NHS CyberSecurity lessons arising from the worldwide ransomware attack that occurred on the 14th of May is already prompting much debate for the NHS, much of which focuses on the failure of affected organisations to ensure adequate levels of investment on IT systems to mitigate the risk of this event.
The ransomware exploited a known issue with Windows XP, for which a patch had been issued earlier in the year. The biggest news headlines here in the UK concerned the impact this exploit had on the NHS, with a great many organisations appearing to have been caught out by the Windows XP vulnerability.
As is the case when the public sector suffers an adverse event, the call goes out for lessons to be learned, usually with an assumption that these are all new, but inevitably there will be those lessons that have already been learned, but just not put into practice.
Those that have been around NHS IT for a while will remember the last elected labour government’s implementation of the National Programme for IT (NPfIT) tasked to deliver a standard national NHS IT system. Regardless of what is thought about the success or failure of the programme, it did leave a lasting legacy long after it was cancelled.
Not least with those NHS organisations that had progressed to implementing NPfIT systems and solutions and in doing so, had tied themselves to technology standards defined by the program that could not be easily changed. In the commentary on following the ransomware event it has been highlighted that the legacy of NPfIT Windows XP implementations was the reason so many organisations were adversely affected.
In September 2011, the government announced the acceleration of the dismantling of the National Programme for IT*. Whilst at the time the impact of this decision was not significant, because NPfIT technology was still current and thus supported by providers, it should have perhaps been better recognised that this state was not sustainable in the long term. Especially for Windows XP, because the next version Windows 7 was already available (released Oct 2009) and being adopted across health in non NPfIT legacy environment.
Things finally came to a head for XP when Microsoft announced that it would be ending its patching and maintenance support for the platform in April 2014. Thankfully in acknowledging that there was still a dependency on this technology platform, the government took steps and signed an extra-ordinary deal with Microsoft** that secured continued support for XP across the UK public sector for another 12 months.
Critically, a condition of this agreement, was that any public sector body wishing to take advantage of this extended support arrangement, had to commit to development of a “robust plan” to move off Windows XP, Office 2003 and Exchange 2003 within the year.
Roll forward to 2015 and the next government decision on the matter was just as they had advised, that they would be closing down this extra-ordinary support arrangement ***, and is has to be said for good reason, on the basis that it was felt that continued central government funding of this deal was not consistent with the need to encourage organisations to urgently upgrade or migrate.
The question here however has to be, “was it reasonable to expect trusts to be able to find the funds for wholesale upgrade of unsupported operating systems in such a short time frame (this being equivalent to a single financial year)?
To further compound matters at the time, NHS organisations had been shielded from the full cost of wholesale systems upgrade throughout the time of NPfIT. A national licencing deal with major suppliers like Microsoft, removed the need for software costs to be met locally by NHS organisations ****.
It is accepted best practice that when a pre-existing programme or project is to be closed down, an impact assessment of the consequences should be undertaken. Not least so that the risk can be properly understood and adequate mitigations planned. If nothing else there is nearly always a financial consequence to closing programmes and projects and this is a very good example of one.
The NPfIT programme along with central licensing deals transformed the model of IT investment within the NHS for a decade. Switching these off and closing down the national deals the programme created was inevitably going to have consequences for participating organisations.
Some will argue that the implementation of the extra-ordinary support arrangements for legacy software was an act of risk mitigation. However, was it reasonable in 2014 to expect affected organisations to plan and implement an upgrade or migration of XP in a single financial year, without any additional financial support being provided?
The NHS had already been managing financial pressures for a good number of years before the decision to end XP support was taken. Certainly long enough for organisations to flag this to be a risk of significance, that without additional and extra-ordinary financial support, there was no way they were going to be able to take the steps needed to address the situation accordingly.
In summing up, it is clear that although the NPfIT national licencing deals themselves had been closed down some years earlier in 2010, the impact of this decision on local investment plans going forward, was never properly qualified or understood, and that further opportunities to address this in 2015 were missed and all the way up to 14th of May this year, 7 years on!
As an acknowledged risk, the XP issue should have been raised on the Information Governance (IG) Risk Register and flagged as a serious concern to the Senior Information Risk Owner (who by now and as a result of improvements to NHS IG standards) was a role assigned to a senior management representative on the board of the organisation.
