As part of this year’s Leeds Digital Festival, I was invited by mHabitat’s Victoria Betton, to join a public debate and argue the case that “digital innovation in health is benefitting big business over patients.”
Dr. Chris Till and I were to speak for the motion, joined by Dr. Ian Kellar and Anne Cooper to argue against.
Votes were taken from the audience, before and after we made our arguments and took questions. Chris and I managed to swing the vote towards our position, but not enough to carry the motion.
Without expertise in digital health, I had to contrive my argument to suit the motion somewhat, but I did want to poke at the politics and power of the broader corporate cultures behind digital innovation.
What follows is the argument I made…
(In tribute my recently departed sonic crush Prince, I managed to work in five of his songs… see if you can find them :)
Hey everyone, I’m Imran Ali one of the cofounders of Carbon Imagineering a boutique digital R&D consultancy.
My work largely explores the implications of emerging technologies and disruptive innovations.
The Web Is People — not code, not data
I was lucky to have started my career at the birth of a new medium, the web. One of my first jobs was here in Leeds, with Freeserve, designing the services that got much of Britain online for the first time.
Many of my mentors, peers and colleagues were drawn to the countercultural, democratising and empowering promise of the Web. Later, I got to work alongside people like Tim O’Reilly, who coined terms such as open source and Web 2.0, labels that helped coalesce many of the ideas of the social web.
Big Business >> Patients ?
You might find it strange to hear a technologist argue that innovation is benefitting big business rather than patients; especially when companies like mine would likely benefit and because I’m also a consumer of those innovations…
The previous 1196 days of my are mapped and presented to me as daily stories by Facebook’s Moves; Strava records and analyses my heart rate each time I cycle; a Google Nest Protect warns me when I’m about to die in my sleep from carbon monoxide poisoning. Even my DNA has been genotyped, analysed and published online using Google’s 23andMe.
(the good news there is I’ve a low risk of male pattern baldness…)
The Stacks
These individual experiences and technologies are wonderful and offer perspectives that are truly remarkable. But they come with a price…
The era of the open web and its open source cultures are under threat. Discussing ‘digital’ innovation no longer makes sense, when just five vertically organised silos — Google, Apple, Facebook, Amazon and Microsoft — are remaking the world in their image. What writer Bruce Sterling calls The Stacks.
We compliantly inhabit their walled gardens and electronic reservations, moving between them on legally policed pathways. In just a generation, these stacks from Silicon Valley have disrupted orthodoxies in healthcare, transport, media and communication across much of civilisation. But most crucially they are disrupting our governance and evading scrutiny often using the very same networks they create.
We fetishise the inventiveness of The Stacks and their show of America’s prowess. But we must resist the temptation of concentrating so much political and commercial power in such few hands.
The Stacks are built for growth, to extract wealth and capital to maximise shareholder value. They are not deliberately architected for social good, for enhancing community resilience, or to share power, governance and ownership beyond their investor pools.
Data as Toxic Waste
Data is a useful starting point for how we begin to reframe digital innovation around people and patients, rather than business. We often hear about “Data As The New Oil” and the Stacks remind us how they can extract it at will.
But perhaps if we think about data as a waste product, with a lingering toxic half-life, it might lead us to more humane technologies.
Humane Technologies
The Stacks have provided us with astonishing conveniences, but not allowed us to share in their scandalous wealth or trust us with shaping and governing their work.
The Future is however promising — open standards, codesign methods, sharing economies, blockchains, social enterprise and shared ownership — all offer patients and citizens an array of tools to bend the Stacks to our will; as patients, not customers, and as humans, not just moments of data.
Did you find the Prince references? Scandalous!, Trust, America, Temptation and The Future — I couldn’t quite work in Condition Of The Heart and I really wanted to include Vicki Waiting for Victoria :)
