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Perhaps one of the greatest future challenges for healthcare stems from the evolution of the times themselves.  Knowledge is converging and increasing in an exponential, and some might even say a limitless way.    Consequently its anticipated that we are due to witness, a repeat of all the innovation, from the beginnings of time, to date in the next 13 - 14 years.  ​In the previous ThoughtCast for our Blog, the Digital Paradigm which was entitled, Revolutionising Hospitalisation - Trends & Key Enablers, we touched on the point that Healthcare now finds itself in the unique position, especially as compared to other sectors of the economy, in not having yet fully attained transformation (digitally), yet now due to the 4IR being upon us, needing to speedily adapt to operate in this new technological era.  However, these transitions are never easy, and just to add to the complexity, we are also now witnessing the convergence of eras also, because the inception of the 4IR, which is otherwise known as Industry 4.0, an era broadly defined by 'the convergence of exponential technologies,' was followed almost immediately by the onset of the Fifth Industrial Revolution, (5IR), which was believed to have actually started back in 2022.  ​The Fifth Industrial Revolution is essentially a refinement of the Fourth, so namely 'the convergence of exponential technologies', but now also with the admittance of attributes like values, and sustainability to the remit of digital innovation, so that what we are now seeing is the emergence of a new technological paradigm, fuelled by creativity and ideas, which have now become the new economic drivers for innovation and technological change.

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The 4IR  - The Challenges for Healthcare

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The new technological era, presents a challenge for Healthcare on several fronts.  The adoption of such monumental change would be a challenge for even the most experienced digitally-native corporations in any sector of the economy.  However, the NHS now finds itself in the position of needing to negotiate this migration to the 4IR with some critical gaps in their preliminary digital knowledge, experience, skills and maturity.  We're going to examine in highlight some basic implications of this, commencing with some recent published findings, not from the remit of Healthcare, but Human Capital, that can contribute to our understanding of some of the issues we typically see in relation to innovation in healthcare; and while we are on the subject of Human Capital also address. The issue of the role of Health-IT professionals and professionalism in Healthcare, as Healthcare finds itself in the unique position of no longer really having a mature, trusted, inculcated 'tribe' of specialist Health-IT innovators and experts.  We'll come on to look at why this is important, examining some of the reasons for this, and the effect this is currently having on innovation within the sector as a whole.

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Furthermore, in terms of the challenges certainly, as far as the Health CIO is concerned, of which they should now be aware and ideally be working actively towards remediating in managing their approach to the 4IR, arise from both the 'experimental' nature of some of the technologies themselves, and the fact that governments are still very much in the position of catching-up, as regards providing comprehensive legislative guidance and direction around a number of them.  This leaves Trusts potentially open to risk, and importantly also has implications for patient safety, privacy and Trust, including for things like informed consent.  We're going to evaluate these issues and provide pointers to others that the Health CIO should now ideally have thought about, or be thinking about, and provide some suggestions and/ outline guidance for the Health CIO, to think about, in constructing their own narratives to their Boards and organisational Execs especially, around the adoption of 4IR  technologies by their hospitals.

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Negotiating the Ethics of the 4IR

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The absence of debate about the ethical considerations around the development and use of 4IR technologies is increasingly becoming an issue.  From the wider societal and even global context, the whole debate around the ethics of these technologies, on account of the 'experimental' nature of many of them, really does needs to be addressed.  While governments take the stance of not wanting to intervene too early, so as not to stanch innovation, and also in part because in many cases they are largely in the process of trying to figure out, what exactly the 4IR is, and will become.  This leaves Trust's, and those wanting to embrace and innovate in these technologies in the position of needing to understand how they proceed, and work with these technologies in the meantime, as there is the risk, that once governments become clearer,  they could subsequently intervene with laws, and restrictions that could have the effect of making a Trust or health organisation, if not directly legally, then even morally culpable in retrospect, including in the eyes of public opinion. How Trusts, and those wanting to deploy these technologies proceed in this gap? Is something that certainly needs to be thought about, and planned for, as the position of Trusts wanting to hold back, and do nothing, either to wait for governments to lead, by mandating policies and laws; or to learn from other 'early adopters,' or those who've gone on before, which is a miniscule factor in the 'story' of good digital/ technological adoption, will mean that the Trust will ultimately miss a vital component in its own self-development, to evolve its digital capability, build digital resilience, and ultimately attain transformation.  There is no short-cut to the journey, Trusts just need to engage, and in order to do that, they must be brave in inculcating the mindset of the previous digital era, industry 3.0, which they are still largely in the process of mastering, of deploying these new technologies via the small iterative experiments, that are characteristic of digital (deployments), refining as they go, and trust the process.  The alternative, namely to wait, is to repeat the mistakes made by the industry with the adoption of digital in the previous era, (Third Industrial Revolution, 3IR), miss the wave of opportunity to onboard the technologies, together with the resilience needed to sustain it organisationally, including into the long term. This breaks the process or model for digital adoption, as is slowly coming to be understood now in retrospect, and means that ultimately without this knowledge or experience, not only will the Trust, or sector not transform, but if another wave of opportunity is lost, the sector could find itself permanently hampered from digital participation in the economy of the future.​​​