Additionally, given the dependence on technology in meeting clinical outcomes, the risk should have also featured on the Clinical Risk Register, which would have flagged it up to the Chief Medical Officer, also a member of the board.
Just a cursory glance at most organisations annual reports and board papers will expose the fact that IT barely gets a mention, certainly any reviewer will be hard pressed to find any mention of XP specifically in the dealings of the boards in any one of the organisations affected, at any stage of the timeframe of this being an ongoing concern.
This therefore exposes a potentially bigger issue in that information technology investment and dependence is not a matter adequately represented at the board level, then or now.
This clearly is a matter of concern, given as the recent event exposed the criticality of the services dependence on the information technology in the performance of its primary function, delivery of treatment and care.
Frustratingly some of the commentary on the event included the phrase “IT is not the primary business of the NHS”, suggesting therefore it is not the NHS responsibility to ensure the reliability and safety of the tools it uses to deliver care, this is clearly nonsense.
It is perhaps partly this attitude that has excluded proper IT representation at the board level? Given the next stage of investment required and proposed by “paperless at the point of care” and “integrated digital health and care plans” and additional dependence on technology this will deliver, it is now time for IT to have a seat at the top table.
The NHS has an excellent online tool and system of guidance and assessment addressing information systems, security and good practice management standards (NHS Information Governance Toolkit). The tool is well established having been around and in use for more than 15 years with NHS organisations status reports openly published and available for review.
In April 2014 in a blog article entitled Patient Record Access – A Perspective 2 Years On I set out the more fundamental data protection and information governance challenges that the NHS needed to address to maximise the benefits potential of digital engagement. Not long after the original 2015 target for achieving patient record access was deferred to 2018 and linked to the “paperless at point of care” requirement.
Then and still today, technology innovation is widely acknowledged and accepted to be the primary method by which transformation of current health and social care models, and opportunities to deliver service effectiveness improvements and efficiencies at a substantial scale (£20bn+) going forward is to be achieved.
NHS 2020 digital roadmaps across the country outline ambitious plans addressing technology integration and innovations requirements needed to achieving “paperless at the point of care” and “integrated digital health and care record”. The levels of investment are significant, but then so is the benefits potential. For the first time in the history of health and social care, the technology to support transformation to a more pro-active and well-being orientated model is possible.
Success however will be heavily dependent on the digital engagement of patients and their carer’s and how effectively this is achieved. In this respect information governance will be a key deliverable and factor in how much and how quickly the benefits of patient digital engagement are secured and maintained going forward. Patients will need ongoing assurance that digital engagement is safe, and that their right to privacy is being properly protected.
Of the 33 major NHS organisations (community and acute hospitals) identified to have been affected, all have reported a “satisfactory” rating in the information governance self-assessments completed in March this year, in particular for the following requirements:
|Information Security Assurance|
|14-301||A formal information security risk assessment and management programme for key Information Assets has been documented, implemented and reviewed|
|14-307||An effectively supported Senior Information Risk Owner takes ownership of the organisation’s information risk policy and information risk management strategy|
|14-309||Business continuity plans are up to date and tested for all critical information assets (data processing facilities, communications services and data) and service – specific measures are in place|
|14-310||Procedures are in place to prevent information processing being interrupted or disrupted through equipment failure, environmental hazard or human error|
|14-311||Information Assets with computer components are capable of the rapid detection, isolation and removal of malicious code and unauthorised mobile code|
|14-313||Policy and procedures are in place to ensure that Information Communication Technology (ICT) networks operate securely|
The recent CyberSecurity event serves to remind the NHS, that despite all the good work done in the development of the information security and governance standards and despite all the resources that have been provided to help organisations get good at this, there is so much more to be done, and this too is going to require additional investment at the local organisational level.
Links to Articles
Cybathlon, the first Olympic Games for bionic athletes was hosted on 8 October 2016, in Kloten, Switzerland. This world premiere saw 74 international disabled athletes – kitted out with bionic prostheses and brain-computer interfaces – compete with each other at the specially created events. These modern-day cyborgs from 25 different countries competed in 59 different teams from all over the world.
The initiative was launched by Robert Riener, a professor of sensory-motor systems at ETHZ. “One of the goals of the cybathlon is to encourage researchers and developers to work on robotic technologies that can substantially improve daily life for people with disabilities.”
The unique competition for people with disabilities will continue!
