SBA

Smart Island

So here we are with a nice shiny new House of Keys, and with one exception new ministerial responsibilities - a new dawn for the island although with a general consensus that dawn has brought a red sky and the expectation of storms ahead. The one exception in ministerial responsibilities is of course the Minister for Economic Development, who has been lumbered with the same portfolio he held prior to the election albeit with different partners in the CoMin team. The DED Minister has not been slow to signal the need for change, reportedly saying that “more focus needs to be put on the local economy on the Isle of Man”, and the “private sector will show us the 'next big thing'”.

Whilst I’m unconvinced that there is, or should be any aspiration towards, a “next big thing” because we should be aspiring to greater economic diversity, whatever the future holds for the Manx economy it’s a cert that ICT will be a major component of success. There are few sectors outside of national governments and state monopolies which can claim “success” without effective exploitation of technology. Blockchain and Bitcoin were, for a little while, forecast to be our next big thing. Blockchain certainly has more potential yet, Bitcoin I’m now less sure about, but neither will be the next big thing for a while; they’re on a slow burn and while both should continue their contributions to our economy, neither is likely to achieve the scale of Insurance, Banking, Fiduciary or Gambling.

The Blockchain & Bitcoin niches have however, like Space, something in common with the island’s economic powerhouses - they were all products of conscious interventions by Government to create the climates in which they could thrive. So can the Government intervene again to stimulate new opportunities?

Previous interventions have focused on providing enabling legislation, perhaps unsurprisingly because legislation is one of the easiest things for Government to change, but most ICT innovation is not fettered by regulation except for data and communications. Instead our new Government will need to be more imaginative in order to stimulate technology-based economic development, so here are a few ideas for starters:

Digital Health

The island has been exploring this opportunity for the past few years, but health is a public sector domain and efforts have been hampered by caution in cooperation between government departments, and between the public sector and private sector. This cautious climate has stymied some well-intentioned and viable proposals to develop Med-Tech, so whilst there have been successes there have also been initiatives that have run out of steam.

The opportunities are there for the island to become an exemplar in Telemedicine - remote diagnostics which extend the health capabilities that can be delivered to patients on island, and thereby enable earlier interventions at lower cost. Similarly the island has had, and hopefully will have more, opportunities to trial and deliver diagnostic screening technologies into primary care, enabling more diagnosis in GPs surgeries and even at home, reducing the cost and burden of in-person diagnosis by specialists in Nobles or across.

Clearly all health technologies need careful scrutiny and trial, but we have the opportunity to create a climate in which these can be performed robustly thereby enabling the development and proof of new Med-Tech - which is the opportunity craved by many Med-Tech innovators because proof of benefit is the single toughest barrier in bringing Med-Tech to market. Greater cooperation between DED, DHSC, Hospitals, GPs and Med-Tech entrepreneurs could benefit the economy, patients and the public purse. Personally, and having been a guinea-pig for a new Med-Tech in the past when the NHS treated my cancer, I would go for it.

Extra-Care

One of the consequences of our extended durability is that we are frailer for longer. The days when a chap might consider himself lucky if he lived two years past retirement are, for most people, behind us - instead we are more likely to experience a gradual decline in capability over fifteen years or more before shuffling up to St. Peter’s gates. As we become more frail we need more care, more assistance and supervision, whether supplied by the state or private care operators. Many elderly people depend upon, but resent the intrusion of, care at home. Some need full-time supervision in residential care. Either way becoming frail is expensive and constraining, and both cost and constraints are unwelcome.

Extra-Care is one of the terms given to describe technology which assists care providers by minimising their need to regularly visit the stay-at-home frail and elderly, and thereby reduces the cost of care in the community, reduces the intrusion of care visits to those who are vulnerable but not incapable, and defers the need for residential care. The most basic of extra-care technologies is the assistance button - a dongle typically worn around the neck with a panic button to summon help if needed. The weakness of this is that some elderly people don’t recognise when they need help, and others may fall bady or otherwise become unconscious and therefore unable to push the button.

Modern extra-care concepts include more sophisticated assistance dongles or bangles which may incorporate activity monitoring, fall detection, location reporting, pulse detection, and body temperature monitoring along with two-way voice communication in addition to the panic button. These devices are still very much in the experimental phase but offer care providers the information they need in order to leave the care subject well alone until assistance is required. If all that sounds rather intrusive the other major technological support approach to extra-care or assisted-living is the smart home, in which sensors detect occupation, movement, use of kitchen and bathroom etc. to ascertain that the activity levels of the occupant are normal for them.

In both types of technology - the worn monitoring device or the smart home - data is continuously reported back to self-learning diagnostic software which automatically raises an alarm if the care receiver’s behaviour is unusual for them, so that a care-giver contacts or visits only when necessary, reducing the intrusion and cost of providing care in the community.

Extra-Care technology appears to be one of the strongest options to significantly mitigate the cost to society of care in the community, and presents opportunities to both open a new tech sector and enhance quality of life for our frail and elderly. All it needs is for DED and DHSC to cooperate, and to promote the island as a technology development and validation opportunity to the many researchers and entrepreneurs in the Extra-Care sector.

Internet of Things

Whilst Extra-Care is a special case of the Internet of Things (IoT), there is a much wider opportunity, particularly in the utilisation of public infrastructure. The island already has a few piecemeal initiatives in the IoT space, but we could do much better and in creating a national strategy and infrastructure for IoT we could become a centre for development and test of IoT technologies. A major function of the IoT is to provide data about environments, which may then be multipurposed.

Such data includes real-time ultra-local air quality, wind, precipitation, temperature, visibility, ice, sunshine and ultra-violet levels, road traffic density, public transport arrivals/departures (we already have this), journey times, water / flood levels, parking occupancy / availability, A&E waiting times, taxi availability, street lamp  status, waste receptacle (bin) status etc. Basically data about anything and everything in our public environment.

The difficulty of acquiring this data is not so much the sensors, although they of course cost money, but the energy to power them and the communications infrastructure to relay the data back to a central point. Many environmental sensors can be solar powered, and there are emerging standards for low cost wireless data communications specifically targeted at IoT applications. An Isle of Man project led by the DoI in conjunction with the DED, the Communications Commission and private sector to provide the base communication infrastructure and mounting points for sensors (e.g. on signposts, lampposts etc.) could create an environment which enables IoT device and application developers to innovate, turning the island into a major Internet of Things testbed which attracts IoT developers to create their products here and exhibit the island as their European reference site. In addition to the economic benefit of more high-tech development on the island we would gain much more detailed factual information about our environment for our own use in driving public service efficiencies, and this information would also reinforce some of our environmental claims for the island as a visitor destination.

These are my top three technology desires for the new Government. Each provides economic benefit for the island, benefit for our residents, and cost reduction opportunities for public services. Each requires cooperation between Government departments rather than legislation. If there is a next big thing which Government can help to stimulate then I’m sure it will be the product of a holistic approach; aside for our ability to create enabling legislation quickly one of our greatest potential strengths is the compact nature of our public administration - interdepartmental collaboration can be easy if the parties are minded to work together for the common good.