26 February 2014

Disruptive technology

What is disruptive technology?  It is technology that brings in a change to our understanding of what is fundamental to a system.  Computers changed how businesses processed information which meant that whole categories of workers were put out of jobs.  Rooms that used to be filled with accountants were downsized.  Similarly rooms full of draftsmen and architects got pared down, as did rooms of engineers to design everything from squeeze bottles to jet aircraft.  Computers disrupted business in ways large and small, and that intruded on our lives and our lives slowly began to change, as well.  Connecting computers to a network and having them internetworked was meant, way back when, to be a way to have computers split processes amongst them as they were few and expensive and idle time was money lost.  Instead the internetworked systems allowed people to contact each other across all the networks in a way that enabled human intelligence to be shared and increased.  E-mail was the first real disruptive technology of networks, and then, later, would come the ability to browse from site to site with information put up in a flat network system with agreed-upon means to display information.  The Internet with World Wide Web came into being and the compelling way it changed lives was through interaction of people to do many things that they could have never done before.  People who would never dream of publishing anything soon had blogs and realized that there was readership available with people desperate for something interesting to read.  Videos also were shared when bandwidth increased, and that also changed our view of each other and the world.  And commerce moved onto a global stage accessible by anyone with a computer connected to a network, and competition became global at a retail level.

Our world changed.

Yet the seasons still come and go, the Earth orbits the sun and the Moon orbits the Earth.  That world did not change as it is Nature and beyond our reach to change, as its laws are required to allow us to be here.

Today we see the last gasp of governments trying to regain control of people in ways large and small, from the Transnational Left and Right we see the disruption of societies as governments and companies try to liquidate what it means to be a citizen of a Nation.  Across much of Europe the attempt to socialize health care has resulted in the horrors of the British system and people left to die of thirst, to the lax attitude of physicians all taking their holiday on the hottest days of the year so that hospitals cannot treat those with heat stroke, to the much admired German system that can't seem to ask its own people if they actually like having to wander from doctor to doctor to get seen on a timely basis and never have continuity of care from a physician that knows them.  These systems have tremendous overhead and lacks big, small and always at the cost of actual health provisioning in a way people prefer.  Bureaucrats run these systems and they are run for the interest of the governments involved, not the people.  Control over personal health is one of the fastest ways a tyrannical system can find and eliminate opposition as it finds out just who has what, and then figure out how to deny opponents actual health services.  With such a whip the political class finds ways to dole out a bit here and there to get re-elected, all in the knowledge that the people are afraid of government as it has taken over the health care system.

This is an antiquated way of doing things, with large lab systems taking lots of time running costly tests at high overhead with may companies and levels of bureaucracy which now must be sustained by the individuals actually using the system.  Put in a few levels of bureaucracy and the actual cost of provisioning health care goes up, timeliness and quality of care goes down.  Computers have not made inroads to anything but forms processing so that forms get ignored on a more timely basis by bureaucrats playing solitaire on their systems instead of just hanging out at the water cooler instead of doing their jobs.  They do that, too.  Computers increase inefficiency as well as efficiency and provide many ways to goof off that could not have been conceived of just 30 years ago.  Health care has resisted disruption from the inside as the insiders have a vested interest in keeping a high overhead, high cost system going: it provides control and makes money for them, and grants those running it much power over others.

Yet automation and miniaturization are coming to the health care system, but this isn't coming from the decaying inside-out.  No this is coming from the outside, from people who don't much care for the inefficient, high overhead and centralized control realms that are the tyrannical features of government controlled health care.  Disruptive technology threatens the apple cart by putting power back in the hands of individuals who are able to walk away from aspects of the system to save money and empower those doing the liberation.  The place to start isn't with the 3D printing of organs... well, that is a pretty good place, actually, but to disrupt the entire system requires hitting at its underpinnings and that is with blood tests.  The things you have to get done to yield some information about what is going on with your body.  I've had so many of them it isn't funny, and if you have ever seen a nurse walk into a room with a full rack of vials to test your blood then you have some understanding of just how important the tests are.  Due to my health I've had up to 35 taken at a single draw, and there are people who have many more than that taken just to try and identify what is going on in their bodies.

