A quick interface study on the effects of fourth industrial revolution on health.

1. FOURTH INDUSTRIAL REVOLUTION
AND
HEALTH
Moderator: Presenter:
Dr. Arun Aggarwal Dr. Jitender Kumar
Professor Junior Resident
Department of Community Medicine & School of Public Health,
PGIMER Chandigarh

2. Five Ages of Civilization
Source: Steven Covey in his book 8th Habit. (2011)
Hunter/
Gatherer’s
Age
Farmer’s Age
Industrial
Age
Information
&
Knowledge
Age
Age of
Wisdom
INDUSTRIAL REVOLUTION . . .
2

3. Five Ages of Civilization
• With each subsequent age productivity goes up multifold
over the preceding age
• Each subsequent age destroys many of the jobs of the
preceding age
• In the first three ages of civilization manual workers
produced most goods and services with physical labor, but in
the last two ages, knowledge workers produce most goods
and services with intellectual inputs
3

4. 1st IR
Mechanization
Water power
Steam power
2nd IR
Mass
Production
Assembly lines
Electricity
3rd IR
Computer
and
Automation
4th IR
Cyber
Physical
Systems
1760 1870 1969 2000
The Four Industrial Revolutions . . .
4

5. Negative Effects of First Industrial Revolution
Urbanization
Poor sewage and Drainage
Creation of slums
Overcrowding
Accumulation of filth in cities and towns
High sickness and death rates
Infectious diseases
5

6. 6

7. 7

8. Concept of Health during First IR
During the period of First Industrial Revolution, focus was on
productivity by healthy workforce. Those who used to get ill, used
to get fired from work. Thus the value of health was such to enable
profit
8

9. Health and Living Conditions
By 1850, working conditions had become worst & uprising
started after that.
• The struggle against epidemics,
which was required for industrial
society to proceed, brought
together activities by various
types of people: social reformers,
microbiologists and sanitary engineers
• Led to improvements in cities
• Public Health Act 1875 forced towns to pave, light, and clean
roads; appoint Medical Officer of Health
• Problems with sewage, water supply, disease, food, housing
were examined
Sir Edwin Chadwick
9

10. Medical Improvements
Edward Jenner-
Created first
vaccine (1796)
Louis Pasteur-
Germ theory of
disease (1873)
Marie and Pierre Curie-
Discovered radium(1898).
Used to develop x-rays
10

11. Positive Effects of Industrial Revolution
Increase in wealth
Increased production of goods
Improved standard of living
Access to healthier diets, better housing
Education
Better Health care
11

12. • Decrease in Communicable Diseases
• Increase in average lifespan
12
Penicillin (1928) Pertussis (1914),
Diphtheria (1926)
Tetanus (1938)

13. Negative Effects of Second Industrial
Revolution
As Industrial society advanced:
• Manufacture and marketing of cigarettes and related
products increased
• Requirement for physical exertion in daily life decreased
• Changes in pattern of food supply Obesity
• Longer life spans bodily damages accumulated
Modern chronic disease epidemics, including heart
disease, cancer, stroke, and diabetes, respiratory
problems due to pollution
13

14. Concept of Health During Second IR
“Health is a state of complete physical, mental
and social well-being and not merely the
absence of disease or infirmity”
World Health Organization (1948)
14

15. Third Industrial Revolution
Digital Revolution
• Advancement of technology from analog electronic and
mechanical devices to the digital technology
• Personal computer, Internet, and information and
communications technology (ICT)
15

16. Technology and Mental Health
Sleep
• Seriously mess with our
sleep patterns and habits,
potentially causing
sleep disorder
• People who read from an e-book needed an additional 10
minutes to fall asleep.
• They experienced 90 minutes of delayed melatonin onset —
and had half the amount of melatonin released.
• They also had diminished rapid eye movement sleep
16

17. Technology and Mental Health
Depression
A study found that people who keep their cell phones
constantly accessible are more likely to report depressive
mental health symptoms
17

18. Technology and Mental Health
Addiction
24/7 stress
Fear of Missing Out
18

19. Technology and Mental Health
Feelings of isolation
People are spending much time with technology than to make
real connections/ human friends
Incivility
Research has shown that with increased Internet and
technology use, rudeness and incivility on social media sites has
also increased
19

20. Technology and Mental Health
Insecurity
We are constantly plugged into what everyone is doing. We are
constantly comparing ourselves to everyone else. But what we
are seeing is everyone’s glamour shots and our average
moments
Anxiety
Social media on our gadgets can give us anxiety, anxiety such as
fear of not being successful enough or smart enough with use
of sites like Facebook and Twitter
20

21. Internet Addiction Disorder
DSM-V Criteria (Symptoms):
• Preoccupation with the internet or internet gaming
• Withdrawal symptoms when the internet is taken away
• Tolerance
• Loss of other interests
• Unsuccessful attempts to quit
• Using the internet to escape or improve a bad mood
21

