Disability and technology: an upside for everyone!


At the Digital Enterprise Show (DES) in Madrid on May 26 we assembled a group of presenters to look into the issue of technology and disability. I have been looking at the subject for the last 3 years through reports working with Telefonica. In the reports I sized the disability market and began the process of mapping the technology space to this hitherto hidden market. The reason it had been hidden is that technology was very specific to each disability and was very expensive. The main change that has propelled the topic into mainstream discussion is the smartphone. It acts as a commoditised hub for bringing accessibility to many disabled people. Add to this the emergence of wearables, sensors and the Internet of Things (IOT) and we have the beginnings of a mainstream approach to making accessibility for many disabled categories an issue for all industry players and indeed for everyone in business and society. The fact that such a session appeared at a major enterprise-focused event such as DES is a good indication of the topic going mainstream.

The numbers are compelling: there are roughly a billion people in the world with different sorts of disabilities. Analysis in the initial report shows the largest category being hearing impaired, followed by those impaired visually, cognitively and physically in that order. The absolute numbers are not the issue; we now have a possibility of helping a large proportion of these people. And, don’t forget, the able-bodied also have a need on a temporary or situational basis to use some of this highly accessible services – for example when driving or recovering from a temporary injury.

During the panel I outlined some of these key themes from my previous research and then asked Vodafone, Atos and Telefonica to present their high-level thoughts.

The Vodafone Foundation from Spain showed how they are using mobile technology and cloud platforms to deliver services to the elderly and disabled to get people better connected. Enhanced interfaces are being developed to allow even those with just head movement to interact with the digital world.

Atos gave examples of how they have been working since 1998 to build accessibility and inclusivity into programme frameworks. Their experience shows how difficult this has been in areas like education but how it is gradually emerging from under the Corporate Social Responsibility shadow to be considered in a more mainstream light. More recent examples in areas like e-health show how combining applications development with wearables and the technology surrounding people with disabilities can help educate individuals as well as improve services surrounding them.

Telefonica, the sponsor of my two initial reports, presented how the accessibility issue is coming out of the shadows of Corporate Social Responsibility and is entering the activities of the main Lines of Business (LOBs) of the telecoms service provider. E-health also figured in Telefonica’s initiatives both in Europe as well as in Latin America. The company is using its geographic reach and overall scale to help promote accessibility and inclusion. Telefonica also showed an app which it has developed in conjunction with the university of Madrid, to present an accessible television experience to the two million Spaniards who require some form of audio description, subtitling or sign language to enjoy television and cinema programmes.

The message is clear: place accessibility in the early components of applications and services design and build it into the development programme and it will contribute to a cleaner, simpler design with a simpler interface which everyone will find easier to use. If the needs of the different disabled groups are taken into account, then the mass market’s experience will also be better.

The need to raise awareness of the issue at every company, public sector organisation and even household is what we need to make a success of this and bring all disabled into the digital era from a personal and work perspective. Accessibility is not an issue to be isolated in the CSR parts of a business, but should be brought out into the LOBs and considered as part of every market offering. In addition, all of this technology is opening up employment opportunities for people who would have previously been excluded from the workforce.

Accessible technology will help everyone, so let’s encourage inclusive design and a more open attitude to let the world’s disabled billion benefit from the technology, employment and the benefits of the Digital environment in which we all live.

The Hyper-connected individual meets the Healthcare system

At the Great Telco Debate last year, one of the biggest laughs was when my co-host Graham Wilde was attacked for buying his wife a FitBit, implying she needed to lose weight! The success of these so-called health tracking devices, and their associated apps, is an indication of how wearables, combined with smart phones and tablets, are beginning to change our behaviour and our lives.

Outside the healthcare industry, these devices with their life-changing outputs are seen as wondrous. However, inside the healthcare sector, they are often dismissed as being toys providing inaccurate and misleading information.

The consumer electronics industry, with its dynamic gadget crazy geeks, coming up against the established healthcare profession, with its hospitals and insurance organisations, represents a key battleground for us all. Regulation in the medical area is rife, and so it should be. Consumer electronics is a considerably more liberal environment. So we have the challenge of making money and identifying new markets on the one hand, whilst accurately treating people with illness and disabilities on the other.