From Instapundit I read, today, about a woman who, at age 19, started a company after dropping out of Stanford University and used her tuition money to put into the company (Article at Wired).  She is afraid of needles and thought that there must be a better way to do blood testing.  Now at 30, Elizabeth Holmes' company, Theranos, is featuring a 30 test service at Walgreens in Palo Alto, CA.  The blood sample is a miniscule amount that fits into a half inch collection vial.  Results for their tests are in 4 hours.  The company posts the costs of its tests on its website and they are a fraction of the cost of going to a traditional lab.  Their goal is to run thousands of tests via a single sample, and to have that sample available so that if a doctor wants secondary tests done on it they can be performed without the need for a re-draw.

Do they test for bacteria and viruses? Yes.  Instead of culturing blood, and risking contamination, they do a DNA screening to see if known viruses or bacteria are present and at what levels.  That is days of specialized culturing thrown out the door and the most definitive way to find a pathogen, via its DNA, put in its place. At some point my guess is that they will be able to give you your entire genome so that physicians can quickly see what medical conditions you might be susceptible to via your genetic profile.  The cost of a full genomic work up has been dropping drastically, and making it an everyday test done in hours, not days, would begin to change the course of medicine as diseases can be cross-referenced with genetic background and statistical results derived from it.

Even with Moore's Law slowing due to the fact that physics at the atomic level limits the size of processors, the ability to multiply what a processor does increases computing power per die for production.  Once some of this technology goes off patent, or once competition with alternative and faster ways gets into play, the cost of the tests will go down, the rate to get results will speed up and the size of the sample will decrease.  Give it two cycles of Moore's Law and the microengineering to get a 'lab on a chip' and you will begin to see the first generation of full spectrum blood sampling devices as something that becomes available in nearly every store.  Put in a few more cycles of Moore's Law and that then becomes a device you buy to add to your cellphone.  Cross that with the X-Prize for a non-invasive tricorder and you have Dr. McCoy's minimal test tricorder.

Time for something like this to get off the drawing board?  Less than a decade.

What is the basis for Larry Niven's device in the Known Space stories called an Autodoc (a capsule you rest in that does full medical procedures from a simple blood test and manicure to setting bones and treating cancer, or replacing organs or limbs)?  A full spectrum blood test.  As results are processed faster and cross-indexed with diseases, pathogens, and genetic background plus having a 360 degree body scan to see what is wrong with you, then the basis for the Autodoc appears.  The blood test is key as it is the basis of so much of modern medicine that it isn't funny.  As of today the first piece of the Autodoc is being worked on, although not as an Autodoc but as a way to get small blood samples to yield up information that used to take racks of vials to get.

This sort of technology is no longer a question of 'if' but of 'when' and 'how soon will it get here'.

Our health care system is on the verge of disappearing as we know it, with its high overhead bureaucracy, within 20 years.  Possibly within 10.

What will you do when you are given the freedom of having all of that medical knowledge on the cheap about yourself and then able to have a doctor step you through the beginning of understanding just what is in your body and how you can deal with it effectively?  Why would you want 'insurance' when you are in control of your medical life in an absolute way that is at once low cost and easy to do?  The power to control you begins to evaporate with low cost, effective blood testing that breaks the old system at its foundations.  How long will it take to do simple genomic cross-indexing of inherited conditions?  I'm guessing less than a decade, but certainly in that 20 year time horizon.

And what happens when governments try to take this away from stores, doctors and you?

That is an obvious power grab directly against you, the individual, to put a bureaucrat in control of your life and death.  Yet it will be cheap and easy to snub these control monsters.  Will you dare to be free of them?

This is just one disruptive technology.  Others are here and just being perfected.  Still more are coming from the horizon at a high rate of speed.  If you want to know why those wishing to dissolve your personality, your bonds to your country and your fellow citizens, are so desperate it is this: the future is arriving far faster than it can ever be controlled.  Governments are ill suited to coping and understanding what this means.  Individuals, however, are very able to do so as they do not have the burdens of collective stupidity and bureaucracy to hamper them.  And those who will benefit most are the poor, who do not need this controlled for them to get a good price as it already comes with a low price tag.  What happens when the poor are set free of the clutches of those wishing to control them?  Will they quake in fear of freedom or just shake their head at those who seek control and let them know that their day is over?

Change is here, but it isn't the one that the controllers hoped for.  Quite the opposite as this kind of change is their deadly enemy.

Welcome to the future.

I embrace it with open arms while those who seek control yell in fear of it.

Oh, happy day.

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