22. Technology and Physical Health
Musculoskeletal Problems
• Neck pains, back pain, shoulder problems
• Carpel tunnel syndrome
• Repetitive stress injuries
Computer Vision Syndrome
• Inc. risk with use of computer
> 3 hrs/ day
22

23. • Exposure to e-waste is causing adverse health outcomes like change
in thyroid function, changes in cellular expression and function,
adverse neonatal outcomes, changes in temperament and behavior,
and decreased lung function
• Also increases in spontaneous abortions, stillbirths, and premature
births, and reduced birth weights and birth lengths.
• People living in e-waste recycling towns or working in e-waste
recycling had evidence of greater DNA damage than did those living
in control towns.
23

24. Concept of Health during Third IR
• The idea of health in a positive sense become more widely
accepted, probably owing to the new era of increasing
freedom from disease
A resource for everyday life… a positive concept emphasizing
social and personal resources as well as physical capabilities
Ottawa Charter, WHO 1986
• It implies a capability to do what one wants to do in life
24

25. Fourth Industrial Revolution
• Fourth industrial revolution began at the turn of this
century and builds on the digital revolution
• New ways in which technology becomes embedded within
societies and even the human body
• Fusion of technologies that is blurring the lines between the
physical, digital and biological spheres, collectively referred
to as cyber-physical systems
Klaus Schwab, founder and executive chairman of the World Economic Forum25

26. Fourth Industrial Revolution
Megatrends:
These three are deeply interrelated and the various
technologies benefit from one another based on the
discoveries and progress each makes.
Klaus Schwab, founder and executive chairman of the World Economic Forum
26

27. Fourth Industrial Revolution
3 reasons why today’s transformations represent arrival of a
Fourth and distinct one:
1. Velocity: Result of the multifaceted, deeply interconnected
world we live in.
2. Scope: Combines multiple technologies that are leading to
unprecedented paradigm shifts in the economy, business,
society, and individually.
3. Systems impact: Transformation of entire systems, across
(and within) countries, companies, industries and society
as a whole.
Klaus Schwab, founder and executive chairman of the World Economic Forum
27

28. Technologies driving Fourth IR
• The Internet of Things: A New Network
• Artificial Intelligence: A New Brain
• Blockchain
• Virtual reality
• Biotechnology
• Robotics
• 3D printing
• Energy capture, storage, and transmission
28

29. Technologies driving Fourth IR
The Internet of Things: A New Network
• How many of our devices and machines can be fully
connected to the internet and to each other?
• All this technology can now communicate with each and
every other compatible device, sending instructions and
activity data back and forth
• Use of the sensors and the internet to blend digital
technology with physical machinery
29

30. Wearable Technology
Internet In Our Bodies
30

31. Technologies driving Fourth IR
Artificial Intelligence: A New Brain
• Computers, software, devices, and robots are being taught by
humans to think for themselves
• Programming and algorithms loaded with data from
numerous real-world experiences teach computers how to
respond to certain scenarios and make their own choices and
actions
• AI enabled software, computers and robots will collate
incoming information and make decisions on things like
emotion and intuition 31

32. Technologies driving Fourth IR
Blockchain
• A new way of storing and sharing data, doing transactions that
are more secure and immutable than the current internet
• Uses cryptographic hashing to encrypt data to provide more
security than existing computer programming and systems
• Time and date information is also encrypted with this data that
cannot be changed, resulting in records that cannot be disputed.
32

33. 33

34. Technologies driving Fourth IR
Blockchain, IoT and AI - perfectly suited to work together
• IoT will generate data about everything happening around
us.
• AI could make a decision based on new information
provided by IoT in the absence of a human to give
instruction.
• Blockchain networks could be carrying and securing this
information, delivering to humans.
34

35. Reactive vs Proactive Care
Many chronic diseases are either largely preventable or fairly
easily managed if patients prioritize preventive care and work
closely with their providers
Reactive Care
i. does not work to stop them from getting sick
ii. more expensive than what preventive care would have cost
Proactive care
- when a consumer takes responsibility to proactively manage
his own health – moving away from the physician “treating an
ailment or disease” to a patient practicing “self-care” activities
35

36. Quantified Self
• Incorporating technology such as sensors and wearable to
acquire data on various aspects of an individual’s life—with
an aim to improve self-sensing, self-awareness and human
performance
• Works on the principle that:
“If you can measure it, you can change it.”
• Emphasizing collection and analysis of data, it enables
individuals to make necessary changes in lifestyle and
health-related behavioral patterns
36

