Category Archives: Healthcare

How we’ll invent the future, by Bill Gates – 10 Breakthrough Technologies 2019 (Part 2, The List)

By Bill Gates for MIT Technology Review – February 27, 2019

As well as his introductory essay, read Bill Gates’ conversation with Editor-In-Chief Gideon Lichfield. Below are his picks for the 10 Breakthrough Technologies:

Robot dexterity

Nicolas Ortega
Robot dexterity
  • Why it matters If robots could learn to deal with the messiness of the real world, they could do many more tasks.
  • Key Players OpenAI
    Carnegie Mellon University
    University of Michigan
    UC Berkeley
  • Availability 3-5 years

Robots are teaching themselves to handle the physical world.

For all the talk about machines taking jobs, industrial robots are still clumsy and inflexible. A robot can repeatedly pick up a component on an assembly line with amazing precision and without ever getting bored—but move the object half an inch, or replace it with something slightly different, and the machine will fumble ineptly or paw at thin air.

But while a robot can’t yet be programmed to figure out how to grasp any object just by looking at it, as people do, it can now learn to manipulate the object on its own through virtual trial and error.

One such project is Dactyl, a robot that taught itself to flip a toy building block in its fingers. Dactyl, which comes from the San Francisco nonprofit OpenAI, consists of an off-the-shelf robot hand surrounded by an array of lights and cameras. Using what’s known as reinforcement learning, neural-network software learns how to grasp and turn the block within a simulated environment before the hand tries it out for real. The software experiments, randomly at first, strengthening connections within the network over time as it gets closer to its goal.

It usually isn’t possible to transfer that type of virtual practice to the real world, because things like friction or the varied properties of different materials are so difficult to simulate. The OpenAI team got around this by adding randomness to the virtual training, giving the robot a proxy for the messiness of reality.

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We’ll need further breakthroughs for robots to master the advanced dexterity needed in a real warehouse or factory. But if researchers can reliably employ this kind of learning, robots might eventually assemble our gadgets, load our dishwashers, and even help Grandma out of bed. —Will Knight

New-wave nuclear power

Bob Mumgaard/Plasma Science and Fusion Center/MIT

Advanced fusion and fission reactors are edging closer to reality.

New nuclear designs that have gained momentum in the past year are promising to make this power source safer and cheaper. Among them are generation IV fission reactors, an evolution of traditional designs; small modular reactors; and fusion reactors, a technology that has seemed eternally just out of reach. Developers of generation IV fission designs, such as Canada’s Terrestrial Energy and Washington-based TerraPower, have entered into R&D partnerships with utilities, aiming for grid supply (somewhat optimistically, maybe) by the 2020s.

Small modular reactors typically produce in the tens of megawatts of power (for comparison, a traditional nuclear reactor produces around 1,000 MW). Companies like Oregon’s NuScale say the miniaturized reactors can save money and reduce environmental and financial risks.

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There has even been progress on fusion. Though no one expects delivery before 2030, companies like General Fusion and Commonwealth Fusion Systems, an MIT spinout, are making some headway. Many consider fusion a pipe dream, but because the reactors can’t melt down and don’t create long-lived, high-level waste, it should face much less public resistance than conventional nuclear. (Bill Gates is an investor in TerraPower and Commonwealth Fusion Systems.) —Leigh Phillips

Predicting preemies

Nenov | Getty
Predicting preemies
  • Why it matters 15 million babies are born prematurely every year; it’s the leading cause of death for children under age five
  • Key player Akna Dx
  • Availability A test could be offered in doctor’s offices within five years

A simple blood test can predict if a pregnant woman is at risk of giving birth prematurely.

Our genetic material lives mostly inside our cells. But small amounts of “cell-free” DNA and RNA also float in our blood, often released by dying cells. In pregnant women, that cell-free material is an alphabet soup of nucleic acids from the fetus, the placenta, and the mother.

Stephen Quake, a bioengineer at Stanford, has found a way to use that to tackle one of medicine’s most intractable problems: the roughly one in 10 babies born prematurely.

Free-floating DNA and RNA can yield information that previously required invasive ways of grabbing cells, such as taking a biopsy of a tumor or puncturing a pregnant woman’s belly to perform an amniocentesis. What’s changed is that it’s now easier to detect and sequence the small amounts of cell-free genetic material in the blood. In the last few years researchers have begun developing blood tests for cancer (by spotting the telltale DNA from tumor cells) and for prenatal screening of conditions like Down syndrome.

The tests for these conditions rely on looking for genetic mutations in the DNA. RNA, on the other hand, is the molecule that regulates gene expression—how much of a protein is produced from a gene. By sequencing the free-floating RNA in the mother’s blood, Quake can spot fluctuations in the expression of seven genes that he singles out as associated with preterm birth. That lets him identify women likely to deliver too early. Once alerted, doctors can take measures to stave off an early birth and give the child a better chance of survival.

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The technology behind the blood test, Quake says, is quick, easy, and less than $10 a measurement. He and his collaborators have launched a startup, Akna Dx, to commercialize it. —Bonnie Rochman

Gut probe in a pill

Bruce Peterson
Gut probe in a pill
  • Why it matters The device makes it easier to screen for and study gut diseases, including one that keeps millions of children in poor countries from growing properly
  • Key player Massachusetts General Hospital
  • Availability Now used in adults; testing in infants begins in 2019

A small, swallowable device captures detailed images of the gut without anesthesia, even in infants and children.

Environmental enteric dysfunction (EED) may be one of the costliest diseases you’ve never heard of. Marked by inflamed intestines that are leaky and absorb nutrients poorly, it’s widespread in poor countries and is one reason why many people there are malnourished, have developmental delays, and never reach a normal height. No one knows exactly what causes EED and how it could be prevented or treated.

Practical screening to detect it would help medical workers know when to intervene and how. Therapies are already available for infants, but diagnosing and studying illnesses in the guts of such young children often requires anesthetizing them and inserting a tube called an endoscope down the throat. It’s expensive, uncomfortable, and not practical in areas of the world where EED is prevalent.

So Guillermo Tearney, a pathologist and engineer at Massachusetts General Hospital (MGH) in Boston, is developing small devices that can be used to inspect the gut for signs of EED and even obtain tissue biopsies. Unlike endoscopes, they are simple to use at a primary care visit.

Tearney’s swallowable capsules contain miniature microscopes. They’re attached to a flexible string-like tether that provides power and light while sending images to a briefcase-like console with a monitor. This lets the health-care worker pause the capsule at points of interest and pull it out when finished, allowing it to be sterilized and reused. (Though it sounds gag-­inducing, Tearney’s team has developed a technique that they say doesn’t cause discomfort.) It can also carry technologies that image the entire surface of the digestive tract at the resolution of a single cell or capture three-dimensional cross sections a couple of millimeters deep.

The technology has several applications; at MGH it’s being used to screen for Barrett’s esophagus, a precursor of esophageal cancer. For EED, Tearney’s team has developed an even smaller version for use in infants who can’t swallow a pill. It’s been tested on adolescents in Pakistan, where EED is prevalent, and infant testing is planned for 2019.

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The little probe will help researchers answer questions about EED’s development—such as which cells it affects and whether bacteria are involved—and evaluate interventions and potential treatments. —Courtney Humphries

Custom cancer vaccines

Paper Boat Creative | Getty
Custom Cancer Vaccines
  • Why it matters Conventional chemotherapies take a heavy toll on healthy cells and aren’t always effective against tumors
  • Key players BioNTech
    Genentech
  • Availability In human testing

The treatment incites the body’s natural defenses to destroy only cancer cells by identifying mutations unique to each tumor

Scientists are on the cusp of commercializing the first personalized cancer vaccine. If it works as hoped, the vaccine, which triggers a person’s immune system to identify a tumor by its unique mutations, could effectively shut down many types of cancers.

