March 13, 2013 By Robert Bell
I came across a great phrase last week: “practicing at the top of your license.” The words come from healthcare – they refer to practicing medicine as a licensed professional. But they also open up a new way of thinking about the future of innovation and employment.
Healthcare is one of the strangest corners of the working world, because it is just about the only one in which technology innovation has done nothing to make things cheaper. Quite the reverse: each new innovation in diagnosis and treatment seems to trigger an arms race in which providers compete to plunk down more millions on shiny toys, with insurers, governments and ultimately patients picking up the tab.
In an intriguing article (“The Robot Will See You Now” in The Atlantic), Jonathan Cohn writes about a new wave of technology innovation in medicine that aims to supplement the judgment of physicians with artificial intelligence. IBM is leading the pack with its Watson computer, which made headlines in 2011 by winning the American game show Jeopardy. The Cleveland Clinic is helping to develop Watson as a training tool for young physicians and ultimately as a tool for diagnosis at the bedside.
Much is expected of Dr. Watson. Human physicians tend to diagnose based on a small set of things they observe, guided by judgment honed with experience. Watson may not have a physician’s judgment or experience, but it has access to vastly more knowledge. So Watson can suggest a range of possible diagnoses that might not even occur to television’s Dr. Gregory House.
“In Brazil and India,” writes Cohn, “machines are already starting to do primary care, because there’s no labor to do it. They may be better than doctors. Mathematically, they will follow evidence – and they’re much more likely to be right.”
So how is this good news for lower-skilled jobs? Unlike medical technology innovation of the past few decades, these changes may well empower lesser-skilled healthcare workers to provide services that only physicians now perform.
One doctor told Cohn, “I think we are transitioning into what I see as super-quality-control officers, overseeing physicians’ assistants and nurse-practitioners, who are really going to be the ones who see the patients.” (For the record, he doesn’t like the future he is forecasting.) Smart information and communications technology will let lower-paid employees deliver a more consistent and evidence-based quality of care. “If technological aids allow us to push more care down to people with less training and fewer skills,” predicted one expert, “more middle-class jobs will be created along the way.” That is, middle-class jobs where people are practicing at the top of their licenses.
Human beings are terrible forecasters of the impact of technology. We always see the dark side first, because it is so easy to recognize. Much harder to imagine are the positive ways we will put new technologies to work to build a future we want. When we talk about the impacts of innovation on employment, we see the machines taking away jobs. But the jobs of tomorrow are taking shape all around us. Community leaders need to keep their minds open to possibility, and steer their constituents toward it.
About the Intelligent Community Forum
The Intelligent Community Forum is a think tank that studies the economic and social development of the 21st Century community. Whether in industrialized or developing nations, communities are challenged to create prosperity, stability and cultural meaning in a world where jobs, investment and knowledge increasingly depend on advances in communications. For the 21st Century community, connectivity is a double-edge sword: threatening established ways of life on the one hand, and offering powerful new tools to build prosperous, inclusive and sustainable economies on the other. ICF seeks to share the best practices of the world's Intelligent Communities in adapting to the demands of the Broadband Economy, in order to help communities everywhere find sustainable renewal and growth. More information can be found at www.intelligentcommunity.org.
Robert Bell is co-founder of the Intelligent Community Forum, where he heads its research and content development activities. He is the author of ICF's pioneering study, Benchmarking the Intelligent Community, the annual Top Seven Intelligent Communities of the Year white papers and other research reports issued by the Forum, and of Broadband Economies: Creating the Community of the 21st Century. Mr. Bell has also authored articles in The Municipal Journal of Telecommunications Policy, IEDC Journal, Telecommunications, Asia-Pacific Satellite and Asian Communications; and has appeared in segments of ABC World News and The Discovery Channel. A frequent keynote speaker and moderator at municipal and telecom industry events, he has also led economic development missions and study tours to cities in Asia and the US.
ICF co-founder John G. Jung originated the Intelligent Community concept and continues to serve as the Forum's leading visionary. Formerly President and CEO of the Greater Toronto Marketing Alliance and Calgary Economic Development Authority, he is a registered professional urban planner, urban designer and economic developer. He leads regular international business missions to US, European, Asian, Indian and Australian cities, and originated the ICF Immersion Lab program. John is a regular speaker at universities and conferences and serves as an advisor to regional and national leaders on Intelligent Community development. The author of numerous articles in planning and economic development journals, he has received global and Toronto-based awards for his work in collaboration and strategic development and sits on numerous task forces and international advisory boards.
ICF co-founder Louis Zacharilla is the creator and presenter of the annual Smart21, Top Seven and Intelligent Community Awards and oversees ICF's media communications and development programs. He is a frequent keynote and motivational speaker and panelist, addressing audiences of tech, academic and community leaders around the world, and writes extensively for publications including American City & County, Continental Airline's in-flight magazine and Municipal World. His frequent appearances in the electronic media have included both television and radio in South Korea, China and Canada. He has served as an adjunct professor at Fordham University in New York and is a Guest Lecturer at Polytechnic University's Distinguished Speaker Series. He holds a Masters Degree from the University of Notre Dame.
This Digital Communities white paper highlights discussions with IT officials in four counties that have adopted shared services models. Our aim was to learn about the obstacles these governments have faced when it comes to shared services and what it takes to overcome those roadblocks. We also spoke with several members of the IT industry who have thought long and hard about these issues. The paper offers some best practices for shared government-to-government services, but also points out challenges that government and industry still must overcome before this model gains widespread adoption.