While doing some work for a client, I ended up putting together a rough outline of what kinds of technological platform shifts we can expect to see in the next 18-24 months. Then I shopped it around the office and got a bunch more opinions, so this is closerlook’s current understanding of what that pharma/tech world will look like in the near future.

Before you jump to the list, I wanted to point out that I built it in WorkFlowy.com, which is a very cool list-building productivity tool. I’m going to link to the live list, in case you want to see the current version, but I really liked working with the tool. 

Enjoy! Comments and twitters always responded to and appreciated.

  • Hardware: The “Big to Small” shift continues
    • Yesterday’s desktops are now laptops
      • Sales data show that desktops are more likely bought by companies for their employees than people for their homes.
      • People buy laptops
        • Computer technology is improving laptops, but we’ve off-loaded more and more work to the cloud
          • If everyone has about 20GB of music (that seems like a safe number, though I have no data to back it up except to say that I have about 80GB, and I’m probably in the highest decile) and no one has to keep it on their computer anymore, that’s a lot of hard drive space saved.
          • Google Docs, Amazon Music Locker, cloud storage and more will free up additional storage space
        • Laptops are evolving and getting closer to netbooks (e.g. Macbook Air) because unless you’re doing a lot of video/music/graphic production, what do you need all that power for?
    • Laptops are now tablets and smartphones
      • Do you know anyone without a smartphone? I do, but she’s 12. Even my parents (62 and 63 years old) have them.
      • Almost everything you’d want a computer to do, a smartphone can do
      • And it can do it wherever you are
    • Cellphones are dead… in the West.
      • Dead. In the next 2-3 years, seeing one will be akin to seeing a checkbook or pager.
    • Phones are and will be a huge deal everywhere else
      • Not to denigrate one or the other, but outside of westernized nations, the cell phone is a computer in the BRIC and other countries.
      • In India, they bank by text. This trend because of the relative affordability of the devices.
      • Mobile health means an app (or mobile web) in the west, but it means SMS everywhere else
    • Faster, yes. Lighter, yes. Smaller, no.
      • We’re pretty close to as small as things will get (if keyboards get any smaller, none of us will be able to use them) so expect to see more power and functionality within the same footprint.
        • Until someone figures out a way of doing virtual keyboards right
      • The tech I’m looking forward to in the next 2-3 years is a flexible, bendable, foldable screen.
        • Imagine an iPad 40% smaller with a screen that opens up to be 40% bigger
    • Near Field Communications (NFC) is almost ready for prime time NFC will require some standardization that is currently lacking. One of my best friends is an architect for Discover and has been working to make this happen for nearly a decade now. Last time we talked about it, he said the tech has been set to go for years but they can’t get device manufacturers in the same boat.
      • NFC is a way for 2 devices to talk to each other very easily and securely. It’s how you’ll be able to pay for parking meters, vending machines and friends without opening up your wallet: wave your phone at the device, get confirmation, walk away.
      • HCPs can pass data to patients without getting their email. And patients can collect their Quantified Self materials and have it formatted and inserted into their medical records.
      • If iPhone 5 comes out with it, expect it to be common in 2 years.
        • If not, 3 years.
  • Mobile World
    • It’s not about the the size of computers but their portability (and the personal connection that portability creates). They are small enough to be carry-everwhere-able and now there’s a decent internet connection just about everywhere.
      • And just wait to see what happens in the 18 months when real 4G internet is everywhere.
    • That kind of shift is changing the way we think about computers and computing
      • We are within a few years of every aspect of our lives being enhanced by phone-based personal technology. It helps us buy wine, choose a restaurant, compare prices, read reviews, make itinerary changes at the drop of a hat in a way we’ve never seen before.
        • Phone-based technology will answer this question: I wonder if we can get a deal on an empty room in this very nice hotel tonight
        • In 2 -3 years, the assumption will be that everyone’s hours/calendar will publicly available and accessible.
          • On the day of my appointment, I shift the start time from 1:30 to 4:45 without having to call anyone and waiting to see if there’s an opening available later today.
        • Here’s a killer: how we make friends is changing. How we meet new people is changing. Our interests are becoming more granular and now we can find people interested in the very very specific thing we are interested in.
          • For example, GrubWithUs lets you join a party of people you don’t know at a restaurant to sample new dishes with new friends.
      • We will expect to be able to make publicly-accessible (and publicly indexed and searchable) comments to the world about what we are doing as we’re doing it.
        • Not like Facebook, where we feel like we have control of our own little castle, but in a publicly open way
        • We will have a period of chaos where the least little bit of waiting or bad service will result in a crazy public letter may feel like the death of a business. That will shift as we get to a point of saturation where no one review/comment is killer. An aggregated opinion will accurately describe the business/practice
    • The world, especially the HCP world, is about to be an iPad world
      • Statistically speaking, its as if there are no other tablets being made or marketed.
        • None. The “existing use” and “intent to buy” numbers are stunning.
        • When Epocrates cancelled it’s webOS version, webOS was dead weeks later