In previous articles I have considered the world’s billion disabled and opportunities for assistive technology in the form of regular smart phones, wearables, apps and the Internet of Things (IoT). I now think it is worth expanding the discussion to include the broader healthcare industry. The simple reason is that if we get it right for the healthcare sector as a whole, the solutions will include everybody, whether suffering from a short-term illness or long term disability.

We all have experiences which involve the healthcare system at some point in our lives. As with many industries, the Internet and availability of smart devices of all types gives us an insight into a world that was previously shrouded in mystique.

From home: remote diagnosis

Before we even enter into a doctor’s surgery or hospital, we are armed with information from our web searches and data from our mobile health lifestyle apps. Exercise, diet, alongside our essential measurements are tracked to give us an indication as to how we are doing. A blip in how we feel, or in the data, might trigger an Internet search – often leading to inaccurate self-diagnosis and unnecessary alarm.

Today we are seeing the beginnings of new fee based services where medical professionals provide consultation via online chat or even video . In many circumstances, such interaction will be sufficient to satisfy the ‘customer’ that everything is fine; or can generate sufficient advice, or even a prescription, to address the issue. If not, escalation to a more formal, traditional consultation will be necessary. This potential virtual triage could be useful for the industry in reducing the number of people unnecessarily entering the ‘real-world’ healthcare system.

The traditional medical system

In surgeries and hospitals, medical professionals can benefit from costly devices and services necessary to diagnose and treat the individual. These devices are increasingly connected through multiple channels allowing even remote specialists to access the patient records and produce a diagnosis. Furthermore, scans which were previously too big to circulate, are now fizzed across the network infrastructure for everyone to share on their multiple self-provided or hospital-provided devices.

Furthermore, we shouldn’t lose sight of the fact that a specialist surgeon could perform an operation via a robot, and indeed with a virtual scalpel, given the right connectivity, video and local support.

And, of course should the condition be acute, an ambulance also completely connected to the medical facilities can be dispatched with diagnostics and treatment carried out by the paramedics. Perhaps we could think of this as mobile triage!

Following medical intervention, physicians and nursing staff are increasingly armed with sophisticated bed-side monitoring equipment, once again feeding into central patient records. However, this is increasingly being complemented with more smart phone based offerings. That’s not to say the clipboard on the bottom of the bed will disappear, but that this ‘analogue service’ will be complemented by electronic versions with analysis and alarms to notify staff.

Developments in devices, sensors, applications and medical add-ons are all helping to change the dynamic of treating conditions:

  • Self-administered blood monitoring is radically changing the treatment of diabetes and dramatically lowering the levels of insulin required
  • Pseudo off-the-shelf 3D-printed artificial limbs are accelerating limb replacements
  • Sensors, cameras and microphones are allowing sensory enhancement or indeed replacement.

Smart phones are the unifying element but this doesn’t have to be the case. We will doubtless end up with many separate connections and data flows from our bodies to our carers, physicians or indeed to our own smart devices.

Aftercare

On leaving the formal hospital environment, there are now many new opportunities to reduce the frequency of return visits and reduce the cost of supporting the patient. The aftercare hitherto confined to follow up consultations at the hospitals can increasingly be delivered via video-based services and ideally some more dispersed facilities in the local community. After all, consultation on how well a hip replacement or skin condition has improved can just as easily be done over a Skype link. As with many industry transformations, this requires an organisational, process, financial and cultural shift. If the follow-up consultation is carried out perfectly well by video link, why should it only command a fraction of the fee usually assigned to an in-person or  in-hospital consultation?

Social care

Follow up social care, whether in the person’s home or in a social care unit, can also benefit from this ultra-connected world. The vastly expensive scanners obviously cannot be dispersed out into the community, but care staff and patient associations can use much simpler, slimmed down technology as well as some of the more consumer-electronics like devices and the myriad of apps to give both the patient and the carer a better-informed understanding of activities. Scheduling appointments is an obvious first step to make better use of care staff. But simple data gathering from questioning the patient, or using medical devices operated by the carer, will certainly be of incremental value to any consumer-like devices in the form of blood pressure or heart-rate monitors and motion detectors.

