Dossier - The Future of Health Data

The Future of
Health Data
Foresight Studio Dossier
Igor Bueno, Riley McCullough,

Liin Nur, Jacquie Shaw
Foresight Studio SFIN-6021

April 16, 2019
1
2
The Future of
Health Data
Foresight Studio Dossier
Igor Bueno, Riley McCullough,

Liin Nur, Jacquie Shaw
Foresight Studio SFIN-6021

April 16, 2019
Part 1
Signals and trends
page 5
Part 2
Scenarios
page 53
Part 3
Innovation Strategy: Fitbit
Excerpts from Strategy Development Final Documents
page 79
Part 4
Designed Future: Immersive Scenario
page 119
3
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Part 1
Signals and trends
6
Process
The first part of this foresight project began with scanning and captur-
ing signals of change related to the general topic of healthcare. To do
this, the students in the Foresight Studio course pulled articles, videos,
podcasts, and other forms of media that were indicative of changes that
may occur in the future. These signals were sorted using the STEEPV tool
(social, technological, economic, environmental, political, and values)
and each signal was classified based on the level of maturity (emerging,
growing, peaking, declining). Following this, a process was undertaken to
review these signals and recombine them into trends with information
about implications and extrapolations for each trend.
7
Signals
The Gym Isn’t Usually A Safe Space For Fat Women,

But It’s Become My Sanctuary
Author: Fancy Feast Implications:

Source: Buzzfeed News • Creating safe spaces for people to focus on
their health
URL/Attachment: https://www.buzzfeednews.com/arti-
cle/fancyfeast/weight-lifting-fat-woman-gym-strength- • Creating personalized health journeys
fitness-gender
• Creating holistic views of fitness.
Published Date: Jan 19th 2019
• Maturity: Emerging, Growing, Mature, Declining
Abstract:
Future impact (on the lives of audience):
Social and cultural signifiers often keep women especially high, medium, low
fat women from entering fitness spaces. Fitness that is
Impact time: 5y, 10y, 20y
less centered around weight loss are hard to find
Certainty (of assessment of future impact):
Keywords/Tags: Fitness, Access, Barriers to Health,
high, medium, low
Gender and Health
“Black Museum”
Black Mirror Episode 6 Series 4
Author: Charlie Brooker (Writer) poisoning Rolo, Nish transfers Rolo’s consciousness into
Clayton’s head, much like Carrie was transferred into
Source: Show available on Netflix
Jack’s head, forcing him to live through the last electro-
Published Date: December 29, 2017 cution which overloads Clayton’s synapses and wipes the
Abstract: digital copies of them both. Rolo’s agony is captured in
a souvenir keychain which Nish takes along with the doll
Nish stops to recharge her car and enters the nearby with Carrie’s consciousness and shorts out the museum’s
“Black Museum”, owned and run by Rolo Haynes. Rolo electricity, starting a fire. Nish drives off with her moth-
shows her various artifacts, all related to illicit technolo- er, her consciousness living within Nish, tells her Clayton
gy that he had been involved with. He describes several would be proud of her. (Wikipedia)
stories connected to them. One involves Dr. Peter Daw-
son, a doctor who developed a device that allowed him Keywords/Tags: Biotech, pain management, medical
to experience the pain of his patients to aid in diagnosis, ethics
but soon found pain giving way to addictive pleasure, Implications:
and eventually killed a man to experience the sensation.
• Psychological considerations on practitioners sharing
Another case involves Carrie, a comatose woman whose
pain with patients
consciousness was transferred into her husband Jack, but
when Jack started seeing another woman, he forcefully • personalized health care and diagnostics
transferred Carrie into a plush monkey for their son Park-
• Believing the pain of patients
er who soon discarded the toy as he grew up; Carrie still
is alive within the plush at the museum. Rolo shows Nish Maturity: Emerging, Growing, Mature, Declining
the star attraction of the museum, a holographic repre- Future impact (on the lives of audience):
sentation of the consciousness of convicted murderer high, medium, low
Clayton Leigh that Rolo bought just prior to his electro-
cution, allowing visitors to electrocute him repeatedly. Impact time: 5y, 10y, 20y
Nish reveals that her visit was not incidental, as she is the Certainty (of assessment of future impact):
daughter of Clayton, who was wrongfully convicted. After high, medium, low
8
Care Work:
Dreaming Disability Justice
Author: Leah Lakshmi Piepzna-Samarasinha • Reframing access to a collective responsibility

