

Some examples of people-(em)powered platforms are meetup and Etsy, Waze, Airbnb or Couchsurfing. This stuf is powerful: Intercontinental built 4400 hotels in 60 years, whereas Couchsurfing has 1.2m “couches” in 8 years (twice the volume of Intercontinental).

The economics are sustainable: I put my excess capacity into a common platform. This can grow very fast (low financial risk) because now the common platforms are completely scalable. This is a much more efficient use of resources. It is a dematerialisation: so more service than asset and it is focused and collaborative consumption. Put another way: ownership will not be the higher status consumption.

Chase has now started buzzcar (they have an app), a way for people to share their cars. It uses a collectively built infrastructure that is collaboratively financed where end users gain financially. Doing it like this she doesn’t have to wait for government or private companies, instead she has “auto-preneurs” putting their cars into the system. See here for a video explaining the concept. This way one well-used shared car can be used by 30-50 people. Some of these people will sell their car so one well-used shared car equals about 15-20 cars and can save 40-60 parking spaces.

This type of collaboratively built infrastructure will create the people’s city. Rather than having centralized or decentralized systems you now get distributed robust and resilient systems. We can finally have a future where there is scale without the homogenisation that this would usually bring.

The final talk is by Frédéric Mazzella. He has created a new way of carpooling and talked about how car-pooling can help forecast car traffic. Covoiturage.fr has 1.2 million members. By using people’s intentions of where they want to go when, they can forecast traffic (he showed a nice visualisation of this).

Innovating within innovations challenges…

Joëlle Liberman (Égérie Research) and François Jégou (Strategic Design Scenarios) are hosting a session titled Innovaton Futures, Innovating within innovation challenges. This workshop is based on an European project titled Innovation Futureswhich is a foresight exercise on emerging patterns of innovation. From their introduction:

How is innovation changing and which challenges innovation will have to face in the coming future? INFU (www.innovation-futures.org) is an on-going European research project focusing futures of innovation, scanning weak signals of change in the current innovation landscape, extrapolating new patterns, discussing emerging visions, scenarios and implications for policy and practices.

At the start of the workshop we were put into pairs and given a “weak signal” that they have identified. Mine was: CoWorking Houses as Creative Hubs: “More and more of the nomadic knowledge workers from the creative class join CoWorking spaces. CoWorking houses offer an easy, flexible and budget workspace combining workspace with a creativty hub. One question to ask about these weak signals is what would happen if they would turn into mainstream which of course begged the question whether maybe in the future mainstream is that there is no mainstream anymore. Next up we were asked to imagine being at a board meeting of the Innovation Agency in 2036 (25 years from now). The agency is facing a couple of challenges and has to find a solution to these. Our table had to think about the following:

Thinking about the challenge — Thinking about the waste challenge

“Waste based innovation has taken off in the 00’s and a complete new range of new products definitions and production processes based on reuse of existing components instead of rough materials. The world waste stock exchange market is working very well, even too well inducing a perverse increasing demand for waste materials. The Innovation Agency is asked to propose solutions to avoid this bias.” ‘

Our initial thoughts were around whether this would be a problem that the market can solve itself or whether this would require some governmental intervention to solve. Could there be a tertiary market around waste credits to counter this? Should we require companies to deal with their waste locally, avoiding worldwide trade in waste materials?

I proposed that the cause of the problem seems to be that the consumer has been educated to appreciate recycled products. This signal for whether something is “good” is not working anymore and we should have an alternative. The obvious thing to do is to take more effects of a product into account when you decide to buy something: look at the total cost of ownership over the use-life of the product. Philippe Méda suggested that one way of doing this would be to focus on making sure that products have longer lifecycles. How do we know whether it is better to drive a very old but wasteful car, versus buying a new one with its environmental costs of production? Somebody suggested that maybe the idea of ownership is the problem and wasteful in itself. Instead of ownership you will start licensing/renting products. Proposing an alternative model to ownership based on sharing. Hopefully the current transaction costs for sharing will be made small enough in 25 years for this to be easier than it is today!

Each group had to present their ideas. Unfortunately this drained the energy out of the room. It seemed like each table had had a good discussion, but these discussions didn’t translate well to a presentation to the whole group. No deep discussions after each presentation. I do hope the output of each group will be digitised in some way and made available (the presenters promised it a link will be published here).

The one question I have after this workshop is about the methodology itself. I think there is a lot of potential in imagining yourself in a board meeting somewhere in the future, but not all the potential came out at this workshop. How could this be improved?

Memory Feed: Reclaiming a Sense of Place through Mobile AR

Introduction

Jie-Eun Hwang and Yasmine Abbas are leading a workshop titled: Memory Feed: Reclaiming a Sense of Place through Mobile Augmented Reality. From their introduction:

With Mobile technologies, Augmented Reality (AR) entered a whole new phase. Mobile AR promises to enable in-situ activities and kinds of communications that allow people to solicit memories of places. Nevertheless, a series of mobile apps that simply overlay bubble icons on the camera viewfinder rather limit our imagination for what we could do with this (possibly) innovative, necessary, and if not useful channel of communication.