The six disciplines from 2016; Brain-Computer Interface Race, FES Bike Race, Powered Arm Prosthesis Race, Powered Leg Prosthesis Race, Powered Exoskeleton Race, Powered Wheelchair Race, will remain in the Cybathlon 2020 programme. The tasks will continue to be relevant to everyday life, but will reflect advances in research. The main goal of the Cybathlon 2020 is to push the development of assistive devices for people with disabilities.
Due to the very successful Cybathlon event in 2016 and the feedback received, the Organising Committee plans an even bigger event, breaking it up into two days. There will also be an attractive secondary programme, wherein the visitors can try out the disciplines for themselves (hands-on demos) and understand the issues surrounding disability in a practical way.
A smart city (also smarter city) uses digital technologies or information and communication technologies (ICT) to enhance quality and performance of urban services, to reduce costs and resource consumption, and to engage more effectively and actively with its citizens. Sectors that have been developing smart city technology include government services, transport and traffic management, energy, health care, water and waste. Smart city applications are developed with the goal of improving the management of urban flows and allowing for real time responses to challenges. A smart city may therefore be more prepared to respond to challenges than one with a simple ‘transactional’ relationship with its citizens. Other terms that have been used for similar concepts include ‘cyberville, ‘digital city’’, ‘electronic communities’, ‘flexicity’, ‘information city’, ‘intelligent city’, ‘knowledge-based city, ‘MESH city’, ‘telecity, ‘teletopia’’, ‘Ubiquitous city’, ‘wired city’.
The Smart City Expo World Congress is the only international event on the smart cities’ calendar bringing together over 400 cities around the world, more than 200 companies, 400 speakers and the leading institutions and experts in urban transformation.
You might be interested (and a little surprised) in knowing the extent to which cities around the world are collaborating with the Smart City Expo World Congress.
Its still early days as far as development of smart city innovations go, but if yours is not on the list, you might want to ask the powers that be why it is not? Because given the rate at which things change, now would likely be a good time to jump on board this initiative!
Spain and Israel seem to have a fervour to develop their Smart Cities in a very big way, with a great many of these countries cities taking part.
India and notably South American countries Argentina, Mexico and Brazil feature as close runner ups, with the USA and European countries making up others that have a good number of cities engaged, though in some case not as many as you might expect?
The UK seems to have only what might be considered a reasonable rather than exceptional number engaged on this initiative, with notably only one in Scotland and none in Wales or Northern Ireland. My home city of Exeter in Devon is not on the list either, so some lobbying to be done here!!!! Good luck to anybody else who takes up the cause for their home city (or even town).
Source: Cities involved in 2014
|Bahía Blanca, Buenos Aires, Cañada De Gómez, Casilda, Chaco, Chanear Ladeado, Córdoba, Hughes, La Plata, La Rioja, Mendoza, Resistencia, Rosario, San Cristóbal, San Telmo, Santa Fe, Totoras, Tucumán, Vicente López, Villa Cañás|
|Australia||Melbourne, Newcastle, Parkville, Sydney|
|Austria||Grödig, Innsbruck, Vienna|
|Belgium||Aalst, Brasschaat, Brussels, Genk, Gent, Gial, Heverlee-Leuven, Knokke-Heist, Kortrijk, Lokeren. Mechelen. Mol|
|Brazil||Belo Horizonte, Brasilia, Cantagalo, Casimiro De Abreu, Curitiba, Divinopilis, Guaruja, Macaé, Porto Alegre, Resende, Rio Das Ostras, Rio De Janeiro, São Bernardo Do Campo, São João De Miriti, São Paulo, Sete Lagoas, Três Rios, Vitoria|
