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What innovations will change society? How will technologies affect our lives in the future?
At Politecnico di Milano there is a working group, Technology Foresight, which explores these questions, declining them on different topics: from the Sustainable Development Goals to the future of urban mobility and smart and inclusive communities. Starting from 2023, the theme that has guided Technology Foresight’s activity is the future of health, investigating how technological innovations will change the way we take care of ourselves.
The working group, born in 2020, is currently made up of:
Cristiana Bolchini, Professor of Information Processing Systems, at the Department of Electronics, Information and Bioengineering
Paola Francesca Antonietti, Professor of Numerical Analysis, at the Department of Mathematics
Francesco Braghin, Professor of Mechanics Applied to Machines, at the Department of Mechanical Engineering
Simona Chiodo, Professor of Aesthetics, at the Department of Architecture and Urban Studies
Giuliana Iannaccone, Professor of Architectural Engineering, at the Department of Architecture, Built Environment and Construction Engineering
We met the five professors to get them to explain what their activity consists of, why it is useful to all of us and what are the results of the work on health. They convey us their passion about the Technology Foresight’s activities, but let’s leave the floor to their five voices.
First of all, what does it mean Technology Foresight?
CB: First of all, it must be clarified that the future cannot be predicted; rather, doing technology foresight means intuiting and imagining possible futures. “Futures” and not “future” because no change is univocally determined. This exploration allows us to identify the most probable scenarios, in order to equip ourselves in time, and the preferable scenarios to facilitate their path.
SC: It is important to understand that the reality we study is so vast and deep that predicting the future is simply out of the picture. Talking about foresight, on the other hand, means admitting that many different scenarios can be likely: in fact, it is enough for an opportunity to veer a little more on the side of risk to radically change the future scenario. Exercising foresight therefore means being far-sighted: understanding risks in order to mitigate them and seizing opportunities to benefit from them.
GI: Such foresight serves to face an increasingly uncertain future in the best possible way. In fact, we live in a present in which uncertainty is no longer a “system error”, but it is the new normal. If we fall behind the impacts of technology on our lives, if technology takes over people, we, as a society, will have lost. If, on the other hand, we train the ability to anticipate the future impacts of technologies on society and to understand the risks and the opportunities, we can arrive prepared and able to manage technological innovations without being subjected to them.
PA: The speed with which technologies are bringing impactful changes has no precedent in the history of human progress. The great discoveries of the past that have changed medicine, e.g. that of antibiotics, have had very long gestations and were often accidental, resulting from impromptu observations in different contexts. The pervasiveness with which technological innovations are integrated into our lives undoubtedly brings numerous benefits, but it must be carefully managed, especially when people’s well-being is at stake, which is an inviolable right. In this sense, the interpretation of the impacts that technology has in this area can only be conducted on the level of ethics, sustainability and responsibility.
Why do Technology Foresight at Politecnico di Milano?
CB: Our working group was formed in 2020 (initially with a different formation: Iannaccone, Braghin and I were already present with professors Matteo Maestri and Paolo Trucco) upon the input of the previous rector, Ferruccio Resta. The goal is to systematize the skills of Politecnico experts to look further and beyond the resolution of punctual and contingent problems: the questions that partners ask us, in fact, are changing, as are the answers we give to the community of which we are part.
PA: The value of Technology Foresight’s activity is not so much in the disruption of messages: that artificial intelligence will play a fundamental role in the future healthcare system, for example, was imaginable. However, the fact that this conclusion is informed with objective data, structured reflections and a content-rich argument is extremely important in the historical period we are living in. The Politecnico di Milano represents an authoritative institution, responsible for the production of knowledge, and therefore establishes itself as an interlocutor for policy makers, institutional actors and the production ecosystem. Universities are not ivory towers, but they have a social role that we must play responsibly as possible.
What is the value of participating in your working sessions?
PA: Technology Foresight’s activity has been first and foremost a great opportunity for self-enrichment and personal growth. The experts who participated had to leave the daily perimeter of their research and the typically vertical approach to scientific issues, to sit around the table engaging in a collective reflection with researchers from different fields.
FB: From my point of view, this experience is useful because it helps not to lose the general view of the research activities that are carried out on a daily basis. One wonders what impact the work I am doing has on society. Let’s take the famous case of research in nuclear physics that led to the atomic bomb: we scientists may develop something out of scientific curiosity, but we must also be aware that that same technology, declined even with a few variations, can be used for very different purposes. It is important that technology is in a certain sense “humanized”. We are engineers, architects and designers: what we do has important consequences on society and it is therefore right not to stop at scientific publication, but to take into account the concrete application of what we do.
SC: The colleagues who participated were not only trained to broaden their gaze using their imagination, but were also exposed to the imaginative exercises of the other participants. This training also brings benefits to the researcher’s daily practice: once back in his/her laboratory, he/she will probably pay more attention, during the research activity, to those signs of change that other colleagues have identified in the foresight activity. This allows them to be forward-looking, i.e. to be equipped and able to mitigate any risks.
GI: It was very interesting to see how from an initial phase of disorientation, and in some cases even scepticism, the participants gradually let themselves be involved, becoming passionate about the activity. Some of them, moreover, shared with us the benefits they have received in the daily sphere: for example, in being able to describe the multidimensional aspects of the impacts of a research project for a funding proposal. The technology foresight activity has also been an opportunity for many to get to know colleagues from different sectors, with whom otherwise there would have been no opportunities to meet and discuss, to start possible collaborations on new lines of research.
Going outside the walls of Politecnico, who else does Technology Foresight?
CB: At the beginning of our activity, we explored the Italian and international scene. From this analysis it emerged that there are very few and no university in Italy. In the business world, some large companies have an in-house team that deals with technology foresight. But the great value of doing this activity at university is that, since there is no interest that guides the experts’ evaluations and no client who commissions the survey, the experts can conduct studies on the medium to long term in a completely independent way. Internationally, there are some centers that can be mentioned, such as Imperial Tech Foresight and Fraunhofer, but I can say that our group has unique characteristics and is therefore a sort of trailblazer.
PA: Our missions, as a University, include training, research, technology transfer and social responsibility. Therefore, as part of our foresight activities, our approach aims to identify future opportunities and risks, supporting decision-makers and stakeholders in developing informed strategies.
In recent years, the group’s work has been focusing on the future of global health, exploring the technological innovations that will have the greatest impact on the care of people and the planet in 2040. Can you tell us what are the reasons for this choice and how you are dealing with the “One Health” theme?
CB: The Rector, Donatella Sciuto, has given us the mandate to highlight the University’s expertise in an area such as life sciences, which is not directly attributable to polytechnic disciplines. To address a complex issue such as health, we are proceeding with a concentric circle method, from the smallest to the largest: in the first year we focused on personal care, in the second we will focus on the public and private health system and the last will be dedicated to the health of the environment.
SC: There are three orders of reasons for choosing the One Health theme. Surely the first is that health is the most precious and important necessity for everyone. Secondly, we must be aware that a revolution is taking place in the way we take care of ourselves; In this revolution, technology has – and probably will continue to have – a huge impact. It seems paradoxical, but in this sense the role of the engineer affects health at least as much as the role of the doctor. Finally, as already mentioned by Cristiana, Politecnico di Milano does not have departments and schools that deal directly with medicine; however, curiously all its departments – without exception – do research in this area. Therefore, it could be interesting for a transversal working group like ours to deal with the topic.
GI: The issue of health allows us to take into account several levels: from person to planet. It is thus possible for us to create links between various disciplinary contributions. Climate change itself is teaching us that the health of the person is closely linked to the health of the planet.
FB: To work on the issue of health, it was essential to collaborate with doctors, who, being in contact with the patient and with the direct application of a technology, have a completely different perspective from ours. To trivialize, we “only” have to make a machine work, but it is the doctor who knows if the technology is sustainable for the patient. It is therefore important that doctors are involved because they are the interface to the real world and the front end of the technologies we develop: they are the ones who realize what is missing and what needs to be developed.
What method do you use in your Foresight activity?
FB: The technology foresight activity is also a great work of systematization, in which the evolution trajectories are analyzed and processed with respect to the context conditions and possible scenarios. First of all, it should be noted that changes do not only occur on academic drivers, but also thanks to patents and industrial research. In the process of identifying the technologies that will influence society, it is therefore necessary not to limit oneself to consulting the scientific literature alone, but also to broaden one’s gaze to the industrial world.
GI: The method used is the one we learned at the Institute for the Future, an internationally recognized institute in the field of foresight, and updated and integrated with additional methods and tools, also in collaboration with the Leadin’ Lab of our colleague Claudio Dell’Era. The process is developed in 4 phases (preparation, actual foresight, insight and action), but at the Politecnico, for the reasons already explained by my colleagues, we stop at the first 3.
To analyse the impact of emerging technologies, we start with the so-called “desk research”, from which the STEEP forces and the signs of change emerge. The analysis of STEEP forces (they are social, technological, economic, environmental and political forces) allows a coherent view of the development of some trends, because they are sufficiently stable and recognized trends, which therefore have a good chance of shaping the future. Forecasting methods based only on trend analysis, however, have the defect of being a little too deterministic (and giving us an illusion of control). Participants in foresight activities, on the other hand, are encouraged to reflect also and above all on the signs of change. These are “weak” signals, elements that are often considered secondary and little known, such that they do not seem to be part of trends already underway, for example the development of an invention by a start-up, but which could have the potential to become something more and force us to think about how the future could change if they were to turn into obvious trends. In the work done this year on personal health, we shared with the participants 50 STEEP forces and 83 signs of change.
In the foresight activity, the involvement of the experts identified in the field covered by our research, and in the directly associated fields, is fundamental: they are invited in preparation exercises and interviews to reflect on a broad time horizon by exercising their imaginative capacity for the future. In the field of personal health, 50 emerging technologies were initially identified, from which the experts selected the 28 most impactful. The next phase, which involves participants in working groups, consists of two workshops: the Imagination Factory, which identifies possible scenarios, and the Reframing Factory, which aims to identify, among the possible futures, those that are also plausible and with respect to which to generate insights on the opportunities and risks related to them. The results of this work are summarized in the booklet available here.
What emerged from the work on personal health?
PA: As part of the categorisation exercise, the definition of precise perimeters proved to be complex; however, recurring dimensions emerged, called ‘insights’ in the methodology, which were the subject of structured reflections. One of the most significant evolutionary trajectories certainly concerns the greater emphasis placed on prevention rather than cure: prediction and tracking technologies allow the individual to actively participate in his or her own well-being.
I would like to emphasize that the ethical dimension permeates every reflection conducted in this area. Numerous technologies, such as the virtual patient model (improperly defined as a ‘digital twin’), which supports clinical decision-making in relation to the physical, physiological and behavioral characteristics of an individual, involve and will increasingly entail costs that are frequently unsustainable for the healthcare ecosystem, focusing on equitable access to care.
Finally, a further theme that emerged from these reflections concerns the dimension of the training of health personnel. The advancement of technologies, which are increasingly pervasive in the health sector, raises significant questions about how to adequately prepare the new professions dedicated to personal care.
SC: The impact of digital technology on the world of health presents opportunities and risks. On the one hand, in fact, we gain in speed, practicality and immediacy (just think of online reports and electronic documents). On the other hand, digital dematerialization does not take into account a very important factor in the doctor-patient relationship: human empathy. In fact, even if people are digitally literate, they need contact with the doctor to feel truly cared for and listened to.
In addition, intuitive ability, which is typically human, is fundamental in the medical profession: medicine is not an exact science but proceeds by trial and error and it is often the doctor’s intuition that picks up signals and information that artificial intelligence would not have access to. In this sense, the skills and abilities that human beings have at their disposal are different and complementary to those of artificial intelligence.
As Paola has already pointed out, individual health is increasingly proactive. This is clearly a great value because thanks to technologies linked above all to wearable devices, people have more and more information about their health: just think of the proliferation of apps that count steps, measure parameters of various kinds, monitor the quality of sleep. In this way, the person is increasingly aware and stimulated to take care of their health. The risk in this case is that of no longer considering ourselves healthy until proven otherwise (as when we obtained information about our health thanks to medical visits and tests), but of considering ourselves, every day, potentially sick. In addition, we must remember that we are not doctors and that we do not have the skills and abilities to interpret the data that new technologies provide us with in a correct and, above all, holistic way. This existential transformation, so to speak, from potentially healthy to potentially sick has obvious psychological implications: we risk becoming more fragile, more obsessive, bordering on compulsive. Finally, it is also possible to be conditioned: if the app says that I didn’t sleep well, I immediately start to feel tired; if it says that I ate more calories than necessary, I feel heavy, and so on.
Another result that emerged from the foresight work is the greater personalization and precision of medicine. In fact, health-related data are no longer just statistical data, but are increasingly data relating to the individual person. Predictive technologies can now tell us what is the risk that a given person has of contracting certain diseases. The social, economic and political implications of this phenomenon can be disruptive, when this information is used to make certain choices by the State or private entities such as banks: a person who has been attributed a high probability of falling ill may not have access to a mortgage, a job that has particular characteristics or the adoption of a child. The risk of inequality is therefore high and arises when these predictive technologies, which certainly have a certain degree of sophistication and reliability, are considered not as highly probable, but as absolute certainties.
From these considerations on the evolution of health in the future, what has already been underlined by my colleagues emerges: the ethical dimension cannot fail to be taken into consideration when reflecting on the impact of technologies. Initiatives such as technology foresight help us face tomorrow so that nothing is completely surprising or shocking. The tool we have at our disposal is not prediction, but imagination. To quote Shakespeare in Hamlet, “the readiness is all”. It is not the prediction that will make us more ready, but the imagination.
If you want to learn more about the future of personal health analyzed by the Technology Fitness group, visit the page www.foresight.polimi.it/health/1/