Rogue Wave

A few years ago I wrote a scenario planning document that talked about a paradigm shift happening to us now that was akin to but much more profound than prior technological revolutions like the Industrial Revolution or the invention of moveable type and the printing press. This came to mind again today when I read a post in Irving Wladawsky-Berger's blog that said "...due to the rapid advances in technology, the increased interconnected, global world we are all living in, and the incredible opportunities now before us..., we are at the onset of a profound IT-based revolution, one with the potential to alter the shape of companies, industries, perhaps even economies, and which could have the kind of impact on us in the 21st century that the Industrial Revolution had on previous generations." The only element with which I disagree is the level of impact. The impact on health IT and biomedical research is already profound and getting more so every day.

A few years ago I wrote a scenario planning document entitled Rogue Wave that talked about a paradigm shift happening to us now that was akin to but much more profound than prior technological revolutions like the Industrial Revolution or the invention of moveable type and the printing press, or for that matter the invention of the written word itself. This came to mind again today when I read a post in Irving Wladawsky-Berger's blog that contained the following quote:

  I truly believe that technical talent is more important than ever due to the rapid advances in technology, the increased interconnected, global world we are all living in, and the incredible opportunities now before us to solve problems and build things that not too long ago would have been considered science fiction.  In my opinion, we are at the onset of a profound IT-based revolution, one with the potential to alter the shape of companies, industries, perhaps even economies, and which could have the kind of impact on us in the 21st century that the Industrial Revolution had on previous generations.

The only element with which I disagree is the level of impact. When I wrote Rogue Wave I had been studying Clayton Christensen's concept of disruptive technologies and at the same time reading Marshall McLuhan's Laws of Media. Thanks to the impact of 9-11 on my consulting career, I had a lot of time on my hands. I thought about what was going on around me and realized there were a lot of different technologies synergizing with each other, in keeping with the economist Brian Arthur's concept of Increasing Returns (aka feed-forward).  Technologies have always disrupted the status quo to some degree, by changing the underlying assumptions of some aspect of society or culture. However, many technologies are sustaining, in Christensen's terms, in that the changes they bring about are evolutionary.  The status quo shifts slowly enough that the dominant paradigm adapts to and is reinforced by sustaining technologies.  Even Christensen's disruptive technologies ordinarily affect a single market, with maybe a few ripples going out from it.

So what causes a revolution?  It seemed to me that prior evolutions were brought about by the synergistic convergence of multiple information technologies.  By providing better and faster and more durable information about the technologies themselves and the effects they were having on the larger culture, the synergy of these information technologies stimulated faster and more radical innovation in the realm of information technology.  Since the synergistic technologies also provide more and better and more durable information about everything else going on around them, the ripple effect is much larger than what any single information technology could produce, and also larger than the sum of the effects each of the technologies could produce on its own.

Look around and it is easy to see this at work.  It started with the emergence of the telegraph and the camera in the mid-19th century, which gradually stimulated other information technologies like telephony, film, radio, and television, not to mention the invention of data processing machines such as card sorters and desktop calculators, then computers. The substrate technologies moved from electromagnetic to electronic and from analog to digital, from copper and glass to gold and silicon... you can see where this is going.

The real issue, as Wladawsky-Berger points out, is not the technologies themselves but how they integrate into the culture in which they are embedded, and in the process alter the nature of the culture in accordance with the laws (actually structurational influences) McLuhan set forth.

What I am trying to do with this blog is to view biomedical research and health IT through this lens.  The possibilities are unimaginable, but imagine them we must.  The greatest challenge in this regard is to educate the field's leaders - physicians, molecular biologists, and CIOs - to take note of the evolutionary path we are on, and get them to at least begin to grasp the rapidity and magnitude of the coming changes.  Healthcare is already a decade or more behind the curve, but advances in genomics, proteomics, and metabolomics are awakening us to the possibilities.

It will be fascinating to observe these changes, but it may also be painful. 9-11 is one of the fruits of these technological advances, for example, and there will doubtless be others more heinous and gruesome to come. Our role in healthcare is to counterbalance the negatives by providing humanity with the means to live longer, more active, more pain-free lives. Information technologies can play a key role in this, but only if we take advantage of the opportunities they present.

The impact of the synergistic convergence of disruptive information technologies on health IT and biomedical research is already profound and getting more so every day. Fellow health geeks, our day has come. Carpe diem!

Comments

[Terry]

"The greatest challenge in this regard is to educate the field's leaders - physicians, molecular biologists, and CIOs - to take note of the evolutionary path we are on, and get them to at least begin to grasp the rapidity and magnitude of the coming changes."

I agree. I recently started blogging on a similar topic. My focus is on the clinical side of healthcare but as you suggested it is bigger than that. Healthcare has been built on a paradigm where the patient-physician relationship was the focal point. The reason was because that was where the patient got their healthcare information and services. That is changing. The new focal point is becoming the patient-information interface, where the information interface will be determined by technology and not necessarily physicians.

[Hunscher]

Terry, your comment is spot-on. I checked out your blog and it is very insightful- I am adding it to my blogroll as soon as I can.
I believe we are moving to a dual interface model - the patient-information interface, as you said, but also the physician-information interface. I see all around me evidence that there is a growing disconnect between these two, with the patient's eyes on WebMD and the physician's on an fMRI or a screenful of lab results. The mental models of health and illness are very different in each of their minds.
I would like to see us bring the patient and physician back together with shared information as the intellectual common ground, but also with eye contact and the healing touch as the physical/emotional common ground. In my experience as a patient, there is nothing better than a few minutes of focused, compassionate attention to raise my spirits and bolster the desire to get better.