5) The lamp summons a new Aladdin

Inventing two extra dimensions of change

The previous section looked at the many ways patient, iterative work by engineers exponentially improves the price, power and size of technology.

While vast, the previous categories of improvement are, each on their own, obvious, quantifiable, predictable in scale, if not precise time-frame. Each can be easily graphed on standard log paper.

The only unprecedented feature of the current technology environment — versus Moore’s law and other previous formulations of manufacturing improvements — is that all the exponential forces working together will move the log base will itself be 1 million (or 1 billion?) rather than the current base of 10 or 100.

Technology is a constantly improving magic lamp that fulfills consumers’ commands. But we also need to remember that technology alters consumers and their needs; rubbing the lamp summons a new Aladdin.

Which brings us the most important two categories of improvement — weird, wild and unchartable change that’s a constantly mutating hybrid of human desires and technical capacity.

Feedback loops and iteration will lead us to multiple new dimensions of utility, for which graph pages don’t currently exist, metrics aren’t invented, textbooks haven’t yet been written. These changes will be, quite literally, “off the charts.”

Again, the mechanism driving these changes is simple but nearly invisible, because we’re each personally immersed in them every day as technology users. Consumers demand both more (power, speed, utilities, functions) and less (size, cost, complexity.) Sometimes requests are incremental (I wish this phone fit in my skinny jeans!), sometimes come in sideways hops (couldn’t you add a UV sensor to this smartwatch?) and sometimes leapfrog forward or upward beyond what’s currently imaginable because precedential, intermediate steps haven’t yet been built (why can’t I predict my SAD-quotient in January versus my maternal grandmother’s cummulative sunlight consumption during her pregnancy with my mother?)

Where does all this lead? We’re surrounded by transitions in daily life. Snow avalanches, personal relationships bloom or die, a puddle of molecules snaps into a sheet of crystals. Writing in the early 19th century just as science was emerging as a profession, the German historian GFW Hegel was the first to articulate that small changes in quantity in an organism or social group sometime trigger qualitative leaps. Herds stampede. Markets collapse. Gradually add neurons to a brain, agitate for a million years, and you get Beowulf in a mead hall, then, 1000 years later, a 160-story tower in the desert.

Unlike the the changes listed above — all of which can be simply quantified by adding more zeros to an existing number — it’s impossible to know where this category of change leads. This category of change goes against everything we learned in first grade, but 1+1+1+1 sometimes equals 6, particularly when each individual unit can affect others (or subgroups of units.) Economists and scientists call this phenomena emergence. Nuclear engineers talk about critical mass or a meltdown. Sociologists talk about tipping points.

Accelerating the supply/demand feedback loop beyond what was seen in pre-1990 innovation cycles, today’s technology change is magnified, diversified and nichified by networked demand.

Until 20 years ago, companies were the main aggregators of consumer requests for improvements in products ranging from autos to PCs to gardening equipment. As the Internet spawned forums, then blogs, and finally numerous species of social media, consumers have become ever more agile in conceiving, demanding and sometimes executing new products and services. Examples include the 7,300 strong Facebook Quantified Self group, 120,000 members of the Facebook fibromyalgia group, 4500 members of Reddit’s quantified self channel, parents allying to agitate for research on rare genetic conditions, 600,000 people use Patientslikeme to compare information about their medical conditions and treatment, and discussions in sports forums driving innovations in heart rate monitors. Innovative UV-sensor Sunsprite, which flags when people are sun-starved, was funded on IndieGoGo. (More IndieGoGo device campaigns here.) The epitome of the novel power of networked demand is Github, an open source community that both embodies and enables software innovation.

In most populations, online sharing is the domain of outliers, geeks and extroverts, but Pew Internet has found that 1 in 4 people “among those living with chronic disease, those who are caring for a loved one, and those who have experienced a significant change in their physical health” was looking online to peers for information and support.

INDEX

Prologue: Two times Fitbit didn’t save my life; my six month journey on the borderlands of my own health data.

Part 1: My night continues downhill. Fitbit’s muteness gets louder.

Part 2: 23andme detects no clotting genes; demand for genetic expertise outpaces supply; DNA surprises about my personality and eating habits.

Part 3: A cartoon of the future of the medical industry.

Part 4: Five categories of predictable exponential tech change: devices, granularity, volume, utilization, software.

Part 5: Two categories of unpredictable change: the demands of individuals and their communities.

Part 6: Medicine, already trailing state-of-the-art techniques and technology by 17 years, gets lapped.

Part 7: Like fax machines, newspapers and encyclopedias, is medicine another information processing machine on the verge of being disintermediated by mutating consumer demands and tech innovation?

Part 8: Ten possible frontiers of consumer-led healthcare change.

Epilogue: Where information flows, medicine follows: how medicine’s stakeholders communicated in different eras ⁠— in formats including medicine shows, newspapers, telephones, medical journals, and TVs ⁠— determined what, and how much, was communicated.

Prologue: Two times Fitbit didn’t save my life; my six month journey on the borderlands of my own health data.