|Canada||Chambly, Kingston, Montreal, Toronto, Wolfe Island|
|Chile||Santiago De Chile, Villa Alemana|
|China||Beijing, Chongqing, Nanjing, Hong Kong, Qinzhou, Shanghai, Shenzhen, Shijiazhuang|
|Colombia||Barranquilla, Bogotá, Ibague, Manizales, Medellín, Pereira|
|Croacia||Dubrovnik , Sesvete, Zagreb|
|Czech Republic||Brno, Prague|
|Denmark||Aarhus, Albertslund, Charlottenlund, Copenhagen, Gentofte|
|Ecuador||Durán, Quito, San Gregorio De Portoviejo, Yachay|
|Finland||Espoo, Helsinki, Mikkeli, Sipoo, Tampere|
|France||Bordeaux, Issy-Les-Moulineaux, Lyon, Nantes, Paris, Perpignan, Roubaix, Toulouse,|
|Germany||Berlin, Bremen, Cologne, Dortmund, Freiburg, Hamburg, Hannover, Oldenburg, Potsdam|
|Greece||Igoumenitsa, Larissa, Patras|
|India||Ahmedabad, Ajmer, Allahabad, Amritsar, Bhopal, Chandigarh, Delhi, Hyderabad, Jaipur, Mumbai, New Delhi, Pimpri Chinchwad, Pondicherry, Ranchi, Thiruvananthapuram, Vijaywada, Visakhapatnam|
|Indonesia||Banda Aceh City, Jakarta|
|Iran||Bandar Abbas, Esfahan, Teheran|
|Ireland||Dublin, Galway, Naas, Phibsborough, Portlaoise|
|Israel||Alfei Menashe, Ariel, Ashdod, Ashkelon, Bat Yam, Beer Yakov, Bnei Ayish, Bnei Brak, Eilat, Eilot, Gedera, Geva Carmel, Gush Etzion, Haifa, Herzliya, Holon, Hurfeish, Jerusalem, Katzrin, Kfar Saba, Kiryat Arba, Kiryat Gat, Luzit, M- Yehuda, Ma’Ale Edumim, Mateh Yehuda, Modiin, Natanya, Ness Ziona, Netanya, Petach-Tikva, Raanana, Ramat Gan, Ramla, Rehovot, Rishon Lezion, Savyon, Shoham, South Hasharon, Tamar, Tel Aviv, Tel-Mond, Yakum|
|Italy||Amaro, Turin, Gènova, Lecce, Milan, Pordenone, Povo, Rome|
|Japan||Fukuoka, Kumamoto, Kyoto, Tokyo, Yokohama|
|Mexico||Álvaro Obregón, Colima, Guadalajara, México, Puebla, Toluca, Zapopan|
|Netherlands||Alblasserdam, Amersfoort, Amsterdam, Assen, Eindhoven, Eursing, Groningen, Rotterdam, Schiphol, The Hague, Tilburg, Utrecht, Zoetermeer, Zoeterwoude|
|New Zealand||Auckland, Wellington|
|Nigeria||Abeokuta, Isolo, Surulere/Lagos|
|Norway||Asker, Oslo, Stavanger|
|Portugal||Gondomar, Lagoa, Oeiras, Portimão, Porto|
|Russian Federation||Moscow, Saint Petersburg|
|Saudi Arabia||Jeddah, Riyadh|
|Solomon Islands||Solomon Islands|
|South Africa||Cape Town|
|South Korea||Daejeon, Seoul, U-Sung|
|Spain||A Coruña, Amposta, Artà, Artesa de Segre, Badalona, Barcelona, Begues, Berga, Cambrils, Castelldefels, Castellón, Cerdanyola Del Vallès, Cornellà De Llobregat, Dénia, Donostia-San Sebastián, Esplugues de lobregat, Figueres, Gavà, Gijón, Girona, Granollers, Jaén, L’Hospitalet de Llobregat, Lliçà d’Amunt, Logroño, Madrid, Málaga, Malgrat de Mar, Manresa, Mataró, Mollet del Vallès, Móstoles, Ordis, Palma de Mallorca, Pamplona, Reus, Rivas Vaciamadrid, Sabadell, Sant Adrià del Besós, Sant Climent de Llobregat, Sant Cugat del Vallès, Sant Esteve Sesrovires, Sant Feliu de Llobregat, Sant Just Desvern, Santander, Santiago De Compostela, Santpedor, Sevilla, Sitges, Tarragona, Terrassa, Valencia, Valladolid, Vic, Vigo, Viladecans, Vitoria-Gasteiz, Zaragoza|
|Sweden||Gothenburg, Kista, Malmö, Lund, Stockholm|
|United Arab Emirates||Abu Dhabi, Dubai, Zaabeel|
|United Kingdom||Birmingham, Bristol, Clevedon, Edinburgh, Glasgow, Greenwich, Leeds, Liverpool, London, Manchester, Milton Keynes, Peterborough, Redruth, Southampton, Swindon|
|United States||Boston, Boulder, Charlotte, Denver, Fort Lauderdale, New York, Orlando, Philadelphia, Portland, Raleigh, Redmond, San Francisco, Seattle, Washington, Wayland|
|Venezuela||Catia La Mar|
Healthcare technologies that have potential to really shape the way medicine and healthcare is practiced and delivered is explored by Dr. Bertalan Mesko, PhD, The Medical Futurist, author, keynote speaker, geek doctor with PhD in genomics, science fiction fanatic who shares his thoughts on his favorite technologies in this video.