By using the body’s natural defenses to selectively destroy only tumor cells, the vaccine, unlike conventional chemotherapies, limits damage to healthy cells. The attacking immune cells could also be vigilant in spotting any stray cancer cells after the initial treatment.

The possibility of such vaccines began to take shape in 2008, five years after the Human Genome Project was completed, when geneticists published the first sequence of a cancerous tumor cell.

Soon after, investigators began to compare the DNA of tumor cells with that of healthy cells—and other tumor cells. These studies confirmed that all cancer cells contain hundreds if not thousands of specific mutations, most of which are unique to each tumor.

A few years later, a German startup called BioNTech provided compelling evidence that a vaccine containing copies of these mutations could catalyze the body’s immune system to produce T cells primed to seek out, attack, and destroy all cancer cells harboring them.

In December 2017, BioNTech began a large test of the vaccine in cancer patients, in collaboration with the biotech giant Genentech. The ongoing trial is targeting at least 10 solid cancers and aims to enroll upwards of 560 patients at sites around the globe.

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The two companies are designing new manufacturing techniques to produce thousands of personally customized vaccines cheaply and quickly. That will be tricky because creating the vaccine involves performing a biopsy on the patient’s tumor, sequencing and analyzing its DNA, and rushing that information to the production site. Once produced, the vaccine needs to be promptly delivered to the hospital; delays could be deadly. —Adam Piore

The cow-free burger

Bruce Peterson/Styling: Monica Mariano
The cow-free burger
  • Why it matters Livestock production causes catastrophic deforestation, water pollution, and greenhouse-gas emissions
  • Key players Beyond Meat
    Impossible Foods
  • Availability Plant-based now; lab-grown around 2020

Both lab-grown and plant-based alternatives approximate the taste and nutritional value of real meat without the environmental devastation.

The UN expects the world to have 9.8 billion people by 2050. And those people are getting richer. Neither trend bodes well for climate change—especially because as people escape poverty, they tend to eat more meat.

By that date, according to the predictions, humans will consume 70% more meat than they did in 2005. And it turns out that raising animals for human consumption is among the worst things we do to the environment.

Depending on the animal, producing a pound of meat protein with Western industrialized methods requires 4 to 25 times more water, 6 to 17 times more land, and 6 to 20 times more fossil fuels than producing a pound of plant protein.

The problem is that people aren’t likely to stop eating meat anytime soon. Which means lab-grown and plant-based alternatives might be the best way to limit the destruction.

Making lab-grown meat involves extracting muscle tissue from animals and growing it in bioreactors. The end product looks much like what you’d get from an animal, although researchers are still working on the taste. Researchers at Maastricht University in the Netherlands, who are working to produce lab-grown meat at scale, believe they’ll have a lab-grown burger available by next year. One drawback of lab-grown meat is that the environmental benefits are still sketchy at best—a recent World Economic Forum report says the emissions from lab-grown meat would be only around 7% less than emissions from beef production.

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The better environmental case can be made for plant-based meats from companies like Beyond Meat and Impossible Foods (Bill Gates is an investor in both companies), which use pea proteins, soy, wheat, potatoes, and plant oils to mimic the texture and taste of animal meat.

Beyond Meat has a new 26,000-square-foot (2,400-square-meter) plant in California and has already sold upwards of 25 million burgers from 30,000 stores and restaurants. According to an analysis by the Center for Sustainable Systems at the University of Michigan, a Beyond Meat patty would probably generate 90% less in greenhouse-gas emissions than a conventional burger made from a cow. —Markkus Rovito

Carbon dioxide catcher

Nico Ortega
Carbon dioxide catcher
  • Why it matters Removing CO2 from the atmosphere might be one of the last viable ways to stop catastrophic climate change
  • Key players Carbon Engineering
    Climeworks
    Global Thermostat
  • Availability 5-10 years

Practical and affordable ways to capture carbon dioxide from the air can soak up excess greenhouse-gas emissions.

Even if we slow carbon dioxide emissions, the warming effect of the greenhouse gas can persist for thousands of years. To prevent a dangerous rise in temperatures, the UN’s climate panel now concludes, the world will need to remove as much as 1 trillion tons of carbon dioxide from the atmosphere this century.

In a surprise finding last summer, Harvard climate scientist David Keith calculated that machines could, in theory, pull this off for less than $100 a ton, through an approach known as direct air capture. That’s an order of magnitude cheaper than earlier estimates that led many scientists to dismiss the technology as far too expensive—though it will still take years for costs to fall to anywhere near that level.

But once you capture the carbon, you still need to figure out what to do with it.

Carbon Engineering, the Canadian startup Keith cofounded in 2009, plans to expand its pilot plant to ramp up production of its synthetic fuels, using the captured carbon dioxide as a key ingredient. (Bill Gates is an investor in Carbon Engineering.)

Zurich-based Climeworks’s direct air capture plant in Italy will produce methane from captured carbon dioxide and hydrogen, while a second plant in Switzerland will sell carbon dioxide to the soft-drinks industry. So will Global Thermostat of New York, which finished constructing its first commercial plant in Alabama last year.

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Still, if it’s used in synthetic fuels or sodas, the carbon dioxide will mostly end up back in the atmosphere. The ultimate goal is to lock greenhouse gases away forever. Some could be nested within products like carbon fiber, polymers, or concrete, but far more will simply need to be buried underground, a costly job that no business model seems likely to support.

In fact, pulling CO2 out of the air is, from an engineering perspective, one of the most difficult and expensive ways of dealing with climate change. But given how slowly we’re reducing emissions, there are no good options left. —James Temple

An ECG on your wrist

Bruce Peterson

Regulatory approval and technological advances are making it easier for people to continuously monitor their hearts with wearable devices.

Fitness trackers aren’t serious medical devices. An intense workout or loose band can mess with the sensors that read your pulse. But an electrocardiogram—the kind doctors use to diagnose abnormalities before they cause a stroke or heart attack— requires a visit to a clinic, and people often fail to take the test in time.

ECG-enabled smart watches, made possible by new regulations and innovations in hardware and software, offer the convenience of a wearable device with something closer to the precision of a medical one.

An Apple Watch–compatible band from Silicon Valley startup AliveCor that can detect atrial fibrillation, a frequent cause of blood clots and stroke, received clearance from the FDA in 2017. Last year, Apple released its own FDA-cleared ECG feature, embedded in the watch itself.

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The health-device company Withings also announced plans for an ECG-equipped watch shortly after.
Current wearables still employ only a single sensor, whereas a real ECG has 12. And no wearable can yet detect a heart attack as it’s happening.

But this might change soon. Last fall, AliveCor presented preliminary results to the American Heart Association on an app and two-­sensor system that can detect a certain type of heart attack. —Karen Hao

Sanitation without sewers

TheDman | Getty
Sanitation without sewers
  • Why it matters 2.3 billion people lack safe sanitation, and many die as a result
  • Key players Duke University
    University of South Florida
    Biomass Controls
    California Institute of Technology
  • Availability 1-2 years

Energy-efficient toilets can operate without a sewer system and treat waste on the spot.

About 2.3 billion people don’t have good sanitation. The lack of proper toilets encourages people to dump fecal matter into nearby ponds and streams, spreading bacteria, viruses, and parasites that can cause diarrhea and cholera. Diarrhea causes one in nine child deaths worldwide.

