The New Digital Age Page 4

  Tissue engineers will be able to grow new organs to replace patients’ old or diseased ones, using either synthetic materials or a person’s own cells. At the outset, affordability will limit the use. Synthetic skin grafts, which exist today, will give way to grafts made from burn victims’ own cells. Inside hospitals, robots will take on more responsibilities, as surgeons increasingly let sophisticated machines handle difficult parts of certain procedures, where delicate or tedious work is involved or a wider range of motion is required.2

  Advances in genetic testing will usher in the era of personalized medicine. Through targeted tests and genome sequencing (decoding a person’s full DNA), doctors and disease specialists will have more information about patients, and what might help them, than ever before. Despite steady scientific progress, severe negative reactions to prescribed drugs remain a leading cause of hospitalization and death. Pharmaceutical companies traditionally pursue a “one-size-fits-all” approach to drug development, but this is due to change as the burgeoning field of pharmacogenetics continues to develop. Better genetic testing will reduce the likelihood of negative reactions, improve patients’ chances and provide doctors and medical researchers with more data to analyze and use. Eventually, and initially only for the wealthy, it will be possible to design pharmaceutical drugs tailored to an individual’s genetic structure. But this too will change as the cost of DNA sequencing drops below $100 and almost everything biological is sequenced, making it possible for a much broader segment of the world’s population to benefit from highly specific, personalized diagnoses.

  For those living in developing countries, basic connectivity and access to the virtual world will offer a resource they can leverage to improve their own quality of life, and nowhere more so than in the area of health. Even though their environment in the physical world is colored by inadequate care, lack of available vaccines and medicines, broken health systems and other exogenous factors that create health crises (like conflict-related internal migration), many important gains in health care will be driven by innovative uses of mobile phones, largely by individuals and other nongovernmental actors who seize the opportunity to drive change in an otherwise stagnant system. We already see this happening. Across the developing world today, the “mobile health” revolution—mobile phones used as tools to connect patients to doctors, to monitor drug distribution and to increase the reach of health clinics—is responsible for a number of improvements as a range of technology start-ups, nonprofits and entrepreneurs tackle difficult problems with technology-first solutions. Mobile phones are now used to track drug shipments and verify their authenticity, to share basic health information that isn’t available locally, to send reminders about medication and appointments to patients, and to gather data about health indicators that government officials, NGOs and other actors can use to design their programs. The central problems in health sectors in poor places, like understaffed clinics, underserved patients in remote places, too few medications or inefficient distribution of them, and misinformation about vaccines and disease prevention, will all find at least partial solutions through connectivity.

  At the very least, the adoption of mobile phones gives people a new level of agency over their personal health, even though the devices themselves, of course, can’t cure illness. People can use their phones to access information about preventative health care or recovery. They can use basic diagnostic tools embedded in their phones—maybe not X-rays, but cameras and audio recordings. A woman can take a picture of a lesion, or a recording of a cough, and send that information to a doctor or health professional, whom she can then interact with remotely, efficiently, affordably and privately. Digital solutions like these are not a perfect substitute for a properly functioning health sector, but in the meantime, they can offer new information and interactions that at a minimum will chip away at a larger and more entrenched multigenerational problem.

  The Upper Band

  Connectivity benefits everyone. Those who have none will have some, and those who have a lot will have even more. To demonstrate that, imagine you are a young urban professional living in an American city a few decades from now. An average morning might look something like this:

  There will be no alarm clock in your wake-up routine—at least, not in the traditional sense. Instead, you’ll be roused by the aroma of freshly brewed coffee, by light entering your room as curtains open automatically, and by a gentle back massage administered by your high-tech bed. You’re more likely to awake refreshed, because inside your mattress there’s a special sensor that monitors your sleeping rhythms, determining precisely when to wake you so as not to interrupt a REM cycle.

  Your apartment is an electronic orchestra, and you are the conductor. With simple flicks of the wrist and spoken instructions, you can control temperature, humidity, ambient music and lighting. You are able to skim through the day’s news on translucent screens while a freshly cleaned suit is retrieved from your automated closet because your calendar indicates an important meeting today. You head to the kitchen for breakfast and the translucent news display follows, as a projected hologram hovering just in front of you, using motion detection, as you walk down the hallway. You grab a mug of coffee and a fresh pastry, cooked to perfection in your humidity-controlled oven—and skim new e-mails on a holographic “tablet” projected in front of you. Your central computer system suggests a list of chores your housekeeping robots should tackle today, all of which you approve. It further suggests that, since your coffee supply is projected to run out next Wednesday, you consider purchasing a certain larger-size container that it noticed currently on sale online. Alternatively, it offers a few recent reviews of other coffee blends your friends enjoy.