And, if a doctor is required to visit the patient, then mobile devices such as ECG machines can feed data back into the patients’ records over cellular or WiFi networks.

Long term care is a major focus for the industry today. With an increase in chronic conditions and subsequent drain on resources, anything which can reduce the total cost of this service, whilst improving the quality of care given to individuals is a ‘no brainer’.

The journey

So, the entire journey from initial Internet search, through formal medical intervention, to aftercare can benefit from the better connected environment. There is, of course, the issue of who pays – public or private. This depends to a large extent on individual countries. No doubt, the best use of fixed broadband/mobile technology, smart phones/tablets, wearables/IoT, consumer/industry-approved apps and a willingness for all parties to adapt to the new environment will pay massive dividends.

Who can argue that the future daily routine of a nurse or doctor will consist of a couple of hours on face-to-face duty, followed by a couple of hours online?

It is vital when designing devices and apps in this area that simplicity and accessibility for all levels of technical ability are built in from scratch. In many countries for the foreseeable future we have an ageing population that is not smartphone literate. This could be one way of bringing many into the touch screen world as long as we don’t confuse the issue with overly complex solutions. Technology exists to hide the complexity behind a simple interface or different accessible features depending if a person has limited vision, dexterity or mobility. After all, if we can build a button to simplify the ordering of a pizza, we can build an app button to address the key requirement for a particular patient and their needs.

What is clear, is that the lines of demarcation between home, formal medical facilities and after care are blurring. Volumes of data and information flows between all participants are increasing with personal and medical devices. Centralised patient records fed from all points are vital. Technology has to be embedded into simpler processes in order to underpin the new healthcare regimes.

We are all part of this particular journey. Let’s encourage all parties, patients, medical staff, administration and perhaps most importantly, politicians, that this is one way that technology can literally help us all to a better life. Many industries have been disrupted dramatically through devices, apps and connectivity. We could see a restructuring of the healthcare sector. Who knows, it might lead to more local services and a move away from the previous trend to bigger and bigger hospitals.

Telcos and the big data-driven opportunity

The big data opportunity for telcos is not a new phenomenon. Vast amounts of data have been generated both internally and externally over generations of fixed and mobile services for consumer, business and partners alike. Over The Top (OTT) players have come into the market and built business models on the amalgamated analysis of data being generated at the customer end from their search, social media and apps store-based activities.

Telcos have missed an opportunity: they had some of the pieces of data in place to address some of these issues, but perhaps neither the telcos nor the market were ready for it. The emphasis for telcos was on internal measures and network-centric KPIs. The focus now has to switch to look at all their data generation points. They need to build a unified view of all activity to improve both the performance of the network as it comes under more and more pressure. But, most importantly, they need to underpin the new business models emerging which include OTT-based services as well as telco-centric ones. This is an inversing of the telco approach: Putting the customer and partners first, and using that insight to help shape the network to ensure all information flows satisfy all parties. That is not to say that the network is not critical. It is, but the emphasis should be on what the network is enabling rather than on the technology of the network itself.

Telcos must step back; gather network-centric, service-centric and customer-centric data into a suitable architecture. This will allow for the interrogation, validation, and extraction of value from the data for all stakeholders. ICT assets exist outside of the telcos themselves to allow this to happen, leveraging both the compute and storage capabilities of the cloud, as well as the algorithms and the data scientists who can work their magic with structured and unstructured data.

Data sources will include the core and edge of the network, the disparate customer, applications and content being consumed as well as the proliferation of social media and comment flowing around the use of broadband, applications and content in both personal and business lives.

The advent of the Internet of Things (IoT) adds another layer of complexity to the data puzzle, but it also allows the telcos to bring their sovereign national assets to bear in building the support mechanisms essential to help drive digital business transformation.

The need has also shifted from a retrospective requirement looking at old data records to a real-time need for insight into customers’ behaviour and the opportunity to adapt service offerings to suit every occasion. In this way, the leveraging of data becomes an essential component of the telco’s contribution to the ecosystem. Sharing some of the data with partners will doubtless become part of emerging offerings. As connectivity approaches ubiquity, it is the insight and knowledge of what is being done by people, households, businesses and ‘Things’ that becomes the fuel feeding the economic engine. As noted above, telcos missed the initial opportunity around data analytics. Let’s encourage all parties to work together to make sure that they don’t miss this next even more exciting wave.