Now researchers are working to build a new kind of toilet that’s cheap enough for the developing world and can not only dispose of waste but treat it as well.

In 2011 Bill Gates created what was essentially the X Prize in this area—the Reinvent the Toilet Challenge. Since the contest’s launch, several teams have put prototypes in the field. All process the waste locally, so there’s no need for large amounts of water to carry it to a distant treatment plant.

Most of the prototypes are self-contained and don’t need sewers, but they look like traditional toilets housed in small buildings or storage containers. The NEWgenerator toilet, designed at the University of South Florida, filters out pollutants with an anaerobic membrane, which has pores smaller than bacteria and viruses. Another project, from Connecticut-based Biomass Controls, is a refinery the size of a shipping container; it heats the waste to produce a carbon-rich material that can, among other things, fertilize soil.

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One drawback is that the toilets don’t work at every scale. The Biomass Controls product, for example, is designed primarily for tens of thousands of users per day, which makes it less well suited for smaller villages. Another system, developed at Duke University, is meant to be used only by a few nearby homes.

So the challenge now is to make these toilets cheaper and more adaptable to communities of different sizes. “It’s great to build one or two units,” says Daniel Yeh, an associate professor at the University of South Florida, who led the NEWgenerator team. “But to really have the technology impact the world, the only way to do that is mass-produce the units.” —Erin Winick

Smooth-talking AI assistants

Bruce Peterson
Smooth-talking AI assistants
  • Why it matters AI assistants can now perform conversation-based tasks like booking a restaurant reservation or coordinating a package drop-off rather than just obey simple commands
  • Key players Google
    Alibaba
    Amazon
  • Availability 1-2 years

New techniques that capture semantic relationships between words are making machines better at understanding natural language.

We’re used to AI assistants—Alexa playing music in the living room, Siri setting alarms on your phone—but they haven’t really lived up to their alleged smarts. They were supposed to have simplified our lives, but they’ve barely made a dent. They recognize only a narrow range of directives and are easily tripped up by deviations.

But some recent advances are about to expand your digital assistant’s repertoire. In June 2018, researchers at OpenAI developed a technique that trains an AI on unlabeled text to avoid the expense and time of categorizing and tagging all the data manually. A few months later, a team at Google unveiled a system called BERT that learned how to predict missing words by studying millions of sentences. In a multiple-choice test, it did as well as humans at filling in gaps.

These improvements, coupled with better speech synthesis, are letting us move from giving AI assistants simple commands to having conversations with them. They’ll be able to deal with daily minutiae like taking meeting notes, finding information, or shopping online.

Some are already here. Google Duplex, the eerily human-like upgrade of Google Assistant, can pick up your calls to screen for spammers and telemarketers. It can also make calls for you to schedule restaurant reservations or salon appointments.

In China, consumers are getting used to Alibaba’s AliMe, which coordinates package deliveries over the phone and haggles about the price of goods over chat.

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But while AI programs have gotten better at figuring out what you want, they still can’t understand a sentence. Lines are scripted or generated statistically, reflecting how hard it is to imbue machines with true language understanding. Once we cross that hurdle, we’ll see yet another evolution, perhaps from logistics coordinator to babysitter, teacher—or even friend? —Karen Hao

Bill Gates: How we’ll invent the future (Part 1, Introductory essay)

The thinking behind this year’s list of 10 Breakthrough Technologies began with the plow.

 

By Bill Gates for MIT Technology Review – February 27, 2019

 

I was honored when MIT Technology Review invited me to be the first guest curator of its 10 Breakthrough Technologies. Narrowing down the list was difficult. I wanted to choose things that not only will create headlines in 2019 but captured this moment in technological history—which got me thinking about how innovation has evolved over time.

My mind went to—of all things—the plow. Plows are an excellent embodiment of the history of innovation. Humans have been using them since 4000 BCE, when Mesopotamian farmers aerated soil with sharpened sticks. We’ve been slowly tinkering with and improving them ever since, and today’s plows are technological marvels.

But what exactly is the purpose of a plow? It’s a tool that creates more: more seeds planted, more crops harvested, more food to go around. In places where nutrition is hard to come by, it’s no exaggeration to say that a plow gives people more years of life. The plow—like many technologies, both ancient and modern—is about creating more of something and doing it more efficiently, so that more people can benefit.

Contrast that with lab-grown meat, one of the innovations I picked for this year’s 10 Breakthrough Technologies list. Growing animal protein in a lab isn’t about feeding more people. There’s enough livestock to feed the world already, even as demand for meat goes up. Next-generation protein isn’t about creating more—it’s about making meat better. It lets us provide for a growing and wealthier world without contributing to deforestation or emitting methane. It also allows us to enjoy hamburgers without killing any animals.

Put another way, the plow improves our quantity of life, and lab-grown meat improves our quality of life. For most of human history, we’ve put most of our innovative capacity into the former. And our efforts have paid off: worldwide life expectancy rose from 34 years in 1913 to 60 in 1973 and has reached 71 today.

Because we’re living longer, our focus is starting to shift toward well-being. This transformation is happening slowly. If you divide scientific breakthroughs into these two categories—things that improve quantity of life and things that improve quality of life—the 2009 list looks not so different from this year’s. Like most forms of progress, the change is so gradual that it’s hard to perceive. It’s a matter of decades, not years—and I believe we’re only at the midpoint of the transition.

To be clear, I don’t think humanity will stop trying to extend life spans anytime soon. We’re still far from a world where everyone everywhere lives to old age in perfect health, and it’s going to take a lot of innovation to get us there. Plus, “quantity of life” and “quality of life” are not mutually exclusive. A malaria vaccine would both save lives and make life better for children who might otherwise have been left with developmental delays from the disease.

We’ve reached a point where we’re tackling both ideas at once, and that’s what makes this moment in history so interesting. If I had to predict what this list will look like a few years from now, I’d bet technologies that alleviate chronic disease will be a big theme. This won’t just include new drugs (although I would love to see new treatments for diseases like Alzheimer’s on the list). The innovations might look like a mechanical glove that helps a person with arthritis maintain flexibility, or an app that connects people experiencing major depressive episodes with the help they need.

If we could look even further out—let’s say the list 20 years from now—I would hope to see technologies that center almost entirely on well-being. I think the brilliant minds of the future will focus on more metaphysical questions: How do we make people happier? How do we create meaningful connections? How do we help everyone live a fulfilling life?

I would love to see these questions shape the 2039 list, because it would mean that we’ve successfully fought back disease (and dealt with climate change). I can’t imagine a greater sign of progress than that. For now, though, the innovations driving change are a mix of things that extend life and things that make it better. My picks reflect both. Each one gives me a different reason to be optimistic for the future, and I hope they inspire you, too.

My selections include amazing new tools that will one day save lives, from simple blood tests that predict premature birth to toilets that destroy deadly pathogens. I’m equally excited by how other technologies on the list will improve our lives. Wearable health monitors like the wrist-based ECG will warn heart patients of impending problems, while others let diabetics not only track glucose levels but manage their disease. Advanced nuclear reactors could provide carbon-free, safe, secure energy to the world.

One of my choices even offers us a peek at a future where society’s primary goal is personal fulfillment. Among many other applications, AI-driven personal agents might one day make your e-mail in-box more manageable—something that sounds trivial until you consider what possibilities open up when you have more free time.

The 30 minutes you used to spend reading e-mail could be spent doing other things. I know some people would use that time to get more work done—but I hope most would use it for pursuits like connecting with a friend over coffee, helping your child with homework, or even volunteering in your community.

That, I think, is a future worth working toward.

 

Digital Transformation, Dynamic Threats and Growing Accountability

March 1, 2019

By Mark Sangster, Chief Security Strategist at eSentire, Inc., contributor to SecurityMagazine.com

 

Businesses today accept the presence of cyber risks. In fact, 70 percent assume a business-altering event will occur in the next few years (FutureWatch Report), but often have a more difficult time identifying specific risks, key factors and mitigation strategies. Worse, the board or senior leadership often makes assumptions about the safety of the firms that is overly optimistic when compared to confidence ratings of security practitioners.

The difference between awareness and understanding is driven by the communication gap between the board and executives steering the business, and the security experts close to the problem. Both parties struggle to comprehend the other’s needs and responsibilities.

A firm’s risks stem from a handful of business aspects, including the firm’s participation in high-risk industries, its appetite for emerging technologies, and willingness to properly invest in targeted security practices. While this sounds obvious at first, it’s lost when the line of sight from the security practitioners to the board is over the horizon.

This article will explore board-level concerns, key drivers to invest in security, and how emerging technologies outpace the evolution of security technologies and services. The data presented in this article was collected in late 2018, through third-party research that surveyed 1,250 security executives, managers and practitioners. Data was collected from the United States, Canada and the United Kingdom. Participants were equally represented across various industries and company sizes, ranging from less than 100 employees to 5,000 employee or more. Read the full FutureWatch Report.

Major Attacks Are an Assumption

Unanimously, business leaders such as the CEO, board members and technical executives (CIO) alike predict a major cyber-attack in the next two to five years. Over 60 percent of respondents assume a major event will occur. Interestingly, 77 percent of CEO and board respondents consider their organization prepared for such an event. As expected, technical leaders are approximately 20 percent more likely to predict an attack and are 10 percent less optimistic than their business peers in their organization’s preparedness.

Senior leadership fears operational disruption, reputational damage and significant financial losses over regulatory penalties as top consequences of a major security event.

While business leaders show a confidence in their firm’s ability to manage a security breach, the devil is in the details. Only 29 percent of respondents indicated that their high-value or high-profile information is not adequately protected. And two-thirds of respondents are not confident that their cybersecurity programs match their peers, nor that their programs are appropriately resourced.

The Cybersecurity Rosetta Stone

Boards and security practitioners still struggle to translate their concerns and objectives. Only one-third of business leaders are confident in their security executive’s ability to monitor and report on cybersecurity programs and 66 percent worry that these programs are not aligned to business objectives.

IT and security leadership sentiments echo this concern. Most organizations struggle to show the value of IT security spend to senior management, including status reporting difficulties. Aligning to enterprise risk management confounds over half of businesses, along with the ability to managed external risks with third-party vendors and the growing complexity of regulatory compliance.

On the positive side, progress has been made over the last few years. The CISO is no longer the least interesting person to the board, until they are the most important person.  Over half of respondents indicate their board is very familiar with the security budget (51 percent), overall strategy (57 percent), policies (58 percent), technologies (53 percent), and currently review current security and privacy risks (51 percent).  Moreover, line of sight from the CISO to the board is more direct. Forty-five percent of security officers report to the board or CEO, 33 percent continue to report to the CIO and a small handful (10 percent) report to a privacy or data officer.

Moreover, nearly two-thirds of security budgets are set to rise in 2019. Spend on the security side is still reactionary. While regulatory requirements is in the basement of the board’s concerns, it tops the list for security practitioners. A security teams spend is generally reactive to client demands, major technology purchases, a major security event or near miss, and the adoption of emerging technology.

Emerging Technology: A Double-edged Sword

IT and security teams find themselves in a difficult position between meeting the demands of the business to adopt emerging technologies that offer competitive advantage, while also carrying the burden of mitigating the risks that come along with new deployments.

Nearly three-quarters of respondents are currently using cloud services or plan to deploy cloud services in the next six months, with financial services, manufacturing and healthcare leading the adoption rate. Only law firms lag in their cloud adoption. Artificial Intelligence (AI), Internet-of-Things (IoT) and Industrial IoT (IIoT) top the list behind cloud.

Cloud security adoption is the priority, followed closely by identity and access management, threat detection and response, and endpoint detection and response. Security Information and Event Management (SIEM) moves beyond a compliance tool and now plays a role in the greater detection and response portfolio.

More than half of telecom, information technology, financial services and manufacturers invested in securing their cloud services. Similarly, financial services, healthcare and manufacturing also emphasize threat detection and response investments. These industries are equally investing in identity and access management as a response to a more distributed workplace. Again, law firms are significantly less likely to adopt these technologies.

Digital transformation is here to stay and brings with it a drive to always evolve and constantly change. Economics demand that vendors constantly improve and offer new features and technologies which outpaces our understanding of the associated risks. We focus on the benefits while assuming vendors have resolved the security issues. For example, cloud technology tops the list of security priorities today, but AI and IoT/IIoT are on track to surpass cloud as the primary risk concern in less than two years.

This challenge will only increase over the coming years as 5G facilitates a ubiquitous mosaic of always connected devices. Risk associated with emerging technologies becomes more concerning as adoption rates accelerate, compressing the time in which organizations and vendors can adapt and develop appropriate security controls and deploy protective solutions.

Most Susceptible to Risk: Law Firms, Transportation and IT

Law firms lead when it comes to risks associated with external actors and attacks and their ability to report status, show value and meet internal risk standards and regulatory requirements. Transportation and IT firms report higher than average levels of risk. Financial services tend to run just below industry averages across external attacks and internal or industry requirements.

Digital Transformation Outpaces Current Security Approaches

Digital transformation touches every facet of business operation and redefines how businesses engage with their customers. The emerging technologies underpinning this tectonic shift must constantly expand capabilities and adapt to survive in a competitive environment. Current security approaches are not fluid enough to keep pace with adoption of emerging technology and platforms.

Today, most firms identify their primary security posture as leveraging prevention technologies and device management. Firms that leverage a predictive security model such as threat hunting, machine learning, and device analytics reduce their risk by thirty percent. Less than one-fifth of firms identify as predictive. The trend is consistent across all industry segments with financial and healthcare services leading the charge and law firms lagging.

Firms adopting predictive security models are better able to identify never-before-seen threats and have engaged rapid response capabilities to reduce the risk of a business-altering event. Over the next two years, older preventative models drop to less than one-third, while predictive threat hunting will more than double to 40 percent. This trend correlates with the shift in business drivers away from regulatory dominance toward business-centric considerations such as operational disruption, reputational damage, and, of course, financial losses.

Interestingly, advanced firms are more apt to adopt emerging security technologies such as endpoint, threat detection and response, identity access management, and cloud security. Moreover, mature firms aggressively leverage SaaS and are more likely to adopt 100 percent cloud-based security services than firms using a device-management model. Outsourcing is a palatable alternative to recruiting and retaining threat hunting talent from a pool that cannot support the growing demand.

Digital Transformation, Dynamic Threats and Growing Accountability

Digital transformation continues to expand a larger and more fluid attack surface from the advanced methodologies used by well-resourced adversaries like organized criminals and nation-state actors. Regardless of industry, businesses operate in a world with ever-increasing accountability to protect their clients’ confidential information, adhere to state legislation, comply with privacy laws and meet the growing complexity of overlapping regulatory obligations.

This triad of risk demands that IT, security practitioners, and leaders align with business governance objectives, while senior leadership acknowledge their role in establishing expectations and providing resources to adequately protect the business, its investors, employees and customers.

We’ve left the world of prescriptive regulations as a measure of security end state. Many organizations recognize that the financial loss associated with operational disruption and reputational damage outweigh the penalties set out by regulators. In the future, organizations will likely move to a perspective driven by their clients. In this state, brand and reputation will form the barometer by which a company’s security performance is ultimately measured. Protecting the client will mean by extension, protecting their data and services, avoiding operational disruption and resulting financial losses.


Author: Mark Sangster, Chief Security Strategist at eSentire

Mark Sangster is an industry security strategist and cybersecurity evangelist who researches, speaks and writes about cybersecurity as it relates to regulations, ethical obligations, data breach incident response and cyber risk management.

Sports Science and Technology Trends

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By Doug West, Contributing Author to How They Play – Updated on August 24, 2018

 

Technology and science play central roles in major sports around the world. Teams and individuals are constantly hunting for an extra performance boost, or a technique that speeds injury recovery. While there is sometimes resistance to new methods from established coaches or team doctors, sports science still makes a huge difference to what athletes eat, how and when they train, how they recover from injuries, and how often they are rested from competition.

Athletes are some of the fittest people in the world. But they also push their body to the extreme on a regular basis. Whether an athlete is attempting to get faster or stronger, or they just continue playing and training despite fatigue, they are taxing their muscles, joints and the whole body to the extreme. In the past, teams had a harder time understanding when an athlete was suffering from fatigue or exhibiting early signs of an injury.

Sports science has changed things in a big way. Teams and athletes can now get real time data on performance, endurance, flexibility, technique and more. They can compare that data with previous benchmarks to understand their body’s condition. And new medical techniques mean recovering from training sessions, games and injuries is better than ever.

The sports science trends receiving prominence over the past few years include using analytics to prevent injuries, the use of new injury recovery systems, sweat analysis, and wearable technology.

Analytics to Prevent Injuries

The risks of picking up an injury while training or playing sports is common. Many athletes suffer serious injuries that keep them out of action for three months or longer. In fact, it is very rare to encounter a professional athlete who did not have at least one or two serious injuries over their career.

Injuries not only rob players of time they could be spending on the field or court, but they also cost their teams money. The estimated cost of player injuries in the four major soccer leagues in Europe – English Premier League, German Bundesliga, Spanish La Liga and Italian Serie A – came to roughly $100 million in 2015. In the American NFL, injury totals are trending upward, despite all the moves the league makes to boost the sport’s safety. Sports teams and athletes want to use technology and data to help understand why athletes are picking up specific injuries, and how to prevent them.

An example of such technology includes VU, by Pivot. VU is a device that uses Pivot’s sensors to understand an athlete’s body and performance in real time. The tech is capable of analyzing player landings, cuts, sprints and other movements to understand an athlete’s performance and technique.

By using such technology, teams and individuals can understand whether specific techniques are causing injuries, or if they are merely suffering because of excessive fatigue or strain. VU is also usable for helping athletes rehabilitate from a major muscular or bone injury, as their movements are tracked and analyzed during each step of their rehab.

It is not possible to understand how each athlete is impacted by different activities or fatigue by applying a “one size fits all” approach. That is why some are taking a very personalized approach to understanding the bodies of elite athletes. Kitman Labs asks players to go through a Microsoft Kinect station daily, where they move different muscles the same way each time. Trainers get the information instantly, allowing them to compare a player’s flexibility and range to other days. If a discrepancy is noticed, further tests can be done to determine the issue.

Some injuries are difficult to prevent, such as contact injuries. But muscular problems are preventable through analysis and rest. If the Kitman Labs system notices a player is moving their left leg differently to previous days, they may be able to spot a hamstring or thigh problem in its very early stages. The player could rest for a week and be back in top condition. If the issue was never noticed, the athlete would keep playing until they tweaked or tore their muscle, which is a much longer and more complicated problem. Per Kitman Labs, they see anywhere from 20 to 33 percent reduction in injury rates among their partner teams.

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“I’ve missed more than 9000 shots in my career. I’ve lost almost 300 games. 26 times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed.”

— Michael Jordan

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Injury Recovery Systems

Cryotherapy is an incredibly popular practice in sports, and it is gaining a lot of attention in the past few years. The concept of cryotherapy is to expose parts of the body to freezing or near-freezing temperature. While it is not the most fun experience, especially for those who hate the cold, it is said to help with recovery during the sports season.

With cryotherapy, it is possible to submerge most of the body into a cryotherapy booth, or target specific areas such as the arms or legs. It helps athletes deal with muscle pain, joint pain, soreness, and it promotes faster healing from injuries. While cryotherapy booths can be expensive, many teams and athletes use ice water baths to achieve the same result. The athlete sits in the ice bath for three to five minutes.

Hyperbaric therapies, such as hyperbaric oxygen therapy, are becoming increasingly popular among sports teams. Hyperbaric oxygen therapy is said to repair and regenerate tissue, limit swelling, stop infections, and aid in muscle soreness after intense training sessions.

The process for hyperbaric oxygen therapy is straightforward. The patient breathes pure oxygen in a pressurized room, or through a tube. When in a chamber, it is possible to set the air pressure to three times the regular levels. The increase in air pressure causes the lungs to get even more pure oxygen than is otherwise possible. The pure oxygen is then carried by the blood throughout the body, where it can help muscles, stimulate growth factors, promote healing and help in other ways.

Hyperbaric oxygen therapy is very good for treating head injuries, such as serious falls or concussions. It is being used at an increasing rate in sports such as American football, where head injuries are a serious concern. But it also helps with other injuries and soreness throughout the body.

There are some risks associated with the therapy, such as middle ear injuries, temporary nearsightedness, lung collapses or seizures. But the risks are not an issue if the therapy is being performed under the continual supervision of a medical expert. When athletes attempt to buy and use equipment to breathe pure oxygen on their own, it can be an issue, as it may result in overexposure that could trigger a lung collapse or a seizure.

Athletes involved with sports that tax their legs can benefit immensely from technology like the NormaTec leg boots. NormaTec combines sports science and technology to create leg compresses that assist athletes in recovery and injury prevention. The system comes with a control unit and attachments that can go on the legs or arms. Compressed air is used to massage limbs and mobilize fluid around the area.

The attachments mold into the exact body shape of the athlete’s legs. Then it begins to compress the area where it is attached, with the compressions going in a pulsing manner to mimic a massage. Athletes can use these attachments after each training session and game, with additional use during moments in the year where they are experiencing increased fatigue. American basketball star LeBron James uses the NormaTech attachments regularly.

Recovering from injuries is not just about the body, but also the mind. Athletes who suffer bad injuries, such as complete muscle tears or broken bones, may face mental obstacles when they are set to resume training. Many teams are beginning to understand the mental and psychological impact of injuries on athletes.

It is common for athletes to feel sad, isolated, angry, depressed, frustrated and disengaged while injured. It is especially true when the injury keeps the athlete from training for three months to a year. Athletic trainers, team doctors and coaches are beginning to understand the issue and take it seriously. Many teams now employ therapists so that athletes can have someone to talk to regarding their emotions when they suffer a bad injury.

Hyperbaric oxygen chambers.
Hyperbaric oxygen chambers.
Sweat Analysis

Teams have begun using smart patches, such as the ECHO Smart Patch, to help analyze a player’s sweat as they train and compete. These patches are useful for monitoring health signs, gathering data to boost recovery, and eventually improving athletic performance. Sweat analysis can provide information about the many solutes in a person’s body, such as sodium, chloride, potassium, ammonium, lactate, proteins, peptides and alcohols.

Since sports teams have benchmark numbers for these solutes on each athlete, the data they gather after every training session and game helps them understand a player’s physical condition, whether they need a rest, and what foods and/or drinks they could use to replenish the body and aid in recovery.

Some of these smart patches can even monitor player vital signs, like their heart rate, respiration, skin temperature or the heart rate variability. Instead of relying on how an athlete feels, or what a coach is seeing out on the field, teams can use real data to shape their decisions on how their star athletes train and recover.

Each individual is different in how they respond to the rigors of sports. Some may have greater natural recovery, while others need more rest in between training sessions and games. By analyzing sweat, teams can put real data next to everything else they know about their athletes.

How Technology Is Taking Over Football | Sports Vests Explained

 

Wearable Technology

Wearable tech plays a huge role in how athletes are evaluated in real time, and after games or training sessions. For instance, coaches can use wearable tech to understand how an athlete is performing compared to their previous training sessions or games. A reduction in physical output could be a sign of fatigue or an injury. Many muscular injuries are the result of overtraining or playing, which is easily remedied by tracking player performance with wearable technology. Coaches have the information at their disposal using laptops or smartphones, and they can make real time decisions about whether to keep a player on the field or make a substitution.

Examples of successful wearable technology include the Catapult OptimEye S5. The device came to prominence when used by English soccer team Leicester City, as they defied 5000/1 odds to win the 2015-2016 Premier League title. Leicester used the OptimEye S5 to track a player’s acceleration, positioning, collision impact and much more. The data arrives instantly, meaning coaches and team doctors always have data to provide greater context to what they are seeing from a player during games.

The product gives information about volume, intensity and explosiveness during games and training sessions. Teams around the world, such as the Denver Broncos, Sacramento Kings, Brazil national soccer team, Newcastle United and Ajax use the OptimEye S5.

Tennis professionals are incorporating products such as QLIPP into their training regimes. QLIPP offers real time data from within a tennis racket, as it attaches to racket strings. The device offers information about the intensity and position each time a player hits a tennis ball with the racket. Coaches can see the information in real time, and tell the player when they are hitting the sweet spot.

Zepp’s Baseball and Softball offering provides players and coaches with real time data regarding bat speed, swing technique, attack angles, and more. Players can use the Zepp Baseball and Softball kit to methodically improve every aspect of how they are swinging their bat and hitting the baseball.

With each iteration, wearable technology improves its accuracy and the type of data it can offer to sports teams and athletes. Wearable tech is useful to understand performance over time, improve technique and prevent injuries.

We have merely scratched the surface of how much science and technology can help sports teams and athletes. As more coaches and sports doctors begin to see the benefits of combining their old methods with new technology, players will be fitter, exhibiting better technique, performance, and less likely to suffer muscular injuries due to fatigue.

Zepp Baseball

 

References

“Five trends for 2017 in sport science and medicine” https://www.globalsportsjobs.com/article/five-trends-for-2017-in-sports-science-and-medicine/ Accessed March 26, 2018.

http://vupivot.com/ Accessed March 26, 2018.

“How Analytics Can Prevent Sports Injuries” https://channels.theinnovationenterprise.com/articles/how-analytics-can-prevent-sports-injuries Accessed March 25, 2018.

Villines, Zawn. “What are the benefits of cryotherapy?” https://www.medicalnewstoday.com/articles/319740.php October 17, 2017. Accessed March 26, 2018.

“Hyperbaric oxygen therapy” https://www.mayoclinic.org/tests-procedures/hyperbaric-oxygen-therapy/about/pac-20394380 Accessed March 26, 2018.

“About the NormaTec Pulse.” https://www.normatecrecovery.com/how-compression-works/how-and-science/ Accessed March 28, 2018.

Putukian, Margot. “Mind, Body and Sport: How being injured affects mental health” http://www.ncaa.org/sport-science-institute/mind-body-and-sport-how-being-injured-affects-mental-health Accessed March 27, 2018.

https://www.catapultsports.com/products/optimeye-s5

 

Healthcare firms go for the hybrid cloud approach with compliance and connectivity key

Commentary by James Bourne, Editor-in-Chief, TechForge Media for Cloud Tech News
18 February 2019, 14:02 p.m.

 

It continues to be a hybrid cloud-dominated landscape – and according to new research one of the traditionally toughest industries in terms of cloud adoption is now seeing it as a priority.

A report from enterprise cloud provider Nutanix has found that in two years’ time, more than a third (37%) of healthcare organisations polled said they would deploy hybrid cloud. This represents a major increase from less than a fifth (19%) today.

The study, which polled more than 2,300 IT decision makers, including 345 global healthcare organisations, found more than a quarter (28%) of respondents saw security and compliance as the number one factor in choosing where to run workloads. It’s not entirely surprising. All data can be seen as equal, but healthcare is certainly an industry where the data which comes from it is more equal than others. Factor in compliance initiatives, particularly HIPAA, and it’s clear to see how vital the security message is.

Yet another key area is around IT spending. The survey found healthcare organisations were around 40% over budget when it came to public cloud spend, compared to a 35% average for other industries. Organisations polled who currently use public cloud spend around a quarter (26%) of their annual IT budget on it – a number which is expected to rise to 35% in two years.

Healthcare firms see ERP and CRM, analytics, containers and IoT – the latter being an evident one for connected medical devices – as important use cases for public cloud. The average penetration in healthcare is just above the global score. 88% of those polled said they see hybrid cloud to positively impact their businesses – yet skills are a major issue, behind only AI and machine learning as an area where healthcare firms are struggling for talent.

It is certainly an area where the largest vendors have been targeting in recent months. Amazon Web Services (AWS) announced in September a partnership with Accenture and Merck to build a cloud-based informatics research platform aiming to help life sciences organisations explore drug development. Google took the opportunity at healthcare conference HiMSS to launch a new cloud healthcare API, focusing on data types such as HL7, FHIR and DICOM.

Naturally, Nutanix is also in the business of helping healthcare organisations with their cloud migrations. Yet increased maturity across the industry will make for interesting reading. The healthcare IT stack of the future will require different workloads in different areas, with connectivity the key. More than half of those polled said ‘inter-cloud application mobility’ was essential going forward.

“Healthcare organisations especially need the flexibility, ease of management and security that the cloud delivers, and this need will only become more prominent as attacks on systems become more advanced, compliance regulations more stringent, and data storage needs more demanding,” said Chris Kozup, Nutanix SVP of global marketing. “As our findings predict, healthcare organisations are bullish on hybrid cloud growth for their core applications and will continue to see it as the ideal solution as we usher in the next era of healthcare.

“With the cloud giving way to new technologies and tools such as machine learning and automation, we expect to see positive changes leading to better healthcare solutions in the long run,” Kozup added.

Photo by Hush Naidoo on Unsplash
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3 Employment Screening Trends to Know Before You Hire in 2019

Roy Maurer
By Roy Maurer, Online Manager/Editor, Talent Acquisition – SHRM Online
January 23, 2019

This is the first article in a two-part series. The next installment will examine how employers can ensure data security in the screening process and what to expect with forthcoming artificial intelligence technology.

Employers are ramping up their use of social media screening and real-time employee monitoring in 2019. And the demand for workers in a tight labor market will push more companies to consider applicants they may have once ignored: those with criminal records.

[SHRM resource page: Background Checks]

Social Media Checks

Employers have shown increasing interest in screening candidates’ online presence.

In 2019, more background-check providers will offer online and social media searches as part of their suite of products, but employers must ensure that these searches protect candidate privacy and don’t run afoul of the federal Fair Credit Reporting Act (FCRA) or standards set by the Equal Employment Opportunity Commission (EEOC).

“Social media screening presents opportunities for recruiters to find candidates and to reduce risk, but at the same time, these searches can create a legal minefield of potential liability,” said Les Rosen, founder and CEO of Employment Screening Resources, a background-screening firm in Novato, Calif.

Interest in social media screening has grown significantly over the last few years, said Bianca Lager, the president of Santa Barbara, Calif.-based Social Intelligence Corp., a leading provider of social media screening reports. “We now see almost daily news stories of someone getting into trouble with their employer over what they’ve written online,” she said. “Hiring companies know they can’t get away with ignoring social media as part of the background-screening process any longer, but the DIY approach is incredibly troubling for candidates in terms of privacy, accuracy and discrimination.”

If HR professionals are conducting their own online searches on job candidates, they need to stop, said Montserrat Miller, an attorney with Arnall Golden Gregory, based in Atlanta. “The potential for a discrimination claim far outweighs the cost of adding a social media screening option from a vendor.”

Rosen said that employers should be wary of discovering too much information—or “TMI”—on social media. ” ‘TMI’ means by looking at [an applicant’s] social media site or perhaps a photo or something that they have blogged about, you are going to learn all sorts of things as an employer you don’t want to know and [that] legally cannot be the basis of a decision,” he said. Job applicants can sue employers for discrimination if they believe they were not hired due to protected characteristics covered by Title VII of the Civil Rights Act of 1964, including race, color, religion, sex or national origin.

“Even the appearance of a decision not to hire someone based on a negative impression related to race, gender, religion, or other protected classes could subject [employers] to a discrimination lawsuit,” said Christine Cunneen, CEO of Providence, R.I.-based background-check company Hire Image.

Experts agree that if employers decide to screen an applicant through social media, the best way to reduce legal risk is by having a third-party vendor perform the search instead of doing it in-house. Background-check providers that perform social media screening must comply with the FCRA and produce accurate reports scrubbed of protected characteristics.

“Social media reports won’t show whether or not someone is Muslim or gay or a military veteran, to protect the employer from a discrimination claim,” Miller said. “They will only provide instances of actionable, offensive information, for example relating to criminal activity, violent behavior or making racist comments.”

Cunneen added that employers need to be careful not to violate candidate privacy. Social media screens should be drawn only from user-generated, publicly available information and not from third-party content or password-protected sites. “If the applicant’s social media settings are set to public, that information is open for anyone, including potential future employers, to review,” she said. “However, if their profile is set to private, the employer cannot try to bypass those settings without risking exposure to potential liability down the road.”

Continuous Monitoring

New technology lets companies go beyond pre-employment checks and rescreens to real-time monitoring of current employees for warning signs of illegal or other concerning behavior.

“Employee monitoring is one of the biggest trends I’m seeing,” said Jason Morris, an employment screening consultant and industry expert with Morris Group Consulting in the Cleveland area.

“Justifiably, employers will always want to know who is working for them—not just [during] hiring but throughout their employment relationship,” Cunneen said. “A current employee can engage in illegal behavior as much now as he or she could have before they were an employee.”

Uber announced plans last year for ongoing monitoring of arrest and conviction data on their drivers. “These tools have been around for a while, but end users are finally seeing the benefits, and the data is getting better,” Morris said.

Uber teamed with San Francisco-based screening firm Checkr to get continuous updates about drivers’ records, including new criminal violations and license suspensions. The technology will notify Uber, for example, when a driver is charged with driving under the influence.

“It is a subscription that listens to a candidate’s data over time, looking for and identifying changes in their background to mitigate risk for companies,” said Tomas Barreto, vice president of product and engineering at Checkr. If new information triggers a full background check, the worker is also notified, he said.

“While there are some industries whose regulations have mandated continuous or some form of periodic screening, such as health care, we are seeing more industries embrace the idea,” said Melissa Sorenson, executive director of the National Association of Professional Background Screeners. “Like any background-screening program, it’s important for employers to ensure they follow both federal and state law related to background screening—including following disclosure and authorization requirements before conducting a background check, as well as adverse action processes in the event that the results of the background check lead the employer to consider not hiring, promoting or retaining the individual.”

Hiring People with Criminal Records

Research shows a majority of HR professionals find little difference in quality of hire between applicants with and without a criminal record.

“The fact that employers cannot find workers due to the current labor shortage has caused them to turn to an untapped and underutilized source of labor: ex-offenders and [former] inmates from the approximately 20 million Americans who have been convicted of a felony,” Rosen said.

The Prison Policy Initiative calculated the ex-offender unemployment rate to be 27 percent, higher than the total U.S. unemployment rate at any time, including during the Great Depression.

Alonzo Martinez, associate counsel for compliance at background-screening company HireRight, said that with the number of unfilled positions now exceeding the labor pool, employers are recognizing the potential in this previously untapped group of candidates.

“While a criminal record should never be an automatic deal breaker—especially for candidates who have misdemeanors on their records, have served their time or have been rehabilitated—in the current market, employers are increasingly considering candidates with criminal records and redefining policies and requirements to lower some of the barriers to employment that ex-offenders face,” he said.

“Companies recognize that hiring from this population is the right thing to do, but it’s also good business,” said Richard Bronson, the founder and CEO of 70MillionJobs, the first for-profit job board specifically for job seekers with criminal records.

“Companies are motivated by the bottom line, and they recognize that unfilled jobs are costly. Every single company I talk to says they are facing a staffing shortage or they have trouble retaining their workers, particularly at the lower end of the wage scale. Perhaps they would not have been eager to consider this population before, but I think they generally recognize that they can ill afford to ignore any large pool of talent out there, and this is arguably one of the largest. One in three adults have a record of some kind.”

The industries most hospitable to people with criminal records have been call centers, construction, health care, manufacturing, retail, and transportation and warehousing. “The technology sector has been woefully reticent to take action,” Bronson said. “They talk a good game but don’t deliver when it comes to actually hiring.”

Martinez said HR must be cognizant of the challenges involved with screening the ex-offender population, such as a longer turnaround time to ensure a complete assessment.

“Companies should continue to perform thorough background checks and conduct individualized assessments of candidates with criminal history, per EEOC guidance,” he said. “It would also benefit companies to review their hiring requirements to determine the types and depth of screening that is necessary for each job position. This can reduce the volume of acceptable hires that are unnecessarily flagged for additional review for reasons that are not related to the role’s responsibilities.”

Disrupting the Outsourcing Model

Steve Maylish and Shannon White, Fusion Biotec – 01.31.19
Contributors to MPO Columns

The rise and relative success of companies dealing in cloud-based systems has revolutionized how we handle data. This is prompting a shift away from traditional software, hardware, and legacy systems, and enabling companies in new and unexpected ways. As cloud-based data systems rise to meet the needs of the modern world, will legacy systems eventually become obsolete? How will this change outsourcing?

In last June’s MPO 15-year anniversary issue, we looked at medical device outsourcing changes over the last 15 years. The industry changes cited were mostly based on OEM attitudes, improved quality and standards, increased competencies, and a growing willingness to outsource. Now we are in the midst of a new paradigm shift. Examples of this are everywhere: Netflix versus Blockbuster, Amazon versus retail, AirBnB versus hotels, and Uber versus taxis—just to name a few. Since the advent of cloud computing, disruption has accelerated. As traditional business models change, will medical device outsourcing experience disruption?

There are great advantages and disadvantages associated with cloud computing and software as a service (SaaS)—some of them more real than others. SaaS delivered via the cloud often doesn’t require users to load, maintain, update, migrate, partition, archive, audit, backup, or license software. It often costs less, reduces the need for IT services and hardware, and is easier to use. But what about the downside? Security, always-on availability, performance at scale, enterprise compliance, and data integrity are important for cloud services. These features are essential for the cloud business model.

First let me share a success story: Salesforce, which launched in 1999. It initially offered a simple, low-cost, cloud-based system to service small and medium-sized companies, but now have disrupted the customer relationship management (CRM) industry. Eventually, Saleforce’s CRM software outsold IBM, Oracle, SAP, and Microsoft. By building a cloud-based system and offering SaaS, users can collect, categorize, analyze, and distribute information on product sales, customer purchases, and sales staff performance. The information can be shared across sales departments, supply chain, management, and executive teams. It can be used on smartphones, tablets, laptops, and desktops. Cloud computing provides shared infrastructure and instant scalability. Salesforce provides continuous improvement for their services.

According to “disruptive innovation” theorist Clayton Christensen, “Disruption describes a process whereby a smaller company with fewer resources is able to successfully challenge established incumbent businesses.” This is certainly true of companies like Netflix or Uber. In fact, a number of industries have been disrupted by SaaS and cloud computing: HR services, payroll services, booking systems, project management, IT, accounting, CRM, software, and eventually medical product outsourcing.

For a healthcare provider like Kaiser Permanente, big data can be complicated and an impediment to change. Sam Gambarin, director of the Cloud Services group at Kaiser Permanente, said, “We wanted to provide our [software] developers with a standardized central platform and shorter time to market. Also, we wanted to optimize our existing systems of records.” To achieve this, Kaiser uses a hybrid cloud solution: an internal data center and external cloud provider with IBM Cloud, plus multiple SaaS providers.

Providence St. Joseph’s Health system uses the cloud-based electronic health record from Epic because its interoperability enables them to practice better medicine, receive appropriate reimbursements, and improve patient experience. For decades, there were failed startups in the healthcare interoperability space. Migrating electronic medical record management to the cloud now provides a viable solution.

While cloud migration is happening at large healthcare providers, disruption is more likely to come from startup companies like Bright Health, Devoted Health, Clover Health, and Oscar Health—Alphabet’s $1B+ investment. These “payvidors” offer patient-centric care designed to support and monitor patients by using data science to cut costs and promote preventative care. Some work with prescription services. Others use genomic data, machine learning, and artificial intelligence to promote health. Some offer in-home primary care programs and house calls.

On the medical product outsourcing side, consider contract engineering. Before the cloud, engineers and hobbyists with small budgets couldn’t afford most professional engineering design software like SolidWorks or Cadence. Now, a number of SaaS companies like Onshape or CircuitMaker offer inexpensive or free software that allows designers to share their work and build on others’ work, decreasing time and reducing risk. The continuously growing database eliminates the need for footprint design for common parts. This open-source approach has helped the maker community flourish in recent years, building on the efforts of companies like Raspberry Pi and Arduino to make powerful hardware building blocks widely available.

For mechanical design, Onshape is a SaaS model created by former designers of Solidworks, a legacy software package. Unlike Solidworks though, Onshape updates itself silently every two weeks and is billed per engineer at a low monthly fee. It holds major advantages over its predecessor with its ability to be used in real time by an entire design team located anywhere with a network connection. Import and export capability allows Onshape to ease the transition from legacy systems.

Disruption will happen in the industry as free, open-source development software is introduced to hobbyists and later works its way through commercial businesses. With cloud and SaaS, multiple people can view a file at once, reducing the amount of time spent on editing. Users can share the document with a large number of people through their browsers, inviting them to view and edit the document in real-time. Furthermore, any edits to the documents are saved automatically as the author types, which prevents accidental loss of data.

Concerns about data integrity during the switch to cloud-based systems are natural and bound to arise. Questions regarding security, accessibility, and cost are among the most asked. Data safety is one of the most prevalent concerns and why most cloud service providers make security their top priority. Cloud infrastructure is constantly monitored, while controlled access to data and frequent auditing reduce the risk of human error and flaws in security protocols.

One company facilitating migration to the cloud is Corent, whose SurPaaS platform analyzes and migrates software applications to the cloud and can even rapidly transform the software application to a SaaS model. Scott Chate, vice president partner and market development at Corent Technology, predicts, “The ongoing global transition to the cloud-based SaaS model is going to affect every industry.”

In a few respects, however, cloud fails to meet the precedent set by its legacy predecessors. Cloud software is often not as refined as older legacy software. Due to this, experienced legacy users often balk at using the new software. Furthermore, cloud systems are often heavily dependent on network reliability and bandwidth. Any outage can leave companies stranded without access to data. Most drawbacks to cloud programs, however, are mitigated by their higher processing power (provided from running on a server) and ability to efficiently update.

It was easier for our company to start in the cloud and incorporate SaaS into the business model. The cloud offers us many advantages. We can securely work from anywhere, using any computer or mobile device. We can leverage previous design work. Reliability is extremely high because cloud providers can invest in infrastructure. Data is stored in a centralized facility with stronger security measures than we could provide on our own, and files can be downloaded when needed. It’s simple to add, remove, or change software and users. Total cost is lower because we require less physical infrastructure and support staff. Our customers’ experiences have changed the way we connect and collaborate, how we do business and, by default, how we innovate. Ultimately, we are more efficient.

Engineering service providers launching new companies today can begin in the cloud, requiring less physical infrastructure and support staff. However, the industry is just beginning to shift from legacy software to SaaS, which won’t be easy for established medical device companies. Eventually, it will transform contract engineering and contract manufacturing services as they migrate to smart manufacturing. Cloud computing is so disruptive because it pressures entrenched firms to modify their business model, often involving changes to business strategy, revenue models, sales channels, and technology.

Jeff Hawkins, president and CEO of Truvian Sciences, reveals, “When Truvian decided to leverage engineering partnerships, we didn’t want to outsource in a classic sense but rather find partners that could operate as an extension of our team. In order for that to be successful, you need a partner with the right company culture and the right tools to facilitate real time collaboration, regardless of where the teams are physically located. New technologies are allowing us to collaborate digitally with our partners on everything from engineering designs using Onshape, to project planning using Smartsheets and general project file sharing using tools like DropBox or Box. These tools make it possible for anyone without training to participate in the process from any location with the [use] of software viewers.”

Technology is evolving faster than ever and business models are changing. The cloud is more secure, cost-effective, and accessible than alternatives, and it’s getting more powerful every year. There are now millions of students using the cloud exclusively. This upcoming generation lives without many past computer constraints.

Like the education system and numerous other industries, the cloud is beginning to disrupt medical device outsourcing. Entrenched companies with legacy systems currently have the high ground, but the cloud is changing everything. With today’s services, remote teams can connect instantly. Cloud services allow for SaaS usability without downloads or installs. Cloud providers make instant scalability possible. Cloud computing and SaaS provide hosting, backup, and security running on various operating systems and mobile apps. If you’ve ever been frustrated with IT requests, firewalls, or internet controls, there’s good news—a solution is on its way!


Steve Maylish has been part of the medical device community for more than 30 years. He is currently chief commercial officer for Fusion Biotec, an Orange, Calif.-based contract engineering firm that brings together art, science, and engineering to create medical devices. Early in his career, Maylish held positions at Fortune 100 corporations such as Johnson & Johnson, Shiley, Sorin Group, Baxter Healthcare, and Edwards Lifesciences.

Shannon White is an engineering student, SaaS user, and intern at Fusion Biotec.

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