  As you mull this over, you pull up your notes for a presentation you’ll give later that day to important new clients abroad. All of your data—from your personal and professional life—is accessible through all of your various devices, as it’s stored in the cloud, a remote digital-storage system with near limitless capacity. You own a few different and interchangeable digital devices; one is the size of a tablet, another the size of a pocket watch, while others might be flexible or wearable. All will be lightweight, incredibly fast and will use more powerful processors than anything available today.

  You take another sip of coffee, feeling confident that you’ll impress your clients. You already feel as if you know them, though you’ve never met in person, since your meetings have been conducted in a virtual-reality interface. You interact with holographic “avatars” that exactly capture your clients’ movements and speech. You understand them and their needs well, not least because autonomous language-translation software reproduces the speech of both parties in perfect translations almost instantly. Real-time virtual interactions like these, as well as the ability to edit and collaborate on documents and other projects, makes the actual distance between you seem negligible.

  As you move about your kitchen, you stub your toe, hard, on the edge of a cabinet—ouch! You grab your mobile device and open the diagnostics app. Inside your device there is a tiny microchip that uses low-radiation submillimeter waves to scan your body, like an X-ray. A quick scan reveals that your toe is just bruised, not broken. You decline the invitation your device suggests to get a second opinion at a nearby doctor’s office.

  There’s a bit of time left before you need to leave for work—which you’ll get to by driverless car, of course. Your car knows what time you need to be in the office each morning based on your calendar and, after factoring in traffic data, it communicates with your wristwatch to give you a sixty-minute countdown to when you need to leave the house. Your commute will be as productive or relaxing as you desire.

  Before you head out, your device reminds you to buy a gift for your nephew’s upcoming birthday. You scan the system’s proposed gift ideas, derived from anonymous, aggregated data on other nine-year-old boys with his profile and interests, but none of the suggestions inspire you. Then you remember a story his
parents told you that had everyone forty and older laughing: Your nephew hadn’t understood a reference to the old excuse “A dog ate my homework”; how could a dog eat his cloud storage drive? He had never gone to school before digital textbooks and online lesson plans, and he had used paper to do his homework so rarely—and used cloud storage so routinely—that the notion that he would somehow “forget” his homework and come up with an excuse like that struck him as absurd. You do a quick search for a robotic dog and buy one with a single click, after adding a few special touches he might like, such as a reinforced titanium skeleton so that he can ride on it. In the card input, you type: “Just in case.” It will arrive at his house within a five-minute window of your selected delivery time.

  You think about having another cup of coffee, but then a haptic device (“haptic” refers to technology that involves touch and feeling) that is embedded in the heel of your shoe gives you a gentle pinch—a signal that you’ll be late for your morning meeting if you linger any longer. Perhaps you grab an apple on the way out, to eat in the backseat of your car as it chauffeurs you to your office.

  If you are a part of the world’s upper band of income earners (as most residents of wealthy Western countries are), you will have access to many of these new technologies directly, as owners or as friends of those who own them. You probably recognize from this morning routine a few things you have already imagined or experienced. Of course, there will always be the super-wealthy people whose access to technology will be even greater—they’ll probably eschew cars altogether and travel to work in motion-stabilized automated helicopters, for example.

  We will continue to encounter challenges in the physical world, but the expansion of the virtual world and what is possible online—as well as the inclusion of five billion more minds—means we will have new ways of getting information and moving resources to solve those problems, even if the solutions are imperfect. While there will remain significant differences between us, more opportunities to interact and better policy can help blur the edges.

  The advance of connectivity will have an impact far beyond the personal level; the ways that the physical and virtual worlds coexist, collide and complement each other will greatly affect how citizens and states behave in the coming decades. And not all the news is good. The coming chapters delve into how everyone—individuals, companies, nongovernmental organizations (NGOs), governments and others—will handle this new reality of existing in both worlds, and how they will leverage the best and worst of what each world has to offer in the new digital age. Each individual, state and organization will have to discover its own formula, and those that can best navigate this multidimensional world will find themselves ahead in the future.

  1 The Korean K-pop star Psy’s fame reached global proportions almost overnight as the video he created for his song “Gangnam Style” became the most-watched YouTube video ever within a span of three months.

