A starting point is Bryan Johnson’s decision to live his life entirely in accord with a longevity optimizing algorithm he calls Blueprint. Every aspect of his life down to what food he eats when and precisely what times he goes to sleep are governed by the algorithm.

The usual immediate response is to ask whether this is a life worth living. Surely the pleasures of life are what make it so wonderful to be alive?

It turns out that many of the deepest pleasures in life, such as watching sunsets, skiing, having sex, eating delicious healthy food, getting massages, and far, far more are completely and utterly aligned with our future as well as present health and happiness.

I think those are all within the bounds of what Johnson is permitted or even encouraged to do by his life algorithm.

Even those who don’t choose to live by an algorithm can and often do live incredibly full and varied and pleasurable lives without negatively impacting their future health or potential one iota.

The question arises of what behaviors might give pleasure (or avoidance of discomfort) in the moment, but negatively impact our future selves: the potential of who we could be in the future.

These are “non future optimal” behaviors.

This most obviously includes eating unhealthy food (which to some degree is most food available), more than extremely moderate (or arguably any) drinking or drug use, and lack of sufficient diverse exercise.

Some years ago I wrote a blog post Zen and the Art of Creating the Future, which discussed how we can resolve the paradox:

“Zen teaches us that the only thing that exists is the present. Yet if there is only the present, how and why should we work in the present to create the outcomes we desire in the future?

I concluded:

“There is no conflict between living fully in the present and working towards the future.”

Which brings us back to, where is there indeed a conflict or choice between living fully and absolutely in the present, and creating the best future possible for ourselves?

Almost everyone alive will sometimes choose to have an extra glass of wine, add another twist of salt, or take a non-scheduled day off exercise, and feel that the indulgence was well worth the negative future impact.

It is a deep human need to feel that we can be spontaneous, that we have free will, that we can choose to do things that we feel like doing, but just might regret tomorrow, or cumulatively in years to come.

The question is the degree of non-future-optimal behaviors you take. What you say you choose is irrelevant, you can only observe your own behavior.

Johnson has set the bar. He is at the extreme end of spectrum in only engaging in future-optimal behaviors.

There are of course unfortunately unlimited examples of the other end of the spectrum.

The question is: relative to the rest of humanity – perhaps expressed as a percentile – to what degree do you engage in non-future-optimal behaviors?

Image: Midjourney

Yet a central issue is the efficacy of healthcare amid rising costs, constrained governments, and deeply entrenched inefficiencies.

Yesterday I gave a keynote at the SA Health Supplier Conference on Creating Tomorrow’s Healthcare Together, addressing an audience of over 600 suppliers to a $6 billion healthcare system.

My keynote looked broadly at the issues shaping the future of healthcare and the vital role of suppliers in effective service delivery and innovation.

One of the issues I touched on was the rise of value-based healthcare and procurement.

In essence value-based healthcare is measuring value by patient outcomes, as defined by the patients themselves, relative to the cost.

While this principle of course guides many choices in how health services are delivered, one of the most important is in terms of procurement. Examples include a Norwegian health system that used patient-reported pain as criteria for procuring IV catheters, and a Canadian province that required pacemaker suppliers to share the costs of replacement surgery.

Perhaps most importantly of all, this is not just about working with single suppliers. A value-based mentality should drive the development of ecosystems of providers and healthcare organizations to collaborate, innovate, and deliver value to patients.

If the future of healthcare turns out in a way that we like, it will be largely due to the development of effective value-based ecosystems.

An article in BBC titled The invisible warning signs that predict your future health provides some great insights into this space.

Among other people involved in the space, I am quoted:

Futurist Ross Dawson, founder of the Future Exploration Network, predicts a shift from the current model of remedial “sick-care” to a new healthcare ecosystem, focused more on prevention and the tracking of potential health problems before they have a chance to develop.

“Shifting societal attitudes, with increased expectations to live full and healthy lives, are driving these changes,” he says. “This decade, the explosion of new technology and algorithms has given rise to deep learning in artificial intelligence, becoming vastly more effective at pattern recognition than humans.”

By harnessing AI to track our heart rate, breathing, movement and even chemicals in our breath, the technology has the ability to detect potential health problems at an individual level long before obvious symptoms appear. This could help doctors to intervene or allow patients to change their lifestyle to allay or prevent illness.

Perhaps most excitingly, these systems can discern patterns that are invisible to the human eye, revealing surprising aspects of how our bodies betray our future health.

Dawson highlights studies in which AI is better able to anticipate people who are likely to suffer heart attacks by constant monitoring of their pulse. One study even pulled out variables that cardiologists had not thought of as having predictive value – a home visit from the GP requested by the patient, for example.

There are many excellent examples in the article, written by doctor and author Leah Kaminsky, it is well worth a read in full.

Image: Becky Stern

The group was the first to get a run-through of my new concept framework Vectors of Disruption, shown below, which I used to introduce and frame the rest of my presentation.

Click on the image for the full-size pdf

Some brief thoughts on the framework:

The first comment is that I – as many others – am not a fan of the word ‘disruption’, which has lost much of its meaning through misuse and overuse in recent years. However I cannot find a better word for what is meant here. I’m very open to other suggestions!

Overall the intent of the framework is to distinguish between the different layers that are driving disruption, from the underlying forces, through the high-impact developments and finally key structural shifts. These are often confused, making the mechanisms – or vectors – of disruption far harder to understand.

The framework is of course immensely simplified. There are many other elements that could have been included, such as demographics, however many of these will play out over a longer period.

Underlying Forces

The most common focus is on Information technologies, with past future exponential growth in Data, Processing, and Connectivity, which a long runway yet for these trends. Advancing Interface technologies are also critical in giving people far deeper engagement to information.

Technologies in other domains, including Materials, Health and Energy are also impacting not just these industries, but many others, including construction, infrastructure, manufacturing and transport.

Expectations are continuing to rise on every front. Societal expectations, notably of sustainability and accountability, seem to be shifting into higher gears. Customers are demanding powerful experiences and customization. Another important force is that of shifting Investor expectations, who not only expect consistent growth, but also scalability and constant renewal.

High-impact developments

Here we can catalog the array of technology buzzwords that soak through almost every business presentation you are likely to see this year, such as AI, Robotics, Big Data and VR. While these developments are hyped, they individually are likely to have a massive impact on business and society, and even more when they are combined. However there are also important non-technological developments, including Power to the individual and active Capital reallocation by investors.

Structural shifts

While it is bold to point to only two fundamental structural shifts in the economy, I believe they will be responsible for the majority of structural change in coming years.
Automation in manufacturing has already significantly played out, however we are really just at the beginning of the impact of automation – as the application of AI and robotics in a work context – on not just almost all job roles, but how organizations function.
Platforms are the fundamental mechanism underlying the network economy. Beyond the evident rise of marketplaces in transport, accommodation, work, and many other domains, platforms also encompass blockchain and crypto-currencies, open innovation structures, and new models of reintermediation.

Disruption

It is clear that these forces, developments and shifts mean that existing Business models are unlikely to be sustainable without changes, sometimes evolutionary, sometimes revolutionary. However we also need to focus on other domains of disruption, including Organizational structures, Urban structure, Education and the Role of Government. Perhaps most importantly there is potentially massive disruption to existing Social structures. Understanding and shaping this in positive directions – to the degree possible – is everyone’s responsibility.

Of course this framework only looks at the vectors and structure of disruption, not the responses or solutions. I will be creating other frameworks soon that focus on what we need to do to create successful outcomes in a disrupted world.

As always this framework is released as a Beta v1, not intended to be final, but a first attempt that will be refined over time if useful. So please let me know your comments, ideas, and constructive criticism so that can be incorporate into subsequent versions.

It was a very broad-ranging interview, however one of the topics I touched on was the concluding point of my keynote that afternoon, on governments as platforms.

I have written before about issues such as the role of crowdsourcing in government, how crowdfunding could shift the shape of taxation and government, how we can envisage the future of government as a solution enabler, and the value of a framework for the Transformation of Government.

As I have recently spent increasing time and attention on platform strategy, it has struck me that “government as platform” provides a clear and compelling vision for the future role of government.

The current view of government is of a set of institutions that take money from citizens in the form of taxes, and spend it to create social value. One of the most fundamental problems with this model is that governments are indubitably highly ineffective and inefficient at achieving the desired outcomes with the resources they have.

Governments should not be doing work that they do very poorly. They should be facilitators, enablers, catalysts, and orchestrators of value-creating interactions between citizens.

The starting point needs to be agreeing and understanding the social and economic outcomes we want, which can still happen through a political process that may not be dissimilar to current structures (though the shift to true participatory democracy is another important topic, to return to another day).

When we know what outcomes we want, we can design platforms that bring together participants to create those outcomes in the most efficient manner possible.

As a small example, HireUp enabling people with disability to find and work with their own support workers. The platform is able to enable the desired outcomes at substantially lower cost than any government body has been able to do. Moreover, since it enables people to find each other, it is far more likely to bring together people who will get on well with each other, rather than be randomly matched.

The idea of government of platform is by no means new. Tim O’Reilly has written and spoken about the idea at length, including an excellent book chapter on the topic. The UK government is currently discussing the topic, though largely from a narrower technological perspective.

Now that platforms models such as Uber, AirBnB, PayPal, Upwork, Tripadvisor, Lending Club and many others have not only helped people understand what platforms are, but also for us to develop far better principles for effective platform strategy, we are in a far better position to build not just the metaphor, but the reality, of government as platform.

The potential is exceptional.

After opening with a discussion of connected work and marketplaces such as Freelancer.com and Upwork, the article goes on:

According to business consultant and futurist, Ross Dawson it’s a trend gathering pace within professional services like business consultancy, marketing strategy, IT services, even engineering and law. “Knowledge work can now be done anywhere.” he says.

It appears that this is another emerging sector where Australia is leading the way.

Sydney-based firms Expert360 and Skillsapien support two of the leading digital marketplaces for professional services, both of which Dawson sees as signalling a transition to “virtual” organisations.

“What is the role of the organisation today?” he asks. “Do they need to have offices with people sitting together? Is that the best way to source the best ideas?”

With the emergence of massive online platforms connecting millions of people it would seem not.

The article goes on to draw on my comments to look at many of the examples of how connected work is disrupting health, including CrowdMed, Doctus.com.au, and Dr Sicknote, and then closes with my comments on the impact on education, from an Australian perspective.

In the case of education, the online learning genie is out of the bottle, Dawson notes, with Australian institutions well placed to capitalise on it.

MOOCs (massive open online courses) have been around for some time with a fair degree of competition. But new opportunities are appearing in areas like professional certification, for which Australian institutions are well regarded.

“Education is and will continue to be one of Australia’s greatest exports,” Dawson says, noting that Australia’s fondness for and skills in developing digital channels will breed further opportunities in this and other knowledge-driven sectors.

Work can be done anywhere. We have reached the point where professions of all kinds will be increasingly practised remotely. While we need to ensure that potential problems are minimized, we also need to acknowledge the massive social upsides. This shift is inevitable.

In the lead-up to the conference, an article Healthcare 2020: what will the future of healthcare look like in Australia? draws on an interview with me to explore this space. Below are just a few excerpted quotes from the extensive interview with me:

On big data and data sharing

“One of the things that is critical not just in the health industry but more broadly, is the ability to find and share data more effectively as an industry.

One of the major challenges the healthcare sector faces in achieving this, is privacy, both from a regulatory and individual perspective and the attitudes towards how information is shared. An education process is needed to show the value of sharing personal data, as well as providing the structures to be able to share data using appropriate tagging or classification of data.

“If you think about data from the big picture or the potential of the sharing of individual genetic data more broadly, this could lead relatively swiftly to a transformation in healthcare efficiency. While there still might be reluctance from people to share personal information about their health, it will be the individuals and organisations that will need to provide leadership to drive this effectively.

Because data sharing won’t happen by itself. There are so many blocks in terms of attitudes and regulations that are currently stopping data sharing.

There are also some layers of resistance in the technology infrastructure currently being used in Australian healthcare, especially when it comes to medical health records. These records are sometimes being designed to be held within organisations rather than to be shared in any way.

The format of these medicals needs to change to promote sharing and this requires leadership to establish and propagate these standards to drive value.

But this is an ongoing journey and for more than a decade we have already had people working on these issues and yet we don’t have a very good sate of medical data sharing at the moment. But at the same time, we need to look at how far we have come and find ways to improve, because we are going to have to move in a world of dramatically different levels of data availability.

In the future industry leadership is required and we need to look at data sharing as not just a sharing of personal health records, but as how we can use data to create more value for the community.”

On tele-health

“A big part of the future of healthcare will be tele-health and the ability to deliver healthcare remotely. We are already beginning to see more and more medical consultation with medical professionals done remotely, using everything from Skype through to richer services, which allows the doctor to instruct a patient to do particular tests on themselves.

This is part of a shift from responsive to predictive medicine. Instead of waiting until something goes wrong and then treating the patient, doctors will be able to anticipate when things might go wrong and take appropriate actions to prevent sickness. This transformation is partly based on data as well as connectivity.

Clearly there will be times when people need to physically go into hospitals, which will mean the most significant driver in healthcare globally will be cost. With an ageing population with increasing expectations on how to manage health, costs are rising. This could begin to be a massive social problem, so one of the things that will become important is the ability to minimise the amount which people have to go to hospital, both by pre-emptive care and being able to consult doctors remotely.”

On community care

“The vast amount of healthcare expenditure is currently going towards ongoing chronic conditions which can last a life time. A shift to community care in the future will provide an opportunity to not only reduce costs, but also shift the focus to patient centered care.

For example, community care will mean that people will be able to live in their homes much long. They will have the data and facilities to be able to monitor their own health. As we are also going to face an increasingly ageing population, community centered care will enable us to support elderly and unwell people to stay in their homes longer in much better conditions than they would today.

This can be achieved through simple robots in the house which through memory aids can help elderly people remember things, such as something as simple as where they left their glasses. These robots can also be supplemented by people in the community can drop by and support them. We have already seen the rise of mobile nurses and in the future the need for mobile nurses is going to be far greater.

Community centered care will improve people’s quality of life, because they are receiving care in their own home and have people around the support them. This will be a more structural and systematic shift that will be driven by cost and the quality of care that people seek. To a degree, it will also change the role of government in how they can best fulfill societal needs as efficiently as possible.”

For additional insights on other aspects of the future of healthcare go to the conference website.

As part of the workshop we used a framework that I originally developed over a decade ago in the context of collaboration in the financial services industry, but I have used in the last year in industries as diverse as healthcare, airlines, and professional services.

The future of every industry lies in value creation across organizations. To achieve that we need explicit discussions and engagements among all industry participants on what it is that they’d like to collectively achieve, and how they can get there. This framework lays out the key components:

Click on the image for a larger version

You have to start with:

Vision

This comes from discovering and finding alignment between participants:
What world do we want to create? What might be possible?

From there you delve into the required:

Foundations

This is where you examine:
What institutions, business models, platforms and systems will enable this vision? What is missing now?

You also need to understand the:

Roadblocks

There are always obstacles; you need to understand and explore:
What is blocking the potential? How can we take away or bypass these blocks?

To get to your vision you need to explore the many possible:

Paths

Having a successful journey to your destination means you must ask:
What possible paths forward could allow us to reach our vision? What is most feasible? What are milestones along the way?

This will inevitably require a high degree of:

Collaboration

In order to build this you first must understand:
What collaboration is needed between whom? How can we foster and enable that collaboration?

And finally you will never achieve the vision without clear and consistent:

Action

Collectively you need to define and agree:
What action today can be taken by the industry? What action can you take to enable the industry’s potential?

This framework, or variations on it, can be applied in any industry. Every industry requires leadership to change from where it has been to where it can create substantially greater economic value for its participants, and social value for all stakeholders.

Some may wonder why they should invest their energy in leading their industry forward rather than focusing solely on their organization, however leading beyond boundaries always brings value to those who help move the system forward.

As I wrote in Living Networks:

Today, you must be a leader across a domain that often extends far beyond the borders of your company. In order for your company to succeed, the whole value network within which you work must succeed as well. Unless you provide the leadership for that to happen, you become the subject of industry forces rather than creating them. Industries will inevitably shift dramatically as the network economy comes to life, and those that will take best advantage of those changes are those that lead them.

In every industry, the opportunity is there.

However in preparing for some TV interviews at the turn of the year I have pulled together 7 themes that will help define 2015. Here they are, together with illustrative videos.

1. Robots are here

Robots have so long being part of science fiction that many have come to believe they will never arrive. With recent technological advances, the age of robots is finally beginning, with humanoid robots finally entering the mainstream in work, retail, aged care, the home and even warfare.

2. From reactive to predictive medicine

Health and medicine has traditionally been about reacting when we get sick. New technologies are turning it around, allowing us to constantly monitor ourselves so we can take action before we get sick. We can get direct feedback to help us change behaviours, and DNA analysis means we can soon get medicines that are personalised for us alone. Health management tomorrow will be very different from health today.

3. Technology is fashion

Technology is not just a fashion accessory, but fashion itself. Smartwatches are making tech giants into purveyors of fashion, and establishment French and Swiss luxury companies are becoming tech firms. Clothes themselves are becoming ‘smart’ as textiles embed technology, monitoring our health, communicating with friends, and displaying people’s moods for all to see.

4. Immersive entertainment

Entertainment is going beyond watching to experiencing. Facebook, having purchased Oculus Rift for $2 billion, as well as Samsung and others are launching virtual reality headsets that will allow people to feel immersed in movies and games. Other immersive technologies that may emerge in 2015 include Star Wars-like holographic communication on mobile phones and the highly secretive Magic Leap, which has attracted a $500 million investment from Google with a mission to transform entertainment.

5. Technology transforms finance

Money, payments and investment are all being transformed by technology. Cash is rapidly disappearing from our lives as payments by mobile and biometric identification become commonplace. Artificially intelligent ‘robo-advisors’, already commonplace in the US, will compete with human financial advisors in helping us make wealth planning decisions.

6. Reversing ageing

Humankind has never been satisfied with mortality. New figures show that the life expectancy of Australians has increased 4.8 years over the last 24 years, more than in any other developed country. Now heavily-funded medical research promises to rapidly extend our longevity. Scientists have recently successfully reversed ageing in mice, with human trials now in progress. Beyond leading-edge medicine, healthier habits of many Australians and changed attitudes are dramatically shifting the perception of age, with an increasing number of 60 year-olds being as vital as our image of 40 year-olds.

7. It’s easy to be perfect

The debate over air-brushed models in magazines has moved on. Now powerful editing tools make it easy for anyone to make themselves look wonderful in photos, and we will soon be able to choose how we look in video calls, making us appear well-dressed, perfectly groomed and made-up even if we’ve just dragged ourselves out of bed. Social media is allowing people to shape how they are perceived online, making boring lives glamourous and fraught relationships appear perfect. We are making our lives appear flawless, and are only seeing the shiny gloss of others’ lives.

Government was designed to be institutional, providing stability to nations. Yet that design and structure means that governmental institutions are generally very poorly prepared to change as required in the face of extraordinary shifts in society and business.

I have been drawn more into the future of government over the last few years, among other activities creating and sharing my Transformation of Government framework with a variety of groups of senior policymakers.

William Eggers and his team at Deloitte have distilled some excellent analysis and insights into the future of government at their Government 2020 site, which includes an overview of drivers and trends shaping government, and views on the implications across domains of government.

The following slides and video provide nice high-level overviews of the work.

The other resources on the website are well worth a look, including the Drivers and Trends sections.