More from Dr Mesko can be found at https://www.youtube.com/user/medicalfuturist/featured
The Internet and digital technologies are transforming our world – in every walk of life and in every line of business. Europe must embrace the digital revolution and open up digital opportunities for people and businesses. How? By using the power of the EU’s Single Market. Today, the European Commission unveiled its detailed plans to create a Digital Single Market, thereby delivering on one of its top priorities.
At present, barriers online mean citizens miss out on goods and services: only 15% shop online from another EU country; Internet companies and start-ups cannot take full advantage of growth opportunities online: only 7% of SMEs sell cross-border (see Factsheet for more figures). Finally, businesses and governments are not fully benefitting from digital tools. The aim of the Digital Single Market is to tear down regulatory walls and finally move from 28 national markets to a single one. A fully functional Digital Single Market could contribute €415 billion per year to our economy and create hundreds of thousands of new jobs.
The Digital Single Market Strategy adopted today includes a set of targeted actions to be deliveredby the end of next year (see Annex). It is built on three pillars: (1) better access for consumers and businesses to digital goods and services across Europe; (2) creating the right conditions and a level playing field for digital networks and innovative services to flourish; (3) maximising the growth potential of the digital economy.
Commission President Jean-Claude Juncker said: “Today, we lay the groundwork for Europe’s digital future. I want to see pan-continental telecoms networks, digital services that cross borders and a wave of innovative European start-ups. I want to see every consumer getting the best deals and every business accessing the widest market – wherever they are in Europe. Exactly a year ago, I promised to make a fully Digital Single Market one of my top priorities. Today, we are making good on that promise. The 16 steps of our Digital Single Market Strategy will help make the Single Market fit for a digital age.”
Vice-President for the Digital Single Market Andrus Ansip said: “Our Strategy is an ambitious and necessary programme of initiatives that target areas where the EU can make a real difference. They prepare Europe to reap the benefits of a digital future. They will give people and companies the online freedoms to profit fully from Europe’s huge internal market. The initiatives are inter-linked and reinforce each other. They must be delivered quickly to better help to create jobs and growth. The Strategy is our starting point, not the finishing line.“
Commissioner for the Digital Economy and Society Günther H. Oettinger said: “Our economies and societies are going digital. Future prosperity will depend largely on how well we master this transition. Europe has strengths to build on, but also homework to do, in particular to make sure its industries adapt, and its citizens make full use of the potential of new digital services and goods. We have to prepare for a modern society and will table proposals balancing the interests of consumers and industry.”
The Digital Single Market Strategy sets out 16 key actions under 3 pillars which the Commission will deliver by the end of 2016:
The Commission will propose:
1. rules to make cross-border e-commerce easier. This includes harmonised EU rules on contracts and consumer protection when you buy online: whether it is physical goods like shoes or furniture; or digital content like e-books or apps. Consumers are set to benefit from a wider range of rights and offers, while businesses will more easily sell to other EU countries. This will boost confidence to shop and sell across borders (see Factsheet for facts & figures).
2. to enforce consumer rules more rapidly and consistently,by reviewing the Regulation on Consumer Protection Cooperation.
3. more efficient and affordable parcel delivery. Currently 62% of companies trying to sell online say that too-high parcel delivery costs are a barrier (see the newly released Eurobarometer on e-commerce).
4. to end unjustified geo-blocking – a discriminatory practice used for commercial reasons, when online sellers either deny consumers access to a website based on their location, or re-route them to a local store with different prices. Such blocking means that, for example, car rental customers in one particular Member State may end up paying more for an identical car rental in the same destination.
5. to identify potential competition concerns affecting European e-commerce markets. The Commission therefore launched today an antitrust competition inquiry into the e-commercesector in the European Union (press release).