  2 Robotic surgical suites are already in operation in hospitals in the United States and Europe.

  CHAPTER 2

  The Future of Identity, Citizenship and Reporting

  In the next decade, the world’s virtual population will outnumber the population of Earth. Practically every person will be represented in multiple ways online, creating vibrant and active communities of interlocking interests that reflect and enrich our world. All of those connections will create massive amounts of data—a data revolution, some call it—and empower citizens in ways never before imagined. Yet despite these advancements, a central and singular caveat exists: The impact of this data revolution will be to strip citizens of much of their control over their personal information in virtual space, and that will have significant consequences in the physical world. This may not be true in every instance or for every user, but on a macro level it will deeply affect and shape our world. The challenge we face as individuals is determining what steps we are willing to take to regain control over our privacy and security.

  Today, our online identities affect but rarely overshadow our physical selves. What people do and say on their social-networking profiles can draw praise or scrutiny, but for the most part truly sensitive or personal information stays hidden from public view. Smear campaigns and online feuds typically involve public figures, not ordinary citizens. In the future, our identities in everyday life will come to be defined more and more by our virtual activities and associations. Our highly documented pasts will have an impact on our prospects, and our ability to influence and control how we are perceived by others will decrease dramatically. The potential for someone else to access, share or manipulate parts of our online identities will increase, particularly due to our reliance on cloud-based data storage. (In nontechnical language, cloud computing refers to software hosted on the Internet that the user does not need to closely manage. Storing documents or content “in the cloud” means that data is stored on remote servers rather than on local ones or on a person’s own computer, and it can be accessed by multiple networks and users. With cloud computing, online activities are faster, quicker to spread and better equipped to handle traffic loads.) This vulnerability—both perceived and real—will mandate that technology companies work even harder to earn the trust of their users. If they do not exceed expectations in terms of both privacy and security, the result will be either a backlash or abandonment of their product. The technology industry is already hard at work to find creative ways to mitigate risks, such as through two-factor authentication, which requires you to provide two of the following to access your personal data: something you know (e.g., password), have (e.g., mobile device) and are (e.g., thumbprint). We are also encouraged knowing that many of the world’s best engineers are hard at work on the next set of solutions. And at a minimum, strong encryption will be nearly universally adopted as a better but not perfect solution. (“Encryption” refers to the scrambling of information so that it can be decoded and used only by someone with the right verification requirements.)

  The basics of online identity could also change. Some governments will consider it too risky to have thousands of anonymous, untraceable and unverified citizens—“hidden people”; they’ll want to know who is associated with each online account, and will require verification, at a state level, in order to exert control over the virtual world. Your online identity in the future is unlikely to be a simple Facebook page; instead it will be a constellation of profiles, from every online activity, that will be verified and perhaps even regulated by the government. Imagine all of your accounts—Facebook, Twitter, Skype, Google+, Netflix, New York Times subscription—linked to an “official profile.” Within search results, information tied to verified online profiles will be ranked higher than content without such verification, which will result in most users naturally clicking on the top (verified) results. The true cost of remaining anonymous, then, might be irrelevance; even the most fascinating content, if tied to an anonymous profile, simply won’t be seen because of its excessively low ranking.

  The shift from having one’s identity shaped off-line and projected online to an identity that is fashioned online and experienced off-line will have implications for citizens, states and companies as they navigate the new digital world. And how people and institutions handle privacy and security concerns in this formative period will determine the new boundaries for citizens everywhere. We want to explore here what full connectivity will mean for citizens in the future, how they will react to it and what consequences it will have for dictators and democrats alike.

  The

  Data Revolution

  The data revolution will bring untold benefits to the citizens of the future. They will have unprecedented insight into how other people think, behave and adhere to norms or deviate from them, both at home and in every society in the world. The newfound ability to obtain accurate and verified information online, easily, in native languages and in endless quantity, will usher in an era of critical thinking in societies around the world that before had been culturally is
olated. In societies where the physical infrastructure is weak, connectivity will enable people to build businesses, engage in online commerce and interact with their government at an entirely new level.

  The future will usher in an unprecedented era of choices and options. While some citizens will attempt to manage their identity by engaging in the minimum amount of virtual participation, others will find the opportunities to participate worth the risk of the exposure they incur. Citizen participation will reach an all-time high as anyone with a mobile handset and access to the Internet will be able to play a part in promoting accountability and transparency. A shopkeeper in Addis Ababa and a precocious teenager in San Salvador will be able to disseminate information about bribes and corruption, report election irregularities and generally hold their governments to account. Video cameras installed in police cars will help keep the police honest, if the camera phones carried by citizens don’t already. In fact, technology will empower people to police the police in a plethora of creative ways never before possible, including through real-time monitoring systems allowing citizens to publicly rate every police officer in their hometown. Commerce, education, health care and the justice system will all become more efficient, transparent and inclusive as major institutions opt in to the digital age.