Talend asked Lewis Insight to take a look at the telco and the data opportunity. The resultant independent paper can be found here.

The telco big data opportunity is one of the debate topics we will introduce to the Great Telco Debate in London on November 15th 2016. To find out more, see last year’s highlights and register visit www.telcodebate.com

 

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The growing influence of independent analysts

Having worked with many of the leading analyst firms over the last 3 decades, it has been fascinating to work as an independent over recent years. More and more independents seem to be springing up either from an analyst or vendor background. Most vendors and service providers are happy to invite ‘us’ alongside the well-represented analyst firms to their product and strategy events as well as to major industry conferences such as MWC and CES. Not surprisingly, given our industry experience and lack of corporate constraint, we are generally more outspoken than many of the representatives of the establishment.

Industry events provide opportunities for analyst colleagues from all sizes of organisation to meet. and share thoughts. Out of some such discussions came the project I have been running with Amdocs Network Solutions Division, where different independent analysts collaborate to produce high-level papers each covering a key topic within the sector. The client gets the benefit of working through a single point of contact, whilst the independent analysts get a streamlined route into a client and the broader market to present their thoughts and opinions. And, through this collaborative approach, our combined knowledge and experience (amounting to over a hundred analyst years), the quality is excellent. Luckily, the technology at our disposal also allows us to build flexible teams to address issues despite our very different backgrounds and locations.

Initial papers have been:

What’s the CTO’s role in the digital boardroom – Marc Dowd and Chris Lewis

App-aware networks vs. network-savvy apps – Dean Bubley and Chris Lewis

The evolving supply chain and its implications for the CTO – Tony Poulos and Chris Lewis

Why 5G won’t be enough – Caroline Gabriel and Chris Lewis

Future papers already in the pipeline include Telcos and the SME, and the impact of the OTTs on telco business and network models.

People are sceptical about the independence of analysts. Some firms, and indeed individuals, have been that ‘gun available for hire’ to promote particular companies or technologies. Obviously, someone has to pay the bills. In this project, the topics are agreed upfront but editorial control remains with the analysts. Since Amdocs Network Solutions Division is using the papers and accompanying videos to help raise their awareness at a high level with the world’s CSPs, there is no product pitch, no axe to grind – just an opportunity to provide high-level content to potential customers to make them think about the future of the telco and its role. So the client benefits from the papers and their thought-leadership, whilst analysts get a platform to demonstrate how they are able to compete in a market dominated by a few major players and a very long tail of small companies.

Whether you are an independent analyst with experience of the telco sector, or a company working in the telecoms industry, there might be an opportunity for us to work together. Take a look at the papers and think about topics that you think could be addressed in a similar way.

Add to this the Great Telco Debate www.telcodebate.com (London on November 15th 2016) as a platform for the independents and more open, wide-ranging discussion around the future of the telecoms industry. Attendees love the format and honesty of debate. In 2015 we used analysts as a panel to sum up the different debates and interrogate their joint wisdom on the future of the industry! Nowhere else do attendees get the contrary perspectives on offer from such a wide variety of industry stakeholders.

Long live the independents!

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Accessibility for the disabled – an opportunity for the telecoms industry that benefits everyone

What is accessibility? Simply put, how people with disabilities can use the same technology as their able bodied peers for work and personal lives.

The numbers and the business case for accessibility are compelling. With a billion people in the world (1 in 7) suffering from some form of disability, most of us will be impacted at some point in our lives. 4% of children, 10% of the working population but over 75% of the over 65s have their lives affected by hearing impairment, vision impairment, physical or cognitive conditions. And, many of those with more acute conditions are unable to enter or remain in the workforce due to accessibility issues.