6. a modern, more European copyright law: legislative proposals will follow before the end of 2015 to reduce the differences between national copyright regimes and allow for wider online access to works across the EU, including through further harmonisation measures. The aim is to improve people’s access to cultural content online – thereby nurturing cultural diversity – while opening new opportunities for creators and the content industry. In particular, the Commission wants to ensure that users who buy films, music or articles at home can also enjoy them while travelling across Europe. The Commission will also look at the role of online intermediaries in relation to copyright-protected work. It will step up enforcement against commercial-scale infringements of intellectual property rights.
7. a review of the Satellite and Cable Directive to assess if its scope needs to be enlarged to broadcasters’ online transmissions and to explore how to boost cross-border access to broadcasters’ services in Europe.
8. to reduce the administrative burden businesses face from different VAT regimes: so that sellers of physical goods to other countries also benefit from single electronic registration and payment; and with a common VAT threshold to help smaller start-ups selling online.
The Commission will:
9. present an ambitious overhaul of EU telecoms rules. This includes more effective spectrum coordination, and common EU-wide criteria for spectrum assignment at national level; creating incentives for investment in high-speed broadband; ensuring a level playing field for all market players, traditional and new; and creating an effective institutional framework.
10. review the audiovisual media framework to make it fit for the 21st century, focusing on the roles of the different market players in the promotion of European works (TV broadcasters, on-demand audiovisual service providers, etc.). It will as well look at how to adapt existing rules (the Audiovisual Media Services Directive) to new business models for content distribution.
11. comprehensively analyse the role of online platforms (search engines, social media, app stores, etc.) in the market. This will cover issues such as the non-transparency of search results and of pricing policies, how they use the information they acquire, relationships between platforms and suppliers and the promotion of their own services to the disadvantage of competitors – to the extent these are not already covered by competition law. It will also look into how to best tackle illegal content on the Internet.
12. reinforce trust and security in digital services, notably concerning the handling of personal data. Building on the new EU data protection rules, due to be adopted by the end of 2015, the Commission will review the e-Privacy Directive.
13. propose a partnership with the industry on cybersecurity in the area of technologies and solutions for online network security.
The Commission will:
14. propose a ‘European free flow of data initiative‘ topromote the free movement of data in the European Union. Sometimes new services are hampered by restrictions on where data is located or on data access – restrictions which often do not have anything to do with protecting personal data. This new initiative will tackle those restrictions and so encourage innovation. The Commission will also launch a European Cloud initiative covering certification of cloud services, the switching of cloud service providers and a “research cloud”.
15. define priorities for standards and interoperability in areas critical to the Digital Single Market, such as e-health, transport planning or energy (smart metering).
16. support an inclusive digital society where citizens have the right skills to seize the opportunities of the Internet and boost their chances of getting a job. A new e-government action plan will also connect business registers across Europe, ensure different national systems can work with each other, and ensure businesses and citizens only have to communicate their data once to public administrations, that means governments no longer making multiple requests for the same information when they can use the information they already have. This “only once” initiative will cut red tape and potentially save around €5 billion per year by 2017. The roll-out of e-procurement and interoperable e-signatures will be accelerated.
The Digital Single Market project team will deliver on these different actions by the end of 2016. With the backing of the European Parliament and the Council, the Digital Single Market should be completed as soon as possible.
For more information:
An astonishing story has recently surfaced of technological progress to overcome disability, about a man called Les Baugh who lost both arms in an electrical accident 40 years ago. That with the help of Johns Hopkins University’s Applied Physics Laboratory and DARPA (Defense Advanced Research Projects Agency), has today a significantly reduced level of disability thanks to the development of Modular Prosthetic Limbs
What is astounding in this story is the fact that the intelligent prosthetic arms are able to interpret muscle movement and nerve signals when Baugh thinks about moving his arms, enabling the arms as a result to respond and move accordingly.
“Baugh is the first bilateral shoulder-level amputee to wear two Modular Prosthetic Limbs at once, according to the researchers. He’s spending a lot of time practising different tasks.”
Technological developments in robotics is certainly starting to break down the human (biological) / machine boundaries and certainly, the early beginnings of a whole new dimension in respect of how disabilities may be overcome is opening up.
“Maybe I’ll be able to — for once — be able to put change in a pop machine and get the pop out of it,” Baugh said in a video about the breakthrough. “Simple things like that that most people never think of.“
Presently he can only use the arms in the lab for now, but someday he will have two of his own.