          • So few HCPs were on webOS that Epocrates didn’t find it worthwhile spending resources on it
          • Those few HCPs, (tiny to Epocrates), were enough of an audience share to break HP.
        • Everyone who isn’t Apple is in a very tenuous position
      • Major current uses in the HCP world
        • Clinical information
          • PDR, look-up tables, conversion tools, things that make it easier for an HCP to do their job
        • Patient education
          • Look at this video to explain your condition, here is material you need to understand, etc
        • Off-line education
          • HCP takes 20 minutes to watch an eDetail, read a paper, practice using a diagnostic tool, etc
      • Major emerging uses in the HCP world
        • Camera
          • “Face-to-face” communications with reps, staff, patients
          • Virtual Detailing
          • Virtual consult
          • iPad “office hours” where patients can call in and ask a question and get 5 minutes of time
        • Augmented reality
          • Education opportunities are pretty intense
        • Clinical practice
          • If phones did a great job slicing tasks into 2-minute slices, the iPad in clinical use will mean that the HCP will get, in a glance, a patient’s history, HCP notes, and pertinent material updates.
            • You’ve diagnosed someone with diabetes. On your way to the exam room, you remember where they were on the progression/continuum, what you prescribed, what factors you suggested that the patient change and what news there was on that type of diabetes.
            • Download and read the charts the patient kept themselves (see next section) to get a sense what’s been happening.
      • Just because they use iPads, doesn’t mean they will need to be marketed to via iPads.
        • Technology is a gimmick to attract attention. What you do with that attention is more important.
        • iPads do not necessarily increase retention or awareness. The content determines the value.
  • Quantified, World, Quantified Self
    • We are 1-2 years away from the point where a smartphone and $150 of accessories will be able to measure what’s going on in people’s bodies better than most private practices have access to now.
      • This includes:
      • Real time vitals like blood pressure, heart rate, blood sugars, white blood cell count, etc.
      • Food intake, weight, etc
      • When did the user take their medicine? (and what did it do to their vitals all day long?)
      • What minute did that person take that drug relative to their last meal and last drink (or exercise, or sleep, or vitamins or whatever)? What was the outcome?
      • We are moving quickly to a world where you won’t hear “it’s 80% effective…” but you will hear “after three days, we can see that this *is* effective in you and can prescribe the following course of action…”
      • Location log (were you at your gym for 45 minutes? It will track that)
      • Food recognition (take a pic of every meal and it will estimate and keep track of calories, fat, protein, etc)
      • Sleeping (a huge market just starting to appear, assuming device makers can convince peole how a device can help them sleep)
      • Prescribe/Administer/Validate feedback loops will be hours and days instead of weeks.
      • Exercise tracking (estimate steps walked, calories burned, heart rate, etc)
      • The list goes on and on.
  • Software Shifts
    • Within 12 months, HTML5 and CSS3 (eventually CSS4) will be the de facto standard for all “modern” browsers
      • Flash is doomed.
      • But until it’s actually dead, Flash developers will shout its relevance to anyone who will listen.
    • Apps vs. Mobile Web
      • Clearly, apps are winning the war, but the war isn’t over. We aren’t sure when or if to expect a winner either way.
      • Apps
        • Are device-specific, giving them access to hardware features (camera, compass, tilt-sensors, etc) that the mobile browser can’t see yet
        • Apps feel like something you own.
          • When you buy an app, it feels like it’s all in your pocket, even when it isn’t (that’s why the Wikipedia app doesn’t take an hour to download: all the data is accessed through the web)
            • Apps usually need access to the web to work properly
      • Mobile Web
        • Aren’t device-specific
          • Can’t access hardware
          • Yet
            • We expect that hardware interfaces will standardize enough so that the web browser will be able to access the phone’s hardware.
            • No expectation as to when, though
          • While you can bookmark a web page to your phone, and even make an icon on your home screen so it looks like an app, most people feel like that the content is “out there” in the cloud where they don’t own it.
          • This creates tension and users opt for less tension.
          • However, it is possible for a mobile web page to cache materials like databases on the phone so that the web page can have just as much of the content stored on the device.
            • So which will be more “owned?” It’s all about the user’s perception
      • Developers vs. Users
        • Developers like mobile web because they can design and build for one ecosystem, not 2 or 3.
        • Users like apps because they “just work.” No fiddling or experimenting and adjusting to make it do what the user expected it to do.
        • We don’t have an expectation as to who will win this war or what will be the deciding factor. We assume as the major platforms develop, things will get even more complicated before a victor emerges.
    • Browsers
      • Soon, all browsers will demand auto-updating a la Chrome to keep everyone up-to-date on tech standards
      • Microsoft will still suck at keeping up with standards and will lose market share.
        • 2-3 years from now they will control 40% of the market (down from 50% worldwide), but they will control the less-advanced/savvy audience’s browser. IE9 will not slow this slide.
    • More and more software will be cloud-based. We’re still years from having a majority of people be comfortable having all their stuff be cloud-able and be comfortable renting software online as necessary.