Why is this especially important to the telecoms industry? Fundamentally because mobile devices and broadband connectivity will be a vital link in allowing the disabled to participate fully in work and social activities. In addition, the advent of the Internet of Things (IOT) and the explosion in wearables also have major sensory replacement and enhancement implications. Under the old regime, all disabilities developed their technology separately and at vast expense. With mobile devices, tablets, TVs, wearables and sensors now available as a platform for everyone, access to specialist equipment, apps and services is much easier and certainly much more affordable. Now disabled people can join many online activities such as retail, banking and entertainment, whilst having the opportunity of getting into the workforce, leveraging those more accessible devices and exposing their individual skillset.

Developments in computing, storage and network capabilities combined with a range of means of interacting with devices and applications such as touch, gesture, speech – and brainwave coming soon – all mean that senses can be enhanced or content adapted to suit an impairment. These are the key components falling into place to make all this possible: –

  • Devices are getting more accessible with adaptation to screens and input assisted by speech, touch or gesture
  • Smart homes mean that access to devices and functions helping around the house are easily adapted to different conditions: lighting that changes colour to announce a phone call or someone at the door is a great mash up example of connectivity, IOT and adapting to a disability. Add to this the potential of domestic robots and the opportunities enormous.
  • Wearables & IOT bring consumer electronics in terms of high-powered camera, microphones and sensors to help individuals who have some sensory impairment better communicate, consume content or interact with 3rd parties for business or personal matters
  • Smart city services also mean that the person with a disability can not only join the online community but can also better navigate their way through the village, town or city with assistive services based on iBeacons and information about accessible routes within the environment as well as public and commercial buildings
  • Applications split into mainstream items such as social media and retail; and specialist apps for different conditions such as help seeing, interpreting speech and learning. People with different disabilities require a combination of regular apps as well as a few specialist ones that focus on enhancing the necessary additional inputs depending on their particular circumstances.

Not surprisingly, with so many contributing components coming from so many diverse sources, there is a lack of consistency when it comes to standards. This is true for the consumer electronics components as well as the operating systems and applications environments being used. Guidelines, such as those from G3ICT, as how to make all components more accessible and more inter-operable do exist but more work is required. Mobile device manufacturers are taking accessibility more seriously with the Global Accessibility Research Initiative (GARI www.gari.info) listing many of the world’s accessible devices and applications.

It is essential to educate all parties about what different disabled people may need. The number of variations in conditions is enormous. Providing flexible font sizes, colour contrast, different speech rates and enhanced volume is obvious. The fact that we now have so many devices adaptable amd personalisable for everyone’s needs is an excellent basis for building a more accessible environment.

The fear factor from those outside of the disability area also has to be addressed.

  • Parents of a child diagnosed with a disability need access to the technology and understanding of how it will allow their child to develop through education and work.
  • Employers have to be made aware of the ways in which disabled people can contribute to business (deaf people doing online chat in a call centre, blind people coding, wheelchair-bound customer care agents and many more)
  • Co workers need to understand how to best interact given different disabilities

In short, the call to arms is for everyone involved in the digital landscape to embrace accessibility from first principles. If digital product design includes accessibility from the get go, then the ease of accessibility and adaptability for all conditions is simplified. Adding dedicated accessibility devices and software on to an existing product is, as we know all too well, an ugly, painful and sub-optimal approach. And, extremely importantly, this new approach to design will improve everyone’s lives. Everyone finds themselves at certain times temporarily or ‘situationally’ disabled. Drivers shouldn’t look at their smart phone screens, deep sea divers can’t use speech nor can people in the more frozen climates use touch through thick gloves!

Once the accessibility angle is built into the cycle of product/application development and included on every refresh cycle, then the issue of accessibility will simply become part of the personalisation that we have discussed for years around the mobile world. In the meantime, it is incumbent on all companies from the smallest applications developer to larger corporations offering services via their apps (including governments), to make sure accessibility is included in the process and implementation flows around digitisation.

Technology is no longer the barrier to accessibility it was 25 years ago. Awareness of the range of disabilities and their adapted needs, both in terms of user interfaces and preferred channels of communications, will lead to better designed products for everyone. Many exist already:

  • Sign language via a video conference link
  • Audio description of television programmes and films
  • People with speech defects using email, Instant Messaging, chat and the like.

