Perspectives

Healthcare, technology, fear, and gratitude

Jack Stockert

Why I’m More Thankful Than Scared About 2020 and Beyond

As the days grow shorter and fall creeps closer to winter, the nation’s usual preparations for end-of-year festivities remain in flux.

We still wear masks everywhere we go. A large portion of the workforce has taken on teaching-assistant duties while also performing “regular” jobs remotely in their slippers. Most of us cannot travel, and we are all missing family and friends that live across the country. The 2020 holidays will be unlike any I can remember.

There’s plenty to frighten us beyond Halloween. But with a nod to the third Thursday in November, there are also changes afoot for which we might be thankful.

While my professional focus centers on US healthcare, the changes I see reach beyond any single segment or sector. The most promising component of the current environment may be what is dislodged and what shapes the new “normal.” It will not be immediate, but the positive inflection of 2020 (as opposed to the negative experience of a challenging year) will be abundantly clear when we recall this time a few years down the road. Those who recognize this now will be the ones smiling the most.

Quite frankly, the disruption we are facing in 2020 may turn out to be the greatest stimulus to innovation in our lifetimes.

Is life materially better than a decade ago?

Broadly speaking, innovation has stagnated over the past decade. The breakthroughs of compute power, connectivity, and social media are maligned for their mix of addictive and dissociative qualities — as well as limited positive impact on productivity and quality of life in general.

Once scrappy tech upstarts have become household names, behemoths of the stock market, omnipresent in ways that often raise more concern than delight: The GAFA today are a far cry from the move-fast-and-break-things trailblazers that made them the darling designers of our future in early years of the century. Certainly, for example, Amazon seems to have made everything available wherever we want it. But this was an evolution — a big and thoughtful one — of logistics viable in part because of partnerships with abiding institutions like the good old US Post Office.

We have evolved, but not made many significant leaps over the last decade. Comparatively, the iPhone was revolutionary, so much that it could be used to date society a generation from now as “Bei” (Before iPhone) and “Afi” (after iPhone). But what has followed has been more evolutionary. And while the internet is certainly an infrastructure breakthrough, it’s an enabling technology that has been evolving for decades — its gains now feel incremental and its realization of promise a continual carrot dangled just out of reach.

But 2020 could be truly a revolutionary moment if we allow it. Another dating year for us as human beings for what life and technology were like before and after.

What comes next will shake our calculus by shifting technology to be the dependent variable — with behavior, design, and imagination becoming independent variables — due to intense focus on the challenges of remote and hybrid work environments, education, consumer purchasing, and even sport and media consumption.

What is this shift?

Historical orientation of services and workforces around breakthroughs in technology has usually assumed a fixed behavior. We spent the first 20 years of the internet’s evolution applying it against use cases of the “present.” We applied technology, learned from those experiences, and advanced. As mentioned in a previous article, this has all been evolutionary.

But the pandemic has presented a truly life-altering scenario. Without diminishing human health implications, it has wrought some changes we should be noticing and embracing.

Innovation around a novel behavior generates revolutionary things. The pandemic has generated a singularity of forced behavior change unlike anything we have seen in recent history. That makes a distinct impression on business and investment. Just look at Zoom’s post-March stock performance or the rapid growth of security tools to meet a more distributed environment. And in healthcare, investment hit a new record in Q3 2020 with a surge in global telehealth and digital health deals.

The market understands future potential, and this activity represents new growth expectations by the market. I take these as early signals of an exceptional opportunity, and there and many gaps that need to be addressed. “Remote” is a transformation necessary to address productivity in our current economy. Fixed behavior can no longer be assumed.

What’s so revolutionary about orienting around a contingent behavior? Why do we see prodigious momentum behind these companies knowing that this pandemic will eventually end?

Quite simply, the 2020 innovation revolution is driven by the sudden flipping of problems to be solved. It represents a 180-degree pivot on what we deem useful.

With the internet, cloud computing, and even more recently AI and ML, habituation to improvements in technological capability largely drove new use case development. Adoption curves in industries and systems defined those use cases, and gradually, an evolution around core technologies drove more incremental improvements. For the record, this author has argued the benefits of an evolutionary approach to innovation: It ensures a consolidated dissemination of new technology and a manageable plotting of where we are heading. It keeps things grounded. However, some revolutionary breakthroughs energize the path to progress. Think of Steve Jobs on the stage introducing the iPhone. We might still be sitting here with slightly fancier flip phones punching a tiny #2 button three times to start a ‘Call Me’ message if it weren’t for this stroke of genius. And consider the use cases inspired and an app economy that grew from such a singular innovation.

Orienting around an unanticipated behavioral constraint, like immediate and sweeping remote and distributed work arrangements, forces an even more expansive new model of use case development. Constraints are defined by limitations on what workers can do remotely at present, and confronting those limitations sparks creativity. New use cases within the realm of possibility are clear, but we’re also suddenly entertaining many that are not quite possible yet. (Once again, try to think back to what would be considered innovative in a cell phone prior to 2007.)

This shift directs collective attention to what is possible, what should be possible, and what we want to be possible. It dares technology users and providers to experiment and improvise and imagine boldly, rather than constrict to fit existing specifications. Beyond ushering in better web-meeting software or cloud security services, it inspires expanded thinking. Consider recent news about the National Center for Data to Health (CD2H): “After only a few months of breakneck work from CD2H and collaborators around the country, the National COVID Cohort Collaborative Data Enclave, or N3C, opened to researchers at the start of September. Now that it’s in place, it could help bolster pandemic responses in the future. It is unique from anything that has come before it, in size and scope,” transforming and consolidating over 1.1 million patient records from 68 contributing sites across the country into more than 1.2 billion rows of data for critical research. As epidemiologist and CD2H chair Melissa Haendel said, “No other resource has ever tried to do this before.” Anyone familiar with the tightly siloed and fragmentary world of health data understands the wonder of this achievement. No baggage of the past, simply an unencumbered “yes and” development for the future. Rising to challenges expands our perception of feasibility.

Try the following thought experiment: If you were asked to design the future of work in 1995, before ubiquitous internet capabilities, what would you envision? In that imagined world, if we encountered the current pandemic and re-oriented our entire workforce, what limitations would be faced and what new tools would be required? Now try to imagine what will you be doing in 2022 and how you’ll be doing it.  This scenario is more than ‘imagine if’ — it will be a real development shaped by the ingenuity and creativity of the people being affected…which is everyone.

I’m hopeful for all of us that it’s something purposeful we never could have dreamt up back in January of this fateful year. We know our health, our care, our lives will never be the same as they were before 2020. But let’s embrace the upset apple cart where we can. This year, my resourceful wife and I wound up developing a Halloween/Easter mashup for our kids with an inaugural trick-or-treat candy hunt. I find myself feeling thankful and looking forward in November, and not scared about what will come next.

— Jack Stockert is Managing Director at Health2047.

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