We’re the Wider Team, High Assurance Identity of Things consulting strategists. As we write this, we’re scattered between Seattle, Cambridgeshire, Miami, & Vienna, Austria.
Though all the 2020 craziness, we interviewed bunches of digital identity, security, IoT, healthcare, medtech, and pharmaceutical pros. Really nice folks!
But it’s December and prediction season? So…
This is Wider’s first batch of year-end predictions as a new team. Here’s hoping hindsight is kind.
1/25
Desperate times and the kind of healthcare access barriers a pandemic exacerbates will keep humans buying digital health tools from the ecommerce greats. Hospitals and other provider networks are encouraging this, seeking data that might help with prevention and wellness, keeping folks out of hospitals.
2/25
A bet we haven’t made yet: when will more health data come from riding in cars than from checkups?
3/25
While a lot of healthcare IoT spend goes to smart beds and smarter robot arms, a surprisingly large chunk is going into the plant itself. Smarter buildings with safer HVAC can and do save lives. And cash flow.
4/25
Right now digital twins for business processes, automated systems, and facilities are ready to start incorporating observations about human interaction. We’ll starting to turning to facilities twins for feng shui advice that improves in-room teamwork and body movement by adjusting the shape of spaces and the placement of things (and people) in those spaces.
5/25
Island nations are eager for the benefits IoT can bring, especially connected medical devices. So are most of the regions that still have unreliable electricity, slow and frequently interrupted connectivity, and few reserves in the wake of catastrophes like pandemics, wars, and extreme weather events. They’re also aware of their lack of buying power for the latest technologies.
So there’s demand for a new category of IoT and IoMD that survives and thrives despite these challenges. Very low power consumption. Lots of storage and caching to hold on through power outages. Ruggedized for use outside clinics. Easy and cheap to field-repair. Lots of smarts inside so they work without an internet tap. Many flavors of connectivity to exploit opportunities as they knock. Open sourced, the better to adapt to new and unplanned problems.
6/25
Anger and frustration. We heard a lot of this from those anchoring healthcare ecosystems. Vendor lock-in of data and identity layers threatens the whole. It’s keeping costs up, stifling innovation, promoting medtech winner-take-all monoculture, and making questionable the billions invested annually in vendors’ proprietary control over clinical data, device security, and device behavior.
7/25
Phone calls largely replaced office visits at the height of the 2020 covid first wave. Everyone wants the cost and convenience to continue. But with more zoom and less dialing. Thank you, reimbursers.
8/25
Nations are doing anything to keep people at home and out of hospitals. Some hospital networks think they can cut patient stays nearly in half with more out-of-hospital care. So we see faster growth of in-home remote monitoring of chronic care, of preventive care, and post-hospital recovery.
9/25
Across Europe and North America, governments are holding big “tech” companies accountable for… well, everything. With more sworn testimony, public interest data analysis, streamed hearings, stronger rules and restrictive laws, expect the rise of defensive thinking among the FAANG behemoths. Healthcare, somewhat regulated, may be thought of as dangerous territory, causing their e-health initiatives to slow down and tread cautiously. WiderPoV: e-health is a carrot to reward regulators for the freedom to intrude on established healthcare industries.
10/25
We’re pulling that 50 percent number out of the air. But we won’t be surprised if the number is higher. The chipsets are available and increasingly cheap, the code to run this is ever more reliable and tested, and the call for making devices more multisensory and multipurpose hasn’t stopped.
P.S. #techmed vs. #medtech? Medtech wins on twitter and linkedin.
11/25
12/25
Most AI is being deployed in the cloud, like most software. But academia and industry are pushing pattern recognition and other AI behavior into clinical devices and the EdgeOps services that care for and authenticate them. Read more about TinyML.
Sutton’s Law: Spending on IoMT is creating more attack surfaces, and more attractive ones. This is one of the safest bets we made. And we’re not sorry we made it. HADI helps defend your things and the lives downstream.
13/25
Supply chains always get short shrift. In 2020 they got attacked. The immune response? Newer identity and security models and tools. More visibility, live tracking, deeper tracing.
14/25
2021 will have as many or more disasters as 2020. Even more cyber crime, terror, and war. Defensive cyber spending by government agencies has been a tiny fraction of offensive spending, if you go by headcount. Dramatic events can and will change this.
WiderPoV: Massive public sector spending on prevention, intervention, and recovery will pull talent from an already understaffed private sector.
15/25
Epic and Cerner will jump on the covid-fueled telehealth bandwagon, awkwardly. But their hunger to control every digital touch point will reach into remote monitoring, telehealth, and consumer devices, and each connected e-health device outside a healthcare facility. Healthcare IT doesn’t want to manage vast fleets of unmanageable devices. But it’s seductive, being part of patient lives between encounters. Having first and best access to that sweet, juicy data to enrich EHR patient histories. Yum.
16/25
17/25
Covid sucked up a lot of cash, budget, and reserves. So cost controls rule in 2021. Federating identity, improving identity quality, agility, reach, trust, and reuse save money. This is the short-term business case for high assurance digital identity, if you need it.
18/25
GDPR and CCPA are government manifesting public will to have more control over their digital lives. This is a long term trend and it’s gathering momentum. Expect this to deepen as it spreads into the world of clinical facts and the analysis derived from those observations. Are your apps and hospital beds, your security systems and flow meters fully GDPR compliant? Ready for what comes next?
19/25
Come the day humans take the climate crisis seriously, IoT will be ready. Here’s hoping it’s long before 2025.
20/25
21/25
Designing for medtech in space is like designing for rural, disaster-strewn, low-infrastructure places. Plan for high-latency, low power, unreliable connectivity. So, by 2025, Nokia’s 4G will be covering Moonbase Alpha, fitbits will be on Dragon flights, and Alexa will counsel you en route to Barsoom.
Five years from now, 6G rises, giving augmented reality its missing identity, security, bandwidth, location data, and coverage.
WiderPoV: Mixed reality eyeware, earbuds, and other wearables directly replace mobile phones and other screens in your life.
22/25
What if we checked each of our vendors? And their vendors? And their vendors? And their vendors? And their… The social graph of things is a ticking complexity bomb.
23/25
You’re still here? Are you the robot we trust or some human in the middle?
24/25
This is true and not true at the same time. Just don’t look too closely.
25/25
A decade? Body augmentations. Workplace mixed realities. Mind-controlled prosthetics. Enhanced perception. Physiology tuning. All connected, and orchestrated.
WiderPoV: each component in and on a human must trust others and be trusted to perform. So this is a many to many constellation, where all of it must live in high assurance digital identity.
So, that’s it for 2020.
Glad that’s over.
From all of us on the Wider Team
May you and yours
have a Healthy, Happy, and Meaningful
2021.
Wider Team 
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