It is a question of making sure this is communicated to all parts of business and government as well as being built into both product development and channels to market. And, most importantly, adding knowledge transfer to all education, charity and NGOs to optimize awareness and usage for people when they enter the disabled marketplace.

In economic terms, this is a powerful group, representing some $4 Trillion of spending power. The more they can benefit from the digital premium and the more we can leverage technology to get them into the workforce, the stronger the group will become in economic terms.

For every business, every government department and for many families, more accessible devices, applications and services will benefit both internally and externally. This is not simply a matter of Corporate Social Responsibility (CSR) but an economic and moral obligation to use technology to build an inclusive society. So, let’s spread the word, build accessibility into products from scratch and let’s make everyone’s lives easier, more digital and more rewarding!

The Six Million Dollar man 40 years on. Wearables, Smartphones, 3D printing. Cost to you <$100k!

As a teenager in the 1970s I loved Steve Austin, the astronaut who crashed and was rebuilt. Remember the tag line “Gentlemen, we can rebuild him. We have the technology, the capability to make the world’s first Bionic man”! It captured my imagination and has come to the front of my thinking now as I consider the possibilities of using technology to compensate for the different disabilities affecting people today. Perhaps we can’t replicate the eagle-eye zoom or the leopard-like speed of Lee Major’s character, but we can certainly bring functional replacement or complementary devices and applications to bring the astronaut-specific re-build of the 70s down to a very affordable level today.

The price of electronic components is continually falling, fueling the consumer electronics boom. Smartphones, and their associated explosion of applications, leverage the mobile network and the cloud computing phenomenon to deliver a wealth of apps both mainstream and specific to certain conditions, often free or at a minimal charge. On top of this comes the wearables revolution: watches, bracelets, eyeware, hearing devices, patches and exoskeleton limbs. 3D printing also means that the manufacturing of specialist devices is literally at the push of a button and can be taken to the most remote part of the world, delivering prosthetics to Africa at an affordable price point.

So how does the $6 million (not even allowing for inflation) look today? What gadgets, software and services could we pluck from consumer electronics retail outlets, apps stores and the medical community to build our modern-day bionic person?

  • Smartphone – $500
  • Exoskeleton bionic hand – $20,000
  • Exoskeleton legs with muscle stimulated control – $30,000
  • Sight (glasses) – $2,500
  • Hearing – $2,500
  • Bracelet with haptic feedback – $500
  • Smart watch – $500
  • Skin patches- $50

Total = <$100,000

There are, of course, some very expensive options such as retinal implants which still cost $100,000s plus complex surgery. However, most of the shopping list is literally off-the-shelf, or even off-the-printer.

The individual will need a subscription to a mobile provider, and probably also a link to their home WiFi, to enjoy the luxury of controlling the various household devices and services in the smarter-home environment; and, outside of the home, to link with the smart village, town and city services that can also complement the items in terms of navigation, linking into public services as well as the broader business community.

The e-health perspective also needs to be built into the thinking. Some of the devices will link into social and e-health services. Some of the information loops could potentially be to doctors and carers without the individual even needing to be involved. In effect, multiple information loops will feed off and to the individual, whilst improved monitoring and reduced cost of maintaining contact will help fund installations where required.

Steve Austin was funded by the US government in the TV show. In the case of a person being disabled through an accident, insurance would doubtless be involved, as would the medical authorities. Most of the items here are off-the-shelf and affordable for a vast swathe of society, not just limited to astronauts!

The world’s billion disabled people (source WHO) will have an increasing chance of joining in the digital revolution at home, at work and in society as a whole if we all help bring it to their attention. We also need to educate other relevant parties – family and friends, doctors and governments to name a few.

In the year that we all went Back to the Future, it just goes to show that time spent watching TV as a teenager wasn’t wasted. In Thunderbirds and Joe 90, Gerry Anderson predicted video mobile phones, Telepresence and brainwave transplants, and don’t forget the crew of the Starship Enterprise had mobile devices. If you want to predict the future, keep an eye on the TV!
six million dollar man

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What tech is out there for disabled people?

Recent interview with Telefonica about accessibility technology available today and in the future. I’m not the one in the bow tie….

Lewis Insight Interview with Telefonica

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