Over the last 50 years, information technology has been revolutionizing the world. The impacts of IT are diverse and numerous; IT has spurred global finance, transportation, smart buildings and virtual communities—even public protests against oppressive regimes.
This revolution has come in waves and each is the result of a new ecosystem of converging information technologies and business models. For example, the networked personal computer wave resulted from advances in microprocessors, the maturation of local area networks, a breakthrough application (the spreadsheet), and the openness of the Intel/DOS platform for use by many independent developers.
The Four Waves of IT Revolution
There have been four major waves of IT revolution:
The mainframe wave introduced IT to the business community and allowed diverse companies to automate routine clerical tasks such as airline reservations, bank asset management and hospital patient accounting.
The minicomputer wave fostered new software platforms such as UNIX, and in health care facilitated applications for departments such as clinical laboratories and radiology. It also made clinical information systems more accessible to medium-sized hospitals.
The networked personal computer wave provided users with a powerful computer of their own and enabled them to share resources, such as printers and storage. This wave accelerated the growth of smart medical devices, enabled an explosion in software for small businesses and brought the computer into the home.
The Internet wave significantly has altered the retail, content publishing, and distribution and travel industries. This wave has seen the establishment of new forms of communities, powerful advances in information-seeking capabilities, and an explosion of new ways to reach customers.
The Fifth Wave
The term "nearly ubiquitous computing" can be applied to the fifth wave of IT revolution, which we are now entering. This wave has several characteristics:
- networked, powerful processors almost everywhere and on almost anything;
- a diverse array of sensitive and specific sensors;
- massive amounts of data, and novel methods to analyze it;
- software delivered as a service;
- a wide variety of collaboration, community and knowledge resources.
Powerful computers can be found on people (in mobile devices like the smart phone), buildings, automobiles, credit cards and electrical grids. In addition to their power, these computers generally are always connected to a very high-speed, usually wireless, network. Often working in tandem with these computers are diverse arrays of sensors that can measure air quality, medical images, chemical concentrations, traffic, human physiology, building temperature and train locations.
These nearly ubiquitous computers are generating massive amounts of data. Novel methods are being developed to analyze this data to conduct post-market surveillance using electronic health record data; determine consumer behavior by examining Web search behavior; and understand traffic patterns in cities.
Increasingly, the software used by these computers is offered as a service. You pay as you "consume" the software, reducing the need to obtain a software license. The data being generated and the software application are hosted in a "cloud"—a set of servers somewhere "out there."
Nearly ubiquitous computing extends the reach and the power of the collaboration, community and knowledge resources that arrived with the Internet. These resources can be accessed from anywhere—not just from the personal computer at work or home.
The Potential of the Fifth Wave
The fifth wave will enable us to:
- develop sophisticated models and test hypotheses using large sets of data;
- orchestrate complex processes;
- deliver new services, e.g., location-aware and location-invariant services;
- extend and enrich fundamental human activities, such as being a member of a community and searching for information.
Using the vast amount of EHR data, health care providers will be able to answer such questions as "Is drug A more effective than drug B?" by analyzing the data gathered during care delivery. Consumer-product companies will be able to assess the degree to which one product often is jointly purchased with other products by analyzing point-of-sale data. We will be able to generate and test complex hypotheses using existing data, potentially avoiding expensive and lengthy analysis approaches like clinical trials.
Using the network of sensors and powerful machines, we will be able to orchestrate complex processes. For example, a smart city will sense traffic jams and alter the timing and duration of traffic lights. Power grids can detect locations consuming more or less power than normal and re-route the grid accordingly.
These devices will cater to the user's location. For example, automobile GPS devices can provide directions and data on looming traffic problems, while mobile devices can consider the location of someone requesting restaurant suggestions.
And these services will enhance core human activities such as belonging to a community or sharing information with a family. Applications can tell you if your friends are nearby. You can take photos with a mobile device and share them instantly with grandparents.
Ramifications of the Fifth Wave
The IT of previous waves does not disappear with the advent of a new wave; many organizations are still using mainframes. However, each new wave builds on and extends the previous waves.
The fifth wave of IT revolution will affect health care. Only health record data can produce some forms of comparative effectiveness research. A powerful, networked computer can help the patient in managing his or her chronic disease. Sensors, along with technology that tracks a patient's location, condition and expected course of treatment, can improve patient flow through a facility. Communities of patients and caregivers long have been central to good care; technologies that strengthen these ties strengthen care.
The impact clearly is not confined to health care. All aspects of society are affected: Witness the use of a mobile device by a fisherman off the coast of East Africa, before he heads to shore, to determine which port is offering the best price for his fish. Or the Twitter, Facebook and Skype accounts of the unrest in Northern Africa. These are a few examples of the revolution that has just arrived.
As remarkable as the fifth wave will be, we should remember that IT waves arrive about every 10 years. We will see several more revolutions in our careers.
John Glaser, Ph.D., is the CEO of Siemens Healthcare Health Services in Malvern, Pa. He is also a regular contributor to H&HN Daily.