37. Use of Technologies for Change in Health
Behavior
Future Mirror 37

38. Use of Technologies for Change in Health
Behavior
• Users who track activities more frequently on average tend
to lose more weight than their peers who track activities less
frequently
• When an individual increases their adherence to tracking
they are more likely to lose or maintain their weight
• “Healthy user effect”???
• Effective interventions can be designed
Pourzanjani A, Quisel T, Foschini L (2016) Adherent Use of Digital Health Trackers Is
Associated with Weight Loss. PLoS ONE 11(4
38

39. Use of Technologies for Change in Health
Behavior
The successful use and potential health benefits of digital
health technologies does not only depend on
penetration and adoption, but on the
design of personalized engagement
strategies considering high
individual variability
of the targeted
users
Wearable devices as facilitators, not drivers, of health behavior change. JAMA.
2015;313(5):459–460
39

40. Digital Diagnosis
OScan which works with a
smartphone to create detailed
images of the oral cavity and
screens the mouths for
suspicious oral lesions
LifeLens: A smartphone
app that can detect
malaria
40

41. Telemedicine
The Uberization of Healthcare:
• Convenience
• Almost Immediate Service
• Customer-centric
• Satisfying Users
• Technology-driven
• The Diagnosis
41

42. Robotics in Healthcare
da Vinci Xi Robot
The ReWalk robotic exoskeleton- a
light wearable brace support suit
42

43. Healthcare in Elderly
Connected home:
• Everything is connected to the Internet to provide data
based services
• Smart care applications
• Home based care robots
• Telemedicine
• Home healthcare:
Hospital in the
home
43

44. Blockchain Technology in Medical Tourism
• Healthcare - global.
One important factor –
Mobility of a pt’s health data
• Lack of access to a pt’s health
records - Slows down the care process
• With blockchain, a patient’s health data are made accessible
to providers (and anyone) to whom the patient grants
authorization.
• Patients can also make smart contracts, allowing them to
access quality healthcare providers anywhere in the world. 44

45. Implications OF Technological Advancements
• Improving Lives
• Adapting Clinical Education
• Need to Work Effectively with New Technologies
• Changing How Care is Provided
• Influencing the Patient Encounter and the Patient Experience
• Democratizing Access
• Impact on Health Human Resources
45

46. Patient- Centered Care
• Patients are active participants in their care
• Patients would get all their healthcare data and do with it
what they would like e.g. put the data in various apps,
choose to contact a clinician or not, research or access
additional information from the internet, connect with
individuals who have similar conditions, create interest
groups etc.
• The physician would be the coach on the periphery with the
patient at the center
46

47. Opportunities For Development
The Public & Patients
• Identify…
• Inform…
• Contribute….
Healthcare Providers
• Identify best use…
• Adapt practices…
• Work with
Persons…
Healthcare Education
• Effective use…
• Persons as
Partners…
• Compassionate care
& Human aspects…
Healthcare
Leadership
• Lead effectively &
with compassion
Government Policy
• Develop &
Implement
Ethical Stnd…
• Evaluate
Performance &
Impact…
• Support & Fast
Track…
• Support delivery
of care in…
• Use of Public
Fund..
• Inc the tax base.. 47

48. Challenges
• To gain confidence of clinicians, nurses, patients, and those
involved in the regulatory and policy making boards
• Clinical prediction models are far from perfect as the there
are many variations - a small variation can change the
outcome
• How privacy will be protected?
• How the benefits can be fairly shared across the society?
48

49. Challenges
• Complexity: Medical issues don’t appear in isolation
• Threat to human jobs: Technology displacing human workers
• Human touch: How will we interact with AI? How strongly
will we require the human touch and human compassion in
health care?
49

50. India and Industrial Revolution
• India was famous for her handicrafts from the pre-British times
• The use of steam power in British mills reduced the cost of cotton
by 85 %
• Restriction of textile imports from India, import textiles to India
• The new colonial law forced the farmers to grow cash crops like
cotton instead of food crops, leading to famine and poverty
• The 3rd IR started in India in 1980s. Advancement in this phase
encompasses the spread of personal computers, internet, and ICT
50

51. Role of India in Fourth Industrial Revolution
• As the world’s largest democracy and the country among
highest number of scientists and engineers, India is a key
political, social and economic player that will shape the
course of the 21st century
• India’s ability to fully capitalize on the emerging
technologies of the Fourth Industrial Revolution will be one
of the leading drivers of global prosperity and peace in
coming decades
51

52. Centre for the Fourth IR, India
• Inaugurated by Hon’ble Prime minister of India on 11th October,
2018 in Mumbai
• Aims to accelerate the adoption of new technologies, minimize
their negative effects on society, and ensure that everyone has
access to the benefits generated by these technologies
• Partners with governments, leading companies, academia, civil
society and international organizations to co-design, test and
scale up policy tools, industry standards, norms and guidelines
for governing 4th IR technologies
• Developed in partnership with the GOI through the NITI Aayog
52

53. Thank You
Have a Nice Day . . .
53