This session is held in a small sweaty square room in a building that has the boring non-appeal that only municipal buildings can have. After a struggle with both the beamer and the Internet connection (for security reasons nobody can go on the network…) we manage to get going.

The group of participants is diverse: there are some people who consult around social media or around innovation (e.g. Merkapt), there is somebody working in the research department of an office furniture manufacturer and thinking about the future of work and the workspace, there is a student who is building a web platform for managing student events, there is the CTO of Evenium, the app that is used at the conference and there is somebody who has started an organisation focused on urban memory as a way to improve the perception of the suburbs.

Jie-Eun is teaching in the department of architecture in the university in Seoul. Yasmine is also an architect, writing a book a neo-nomadism. They both focus on how to integrate digital technologies in the urban fabric. They are currently focused on mobile technologies, mainly augmented reality. How we translate our memories into digital media. Can these technologies be used to regain a sense of space when travelling through the city as a nomad.

Mobile Augmented Reality

Jie-Eun is part of a team developing an AR management platform for the web titled Cellophane funded by the culture/tourism ministry. One part of the project is mapping cultural expressions (like movies, drama, pictures, drawings and advertising) onto the city. Imagine being able to watch a movie and seeing a place you are interested in. You would then be able to visit the place either virtually or in real life. It can also work in the other direction: what movies are shot in the area? The tool comes with a nice admin interface allowing you to match the cultural expression to the physical space with a simple point and click interface.

[vimeo http://vimeo.com/22556755]

They have the ambition to push beyond the current capabilities of apps like Layar. They overlay some icons and text on the camera view. For some reason it is quite difficult to use and doesn’t have a very good user experience.

Use cases

What invisible elements can we reveal through this medium? What types of data would we like to get (that go beyond the obvious things like gaming and tourism). In small groups we prototyped a couple of ideas using a use-case template.

I worked with Catherine Gall, Director of Workspace Futures at Steelcase. We first thought about the potential for mobile augmented technology to help in never making the same mistake twice. This could be at the level of the individual, the organisation or maybe even larger concepts like cities. How come you make the same mistake on that tax form every year? Why do you go a second time to a restaurant that you don’t like. We reflected on how a sense of space could help you in memorize things. We finally settled on an idea titled Location based well-being analytics. Certain places (in the sense of locations, but also spaces), events and situations affect our well-being in a consistent matter (be it positively or negatively) without us necessarily being aware of that. Many companies our now designing little monitors that measure your body for things like activity/movement, calorie intake, blood pressure, temperature, sugar levels and more. In the future these devices might even measure some form of quantified emotional state. Some mobile technology could combine your (intended) location with the historical data of these devices to predict how the location will affect your well-being and give out recommendations. This could be useful for people with fragile health or people who are rehabilitating. Alternatively it could just help people become more aware of their own well-being and how the environment affects this.

Other groups had ideas like:

Moody community: in a community you would have a wall where you would be able to see the mood of the community as it is aggregated by individual “mood” statements by the residents of the community. This could actually help build a community. Who would use this data?
An augmented mirror that you can use to try on clothes in which you can easily change the colour or fit etc.
Supporting professional teams during crisis with incredibly relevant and targeted information.
Maintenance: the system would recognise the part you are working on and it would recognize the context of what you are trying to do. The system would then be able to overlay extra information on reality, including maintenance history, particular advice or the gesture that you need to do.

My personal open questions after the session

All of the solutions assume that you are connected to the net for them to work. Can we afford to make this assumption or should we still explore ways of having the data that augments locally? Might there be other models? Mesh networked? Where the device would get the data from the environment on demand?
Imagine a future in which everything you do is recorded in many dimensions (solving the problem of needing to capture your learned lessons). Would this help you in not making the same mistake twice? What kind of interfaces and experiences would be necessary to not only learn from your own mistakes, but learn from other people’s mistakes? How would you now a “lesson from a mistake” would exist? Would it need to be pushed to you?
For current mobile performance support technology we usually think about location, direction, and maybe some RFID technology as “cues” to match the virtual content to reality. What other cues can be used sensibly? Light? Sound? Temperature?
A recurring question for me in the last couple of years is whether we start lusting for a non-technology mediated experience of reality. Will we put a premium on experiencing something for “real”? Can you see a future where you have “Augmented Reality Retreat Zones”?

Lift France 11 in Marseille: Be Radical!

The next couple of days I will be attending the Lift France 11 conference, titled: “Be Radical!”.

I have high ambitions for the way that I will be reporting on what I see, hear and do. I read this excellent guide for conference bloggers which has inspired me to try to liveblog all the sessions that I am attending (or at least have a post up a few minutes after the session has finished. I will also be experimenting with two new pieces of hardware: a Livescribe Echo and Kokak Playtouch. I have zero experience with either of these things, so no guarantees for any decent results.

The conference itself is different from the ones I visit usually. It does have a track about the transformation of the way we work, innovate and learn (see: the non-learning professionals already know that working is becoming the same thing as learning!), but the focus in a broader sense is on how digital technologies are affecting society.

Check out the programme and let me know if there is anything you would like me to enquire more about.