Thursday, March 10, 2016

The Future Won't Be What You Think

Many of us are feeling pretty smug about our use of 21st century technology.   We love our laptops/tablets/smartphones, and have acquired an impressive collection of apps for them.  We use social media to stay in constant contact with our friends.  We stream TV shows and movies, maybe on our new Ultra HD TV.

It's a snazzy little picture, but we shouldn't assume it predicts as much about the future as we expect.

I'll start with apps.  I've previously expressed my skepticism about apps, but I still have plenty of them on my phone.  Most apps are free, but even the free ones often feature ads or in-app purchases (especially in games).  Every ecosystem has an app store -- iTunes, Google Play, Amazon Appstore, Microsoft Store, even BlackBerry World.  Well, Amazon is throwing a monkey wrench into things.

Wired reports how Amazon Underground is disrupting the "traditional" model for app purchases.  Launched last summer to little fanfare, Underground gives apps away, with no upfront fees and no in-app purchases.  Rather, Amazon pays developers a small amount per minute used on their apps.  They want your eyeballs, and they'll pay for them.

Underground's growth has been impressive: three times as many developers now as initially, royalties to those developers up 3600% since launch (and up 50% just from December to January), and customer base up 870%.  Granted, they started with small numbers, but you'd have to say they're doing better with this strategy than they did, say, with the Fire Phone.

The Fire tablet, on the other hand, not only has been surprising successful, attributed in large part to its $50 price, but it also is a natural target for all those eyeballs Amazon is paying app developers to keep engaged.  After all, Android-based device owners can get Underground, but it is not easy, while iOS aficionados can't get it at all.  Underground apps fuel sales of Fire tablets, and Fire tablets fuel use of Underground apps.  That's not a coincidence.

Amazon is not betting its future only on engaging apps and cheap tablets, or even cloud computing (although AWS continues to impress).  Farhad Manjoo, The New York Times tech guru, is gushing about another Amazon product, the Echo.  He thinks it could be the "Next Great Gadget," and says:
The longer I use it, the more regularly it inspires the same sense of promise I felt when I used the first iPhone — a sense this machine is opening up a vast new realm in personal computing, and gently expanding the role that computers will play in our future
Not exactly faint praise.

The Echo is a voice-activated device that allows Alexa -- Amazon's AI -- to perform various functions for you, with better voice recognition than similar AIs like Siri or Google Now.  At your command, Alexa can read recipes, play music, control your home thermostat -- or order something from Amazon.  Developers are rushing to develop apps for it, while car and appliance manufacturers are furiously trying to figure out how to use Alexa (or its competitors) in their products.

Amazon is looking to expand Alexa's reach, believing that touch screens and keyboards are nice but have their limits, especially at home.  They just introduced two other voice-activated devices, the Tap and the Dot.  The Tap is a portable Bluetooth speaker, and the Dot is a smaller version of the Echo.  The three devices don't yet integrate, but surely that has to be the vision.

Many people, myself included, may not be initially comfortable with having a microphone in their home that can listen to, understand, and act on what they are saying, but twenty years ago most people would have flatly rejected the notion of carrying around a device that tracks their exact location at every second.  Yet most of us now rely on our phone's GPS services (and that phone, by the way, not only has a microphone but also a camera).

If voice-activated services prove their utility, we're likely to give up yet another part of our privacy.

Meanwhile, soon we may be watching concerts and even the NFL on Facebook, as Variety reported, while getting our news from Twitter.  The live video broadcasts that Facebook has done found very high engagement -- just like Amazon, they lust after our eyeballs.  They've already changed how we watch television: Nielsen has just announced that it will factor Facebook use into how it evaluates television viewership, just as it did for Twitter in 2013.

Health care is a lot like Amazon and Facebook, in that health care providers are now all about engagement.  And, like Amazon, health care providers seek consumer engagement mainly to keep selling.  I thought about this last week when I wrote about the perverse incentives that pharmaceutical companies -- and most health care organizations -- have.  Costs in health care keep going up because that means more revenue for those organizations.

What would change health care is if its organizations saw keeping people healthy as their business.  You know, like HMOs were once supposed to do (it is "health maintenance organization," after all).  Most health care organizations mouth the words about keeping us healthy, but that is rarely how they get paid.

Maybe, much as Amazon is trying with Underground, games are the way forward, or at least gamification.  I wrote about it a few years ago, yet it is still mostly just a trend.  MobiHealthNews reported on a gamification session at HIMSS16, noting that the topic "...has a perennial presence at health tech conferences, but never seems to take central stage."

It is perhaps indicative that one of the speakers warned: "Please don’t do this flippantly, it won’t go well."  And, in fact, employers may be starting to take them seriously: a new NBGH/Xerox survey found that almost a third of employers are using gamification as one of their strategies.

You can bet Amazon takes games seriously.

If the above Amazon and Facebook examples tell us anything, it is that even wildly successful, cutting-edge technology companies aren't content with their existing business models.  They know they can't just keep doing more of the same.  Meanwhile, most of the business models in health care are flawed, neither keeping us nor our pocketbooks healthy.    

The difference is, I'm not sure most health care organizations realize the problem -- or that the future is going to catch them by surprise.

No comments:

Post a Comment