URL/Attachment: https://arsenalpulp.com/Books/C/ • Empowering the sick/disabled/neurodivergent in their
Care-Work experiences
Published Date: October 30th 2018 • A wider understanding of medical needs of marginalized
groups
Abstract:
Maturity: Emerging, Growing, Mature, Declining
Essays which centre the experience of Black, Indigneous,
Queer, Trans, People of Colour (BIQTPOC) Future impact (on the lives of audience):
high, medium, low
Proposes “collective access” (access not as a chore but a
collective responsibility) Impact time: 5y, 10y, 20y
Keywords/Tags: Disability Justice, Access to care, Certainty (of assessment of future impact):
LGBTQ+, community care, social justice high, medium, low
Implications:
From bugs to brains:

The microbiome in neurological health
Author: Kyla A.McKay, Kaarina Kowalec, Fiona Brinkman, B. Keywords/Tags: Microbiome, Immunology:
Brett Finlay, Marc Horwitz, Amee R. Manges, Lisa Osborne, Multiple sclerosis
Helen Tremlett
Implications:
Source: Multiple Sclerosis and Related Disorders
• Growth of understanding of holistic brain health ap-
Volume 12
proaches
URL/Attachment: https://doi.org/10.1016/j.
msard.2016.12.007
Published Date: Feb 2017
high, medium, low
Abstract:
Knowledge surrounding the trillions of microbes that in-
habit the human gut has bloomed exponentially in recent
high, medium, low
years, and the emerging concept of a gut-brain axis rep-
resents a major shift in how we think about neurological
health.
A recent workshop at the University of British Columbia,
Canada brought together multi-disciplinary leaders in the
field of microbiomics and brain health and aimed to serve
as a springboard for future combined endeavors in these
areas.
This article provides the motivation for, and overview
of, the workshop, and the next steps in establishing
a cross-disciplinary initiative on Brain Health and
the Microbiome.
9
Is salad a luxury food? One writer argues it’s
time to rethink leafy greens
Author: CBC Radio - The Current Keywords/Tags: Food systems, food distribution, E. Coli,
Farming
URL/Attachment: https://www.cbc.ca/radio/thecurrent/
the-current-for-november-22-2018-1.4915910/is-salad- Implications:
a-luxury-food-one-writer-argues-it-s-time-to-rethink-
• “having all these conversations about how we’re going to
leafy-greens-1.4916002Published Date: Jan 19th 2019
feed a growing population responsibly”
Abstract:
• Examine food distribution costs vs. nutritional value
Lettuce is not particularly nutritious for the cost
of growing
“resource intensive and maybe a luxury food”
high, medium, low
E. coli outbreak in 2018 affected over 50 people
in the US and Canada
E. Coli linked to water from resevoir. water came from
high, medium, low
a canal, irrigation canal, that flowed near a feed lot that
had a 100,000 cattle on it.
Molecular You
Author: BC PMI Keywords/Tags: Personalized medicine, genomics

URL/Attachment: https://molecularyou.com Implications:
Published Date: December 29, 2017 • Growth personalized medicine
Abstract: • Collection of genome data
Personalized health packages for optimizing nutrition, Maturity: Emerging, Growing, Mature, Declining
fitness and health.
Three tiers of health packages: Baseline (Health Snapshot), high, medium, low
Core (Nutrition & Lifestyle), Premium (Optimal Health &
Performance), plus Genetics Add on (Inhereted risks)
MY has a visual dashboard to explore texting results
high, medium, low
Woebot
Author: Alison Darcy, PhD (and woebot team) Keywords/Tags: Mental health; chatbots; depression;
anxiety; Cognitive behavioural therapy
URL/Attachment: https://woebot.io/about
Implications:
Abstract:
• Accessible mental health care using clinically proven
Mental Health Chat bot
approaches
Users can talk to woebot 24/7 in 130 countries for free
Woebot uses Cognitive Behavioural Therapy to assist with
mental health challenges
high, medium, low
CBT is a talk therapy that is highly structured and prac-
tical. Considered to be the most rigorously studied and
most effective treatment for mental health problems Certainty (of assessment of future impact):
high, medium, low
Does not replace the need for human intervention
10
The Multibiome: The Intestinal Ecosystem’s
Influence on Immune Homeostasis, Health, and Disease
Author: Heather A Filyk, Lisa C Osborne Keywords/Tags: Microbiome; Autoimmune disease; In-
flammatory bowel disease; immunotherapy
Source: The Lancet Volume 13
Implications:
URL/Attachment: https://www.sciencedirect.com/sci-
ence/article/pii/S2352396416304625 • Holistic view of immunity and intestinal multibiome
Published Date: November 2016 • Lead to more understanding of holistic/personalized
healthcare
Abstract:
• “ advance our understanding of multibiome-host interac-
new insights into multibiome-host interactions in the
tions and the development of effective treatment strate-
context of host-protective immunity
gies for multiple human diseases”
Mammals evolved alongside a complex and biodiverse
multibiome.
The intestinal multibiome is composed of bacteria, virus-
high, medium, low
es, fungi, and eukaryotes.
Cross-talk between the multibiome and the host regu-
lates immunity and inflammation. Certainty (of assessment of future impact):
high, medium, low
The Personalized Medicine Revolution: How Diagnosing

and Treating Disease Are About to Change Forever
Author: Pieter Cullis PhD.

Published Date: 2015 Keywords/Tags: Personalised medicine; human genome;
genomics; microbiomics; metabolomics; ethics
Abstract:
Implications:
explores recent advances in genomics, the study of the
human genome — as well as its cousins proteomics, me- • Growth in availability of personalized medicine.
tabolomics, microbiomics
• Growth of holistic diagnosis
explains how technology is even now changing the way
• Better diagnostic and preventative capabilities
medicine is delivered
• Ethics/data collection
takes the reader through the five critical healthcare areas
that will be transformed most radically by personalized Maturity: Emerging, Growing, Mature, Declining
medicine — prediction, prevention, diagnosis, treatment, Future impact (on the lives of audience):
and monitoring high, medium, low
examines the practical and ethical issues involved. Impact time: 5y, 10y, 20y
details how readers can use personalized medicine to Certainty (of assessment of future impact):
take charge of their own health high, medium, low
11
3-D printed food could change how we eat
Author: Experimental Biology 2018 Keywords/Tags: 3D printing, customized food, reduced

food waste, food insecurity
Source: phys.org
Implications:
Published Date: April 24, 2018
• This research shows the wide-ranging application of
Abstract:
3D printing that can directly impact our health. If this
Research from South Korea is looking at using 3D printing technology becomes a reality, then other edibles such as
to create customized food to meet nutritional require- medication could also be 3D printed
ments, needs, and preferences of the user
• There are also implications for food insecurity, food
The prototype for this could adapt so that in the future, waste, and food transport costs and emissions
people could have cartridges that contain powdered
Maturity: Emerging
versions of ingredients which, when put in the platform,
creates a 3D printout of their food, ready to eat Future impact (on the lives of audience): High
This ability to print food at home as well as at an industry Impact time: 15y
scale could help combat issues of food insecurity and
Certainty (of assessment of future impact): High
food waste
The food that is printed could also have the ability
to last longer and have more bioavailable nutrients for
our bodies
A subscription for baby food?

It’s not as crazy as it sounds.
Author: Olga Massov subscription services, childhood obesity

Source: Mashable Implications:
Published Date: January 12, 2019 • Healthy food subscription boxes are being marketed to
parents as a way to combat childhood obesity
Abstract:
• There is also a general push to eat more local, fresh, and
Direct to consumer subscription services are continuing
healthy food and while the supermarket was one of the
to increase in popularity
main ways of obtaining this, mail-ordered food is up and
Yumi is a baby food company based in Los Angeles that coming
aims to change the way parents think about baby nutri-
• However, there is a cost associated with this healthy
tion by providing busy parents with healthy, fresh baby
eating lifestyle as it is still being marketed as ‘exclusive’
food offerings via a subscription box
and ‘high-end’ so what about those who cannot afford to
Childhood obesity is a growing concern for parents and pay these prices? Will childhood obesity be a symptom of
some are looking upstream and hoping to provide their poverty while it is eradicated in those with high incomes?
babies with made-to-order food rather than what is
Maturity: Growing
found in the supermarket
Future impact (on the lives of audience): medium
Store bought baby food is filled with “filler” ingredients
which are high in fructose and low in nutrition Impact time: 5y
There are parents who prefer to make their own baby Certainty (of assessment of future impact): high
food because they see it as a way to know what their
child is eating as well as be more eco-friendly since they
can control what to do with the food waste and use re-
usable jars instead of non-recyclable pouches most baby
food comes in
Keywords/Tags: food, healthy eating, pre-selected meals,
12
Dell Medical is Bringing Healthcare
to the Homeless
Author: Mike Clark-Madison Team is made up of a physician or nurse, a psychiatrist, a

drug counsellor, nursing and mental health case manages
Source: The Austin Chronicle
and a peer navigator (someone with lived experience)
Published Date: Jan 18, 2019
Keywords/Tags: homeless healthcare, underserved
Abstract: communities, patient experience, healthcare outreach
Dell Medical School, CommUnityCare and Integral care Implications:
teaming up to deliver street medicine for chronic health Increased health services for traditionally underserved
needs of homeless communities
In healthcare, the burden is usually on the patient to get Maturity: Emerging
treatment - this tries to change that
Future impact (on the lives of audience): Medium
Targeted for homeless men and women with behavioural
Impact time: 5y
health disorders and chronic medical conditions
Certainty (of assessment of future impact): medium
Death and Dying Discussions at DesignTO
Author: N/A Keywords/Tags: death, dying, design, end of life

Source: DesignTO festival Implications:
Published Date: N/A • This is one of many conversations about what it means to
die and to experience death and end-of-life. By looking
Abstract:
at this from a design-perspective, there is the opportu-
‘Death and Dying Discussions’ is an event taking place in nity for different ideas around death to emerge as well as
January at OCAD University that looks to open up discus- different consumer demands
sion about how society perceives death beyond a medi-
• new products, policy changes, etc.
cally oriented event
Maturity: Growing
The keynote speaker is Ivor Williams the lead of an inno-
vative design lab looking at end of life & an event series Future impact (on the lives of audience): High
called ‘Dying.’ is presented by Taboo Health and OCAD
Impact time: 10y+
University’s Design Studio
Certainty (of assessment of future impact): high
Walgreens and Microsoft are taking on Amazon
Author: Nicky Lineaweaver Keywords/Tags: private healthcare, e-healthcare, e

commerce
Source: Business Insider
Implications:
• Growth in influence etc.
Abstract:
Maturity: Emerging
Walgreens and Microsoft have a 7-year deal for in-store
healthcare services, virtual care offerings, and joint inno- Future impact (on the lives of audience): High
vation centres
Impact time: 10y
This is seen as a move by Walgreens to insulate them-
selves against Amazon’s entrance into the health market
13
The Griefbot That Could Change How We Mourn
Author: Chris Godfrey period and transform it into an unhealthy dependence or

reliance on the technology
Source: Daily Beast
Keywords/Tags: grieving, mourning, AI, death and dying,
Published Date: January 12, 2018
social media
Abstract:
Implications:
The way we grieve is changing. Building on an idea that
• Direct implications can be seen for mental health and
was the topic of Black Mirror episode “Be Right Back”,
whether or not this technology can be used in therapy
grief bots are being created to simulate a deceased per-
settings or at home to process grief
son’s behaviour
• This also has implications for dementia care as this
The inputs for these bots include social media posts,
technