IoT=Cyberdisaster, if we don’t chill innovation and secure it. It’s hip to be scared!

It’s hip to be scared and chill out innovation till we can secure it. That is the plain thought behind the new book Click Here to Kill Everybody, Bruce Schneier’s take on how IoT is going to wreck our lives. Basically, if it can be hacked, it will be, and the more we make dumb things smart, the easier this mischief will be able to hurt us–not our data, but our lives, health, and property.

As our Readers know, TTA has been calling out the threat to humanity since The Gimlet Eye lampooned Internet Thingys doing things against their will back in 2015 and more seriously here. (And yes, parking meters can be paid on a smartphone app in the resort burg of Cape May, NJ.) We have explored, for instance, how easy it is for Black Hats to exploit medical devices and to get into networks via fax machines and all-in-one printers.

Mr. Schneier is not a Luddite. For starters, he is a fellow at the Berkman Klein Center for Internet and Society at Harvard University and a lecturer in public policy at the Harvard Kennedy School. He is on the board of the Electronic Frontier Foundation and is chief technology officer of IBM Resilient, which helps companies prepare to deal with potential cyberthreats. But he can’t buy an unconnected new car (think of that eight-year-old Black Hat waiting to sabotage your steering) and you can’t get an unconnected DVR. It’s getting near-impossible to buy a dumb TV that doesn’t spy on you and to live a lifestyle that is fully disconnected unless you go ‘Life Below Zero.’

So what he is proposing is to ‘chill innovation’ as we do with medical devices and pharmaceuticals for safety’s sake. (Editor’s emphasis)

There’s no industry that’s improved safety or security without governments forcing it to do so. Again and again, companies skimp on security until they are forced to take it seriously. We need government to step up here with a combination of things targeted at firms developing internet-connected devices. They include flexible standards, rigid rules, and tough liability laws whose penalties are big enough to seriously hurt a company’s earnings.

Yes, they will chill innovation—but that’s what’s needed right now! The point is that innovation in the Internet+ world can kill you. We chill innovation in things like drug development, aircraft design, and nuclear power plants because the cost of getting it wrong is too great.

Thoughtful writing and point of view. This Editor would also make the argument about public sanitation, public water supplies, and somewhat in housing, although I would argue that the automotive industry pushed for ease of use (the self-starter) and safety long before the government was engaged, and we are sure Readers can cite more examples.

Just because we can do it technologically does not mean it is the safe, beneficial, and moral thing to do. The more you know about technology, the more you realize it’s good to be more fearful and less trusting of technology, an odd sentence for an health tech Editor to write. But she does like living in one peaceful piece. Think about that when you hear the next Rhapsody about All-Electric Self-Driving Cars, Trucks, and Scooter and How Wonderful They Will Be. MIT Technology Review

Themes and trends at Aging2.0 OPTIMIZE 2017

Aging2.0 OPTIMIZE, in San Francisco on Tuesday and Wednesday 14-15 November, annually attracts the top thinkers and doers in innovation and aging services. It brings together academia, designers, developers, investors, and senior care executives from all over the world to rethink the aging experience in both immediately practical and long-term visionary ways.

Looking at OPTIMIZE’s agenda, there are major themes that are on point for major industry trends.

Reinventing aging with an AI twist

What will aging be like during the next decades of the 21st Century? What must be done to support quality of life, active lives, and more independence? From nursing homes with more home-like environments (Green House Project) to Bill Thomas’ latest project–‘tiny houses’ that support independent living (Minkas)—there are many developments which will affect the perception and reality of aging.

Designers like Yves Béhar of fuseproject are rethinking home design as a continuum that supports all ages and abilities in what they want and need. Beyond physical design, these new homes are powered by artificial intelligence (AI) and machine learning technology that support wellness, engagement, and safety. Advances that are already here include voice-activated devices such as Amazon Alexa, virtual reality (VR), and IoT-enabled remote care (telehealth and telecare).

For attendees at Aging2.0, there will be substantial discussion on AI’s impact and implications, highlighted at Tuesday afternoon’s general session ‘AI-ging Into the Future’ and in Wednesday’s AI/IoT-related breakouts. AI is powering breakthroughs in social robotics and predictive health, the latter using sensor-based ADL and vital signs information for wellness, fall prevention, and dementia care. Some companies part of this conversation are CarePredict, EarlySense, SafelyYou, and Intuition Robotics.

Thriving, not surviving

Thriving in later age, not simply ‘aging in place’ or compensating for the loss of ability, must engage the community, the individual, and providers. There’s new interest in addressing interrelated social factors such as isolation, life purpose, food, healthcare quality, safety, and transportation. Business models and connected living technologies can combine to redesign post-acute care for better recovery, to prevent unnecessary readmissions, and provide more proactive care for chronic diseases as well as support wellness.

In this area, OPTIMIZE has many sessions on cities and localities reorganizing to support older adults in social determinants of health, transportation innovations, and wearables for passive communications between the older person and caregivers/providers. Some organizations and companies contributing to the conversation are grandPad, Village to Village Network, Lyft, and Milken Institute.

Technology and best practices positively affect the bottom line

How can senior housing and communities put innovation into action today? How can developers make it easier for them to adopt innovation? Innovations that ‘activate’ staff and caregivers create a multiplier for a positive effect on care. Successful rollouts create a positive impact on both the operations and financial health of senior living communities.

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Don’t be put off by the title, or the conclusion, of this review of reviews

Whenever I see the word “telehealthcare” I feel there should be an ® or perhaps a ™ after it as it so often appears in connection with a particular organisation. However no such connection is evident is this paper entitled “The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview” (published on the PLOS ONE site), especially as the overall conclusion is far from that often found in articles toting that word:

“Policymakers and planners need to be aware that investment in telehealthcare will not inevitably yield clinical or economic benefits. It is likely that the greatest gains will be achieved for patients at highest risk of serious outcomes. There is a need for longer-term studies in order to determine whether the benefits demonstrated in time limited trials are sustained.”

If you stop there though, you miss some very important points (more…)

Establishing high-level evidence for the safety and efficacy of medical devices and systems

I have recently been made aware of an excellent publication jointly by the Royal Academy of Engineering and the Academy of Medical Sciences entitled Establishing high-level evidence for the safety and efficacy of medical devices and systems, so this post is to reach out to those like me who were previously unaware.

It is a major step forward in applying engineering methodology to evaluating the effectiveness of medical devices & systems and, even more important, ensuring their ongoing safety.  Those of us who have participated in a substantial randomised control trial such as the Whole System Demonstrator (see earlier post today) will take great interest at what follows the quote: “For pharmaceutical innovation, the randomised controlled trial is the acknowledged gold standard for creating a body of high-quality evidence. But designing clinical trials to establish the evidence for medical devices has proven more problematic.”

(Included in the paper is the observation  that the ultimate health improvement device when you leave an aeroplane that is in the air – the parachute – has never been proven by an RCT.)

Finally just to return to an earlier comment, the report makes the point that because medical devices can be changed far more often than the composition of a drug, the importance of appropriate safety monitoring is absolutely critical, an issue that is becoming increasingly relevant as penetration of telehealth (in particular) and telecare increases.  Whilst  we might choose to ignore the different nature of medical devices when assessing a trial, we cannot ignore the different nature of medical devices when designing and putting in place appropriate safety systems.