Mike McLoughlin, the program manager at Johns Hopkins
“There’s just a tremendous amount of potential ahead of us, and we just started down this road. I think the next five, 10 years are going to bring some really phenomenal advancements.“
These new developments in intelligent prosthetics capability offer hope to millions of people struggling with the disability of a missing limb, and this will likely be the focus of developments for this next 10 years that Mike McLoughlin is referring to.
But what about beyond this? It is likely increased capability and improvements in performance, will create the potential for the application of this technology to go further, some people will want upgrades to deficient limbs, and even perhaps will seek to replace perfectly capable limbs with solutions that offer enhancements and improvements, ones that biologically alone cannot be achieved.
This will likely arise from the perspective that those once inhibited by disability, not only have the disability overcome, but that their individual abilities returned, are perceived to have become artificially enhanced. Ironically, in this scenario the tables become turned, in that the able bodied are now perceived to be the disadvantaged.
In a much more simplistic sense we have already born witness to this notion in the great debate that surrounded the discussion following the decision to allow Oscar Pistorius, “the blade runner”, to compete against able bodied athletes at the London Olympics.
Whilst the decision was arguably a triumph for those living with disabilities, Ade Adepitan, who competed in wheelchair basketball and now presents Channel 4’s That Paralympic Show, had more conflicted views when he offered his thoughts to the Guardian Article, suggesting that Pistorius could be a radical role model for disabled athletes, saying:
“If he gets into the final it’s going to send shock waves round the world, and if he wins a medal, wow,” picture a double-leg amputee on the podium at the Olympics. What doors would it open up?
What implications does it have? None of us will know until it happens, but that’s the great thing about what Oscar is doing: he’s asking questions.“
In the same article another, as the Guardian author Tim Lewis put it – reliable erudite Roger Black, the UK’s greatest 400m runner, was one of the first to speak out. No scientific consensus, he pointed out, had been reached on whether the blades provided Pistorius with a benefit and until that was clear we did not have the faintest idea whether he was:
“an amazing athlete or a very good athlete with an advantage“
Black also placed himself in the spikes of an athlete beaten – maybe even to a medal – by Pistorius. Would they think, perhaps even justifiably, that it was unfair?
Given human nature being what it is, humans wanting upgrade to overcome limitation of the human condition are an inevitability. A fact already explored by Yuval Noah Harari a historian in his book Sapiens, within which the human race takes on the role as intelligent designer, to surmount evolution by provision of the ability to upgrade ourselves.
The fundamental problem as Hatari sees it is that this upgrade ability will be restricted to the rich, leading in a relatively short space of time to a social inequality of great significance.
Best summed up by the Guardian article, what we are faced with is a revolution already in progress, borne of engineering and exploits mechanical, electronic, chemical and genetic,
“In the 20th century, the main task of medicine was to bring everybody to a certain level of health and capability. It was by definition an egalitarian aim,” Harari told the Guardian. “In the 21st century medicine is moving onwards and trying to surpass the norm, to help people live longer, to have stronger memories, to have better control of their emotions. But upgrading like that is not an egalitarian project, it’s an elitist project. No matter what norm you reach, there is always another upgrade which is possible.“
The question perhaps, is given the increasing rate of technological advancement, could this next stage of human evolution be a reality within the next 10 years?
AN ambitious hi-tech £11m plan to allow any doctor or nurse to access a patient’s information from anywhere in the country is being launched by Islington health chiefs.
Patients will have their own Facebook-style health records page or app, detailing all of their information, which they will be able to invite other people to look at from anywhere from “Cornwall to Scotland”.
As a proposed solution eCulture certainly thinks it is a good way to go in so far as providing a patient consent based interface solution. The key will be however in what platform they build this to integrate with from an existing social network perspective. Or if they decide to establish their own, what additional functionality they would proposed to include beyond that concerning health to keep prospective clients engaged.
Other fundamental aspects of concern, build out of the core infrastructures, taking into account the information governance and cyber security requirements, with the need to build in capacity for growth, this is not cheap, even from a start-up perspective.
Opting for a predominantly open source approach will keep costs down, but there will always be an associated cost incurred on a user by user basis some from commercial off the shelf (COTS) technologies, that cannot be displaced by open source alternatives and, subject to what functionality is provided associated increases in platform costs.
There is potential to offer certain services to clients on a subscription basis to cover this, but this is most easily addressed when the offering is from a commercial third party, not so easily implemented when the solution is being offered from an NHS body?
Affiliate revenues are another potential but considerable care and attention in how this is achieved has to be taken, i.e. if the solution is going to have in time an advertising affiliate revenue based model, then great care has to be taken in what is advertised, again more so if it is presented as an “NHS” solution.
Perhaps the business case at the end of the day can justify the investment and running costs be met by central government, on the basis of strong returns on investment achieved.
When they launch it will be interesting to see what fair processing notice comes with the launch, if it is developed correctly with the right approach in terms of implementing a patient consent / data access assurance model then the notice becomes much less of an issue.
It’s all doable so one to watch for sure….
With a recent refresh of the website and refocusing of what eCulture Solutions was about I thought it was would be good to try and define succinctly a mission, for which I have arrived at…
“To facilitate the exploitation of digital innovation, supporting delivery of positive and inclusive social and business transformation.”
The pace of technology innovation and digital inclusion is increasing at a significant rate and societies the world over, are transitioning to an digitally orientated way of life as governments and institutions adopt digital ways of engaging in preference over existing methods. Societies are entering the “eCulture” digital age .
The measure of success in the development of eCulture, will come down to how well society manages to establish “mutually supporting communities” in a digital context.
It is early days, and so as organisations and business start out on their respective eCulture transitions I thought it would be helpful to offer some guidance on what could be key considerations.
Government, public sector and allied third party service transformation delivered by preference for engagement between service providers and users to becoming wherever possible, a digital process, is presently focused by the premise that this will deliver much needed efficiency gains and cost savings.
UK Government business case estimates presently suggest that transactions online can already be 20 times cheaper than by phone, 30 times cheaper than postal, and as much as 50 times cheaper than face-to-face.
Success however, will not be achieved with this focus alone. Efficiency gains and savings can only be realised by wide scale adoption, that in turn will only be secured by service redesign that delivers mutual benefits to service users, largely recognised by them as improvements in efficiency, effectiveness and / or quality of the service.
There is however something that is fundamentally new in this evolution to eCulture status, on the basis that until now, any digital project concerning the engagement of service users, with notably these being largely commercial ventures, has qualified requirements and measures of success in business plans / profit and loss forecasts, on the basis of focusing engagement on a digitally “included” demographic.
By contrast a key distinguishing factor in the transition to the ‘eCulture’ age, is the social development focus on digital – for example job adverts and applications and critically public services, such as benefits and health and social care services, which for those that remain digitally “excluded”, the prospect of social exclusion and increasing poverty are of serious concern.
Digital exclusion is defined as:
Consequently overcoming the digital exclusion challenges is of greater concern to government, public sector and allied third party provider projects. Because the target demographic for online public services is the poor, elderly, frail and socially excluded, these representing the greatest proportion of citizens making most use of public and allied third party services, that unfortunately are also the greatest proportion that are ‘individually’ digitally excluded.
In the UK, recent research published by the BBC has found that 21% of UK’s population lack the basic digital skills and capabilities required to realise the benefits of the Internet.
Around a third of small and medium enterprises (SMEs) don’t have a website, and voluntary, community and social enterprises (VCSEs), a great many of which represent the allied third parties supporting public service provision, this figure rises to 50%. Independent analysts estimate full digital take up could add £63 billion value to the UK economy alone!
Of 7 billion people, around 40% of the world population has an Internet connection. In 1995, it was less than 1%. The number of Internet users has increased tenfold from 1999 to 2013. The first billion was reached in 2005, the second in 2010, the third will be reached by the end of 2014.
In 2013 in the UK, 89% of young people now use a smartphone or tablet to go online, up from 43% in 2010. At the end of 2013, global smartphone penetration had exploded from 5% of the global population in 2009, to 22%. That’s an increase of nearly 1.3 billion smartphones in four years.
Tablets are showing faster adoption rates than smartphones. It took smartphones nearly four years to reach 6% penetration from when the devices first started to register on a global level. Tablets accomplished this in just two years.
So in conclusion eCulture, is to help the organisations develop their digital skills and understanding of how technology innovation can be utilised operationally to increase the benefits they are able to deliver to their service users, and in the process of engagement help organisations to reach the digitally excluded through the many digitally included.
After all almost everybody will have a family members, carers, friends or benevolent neighbours that are digitally included……
“their digital community”
A noble quest wouldn’t you agree?
Have a digital project idea you would like help with, then check out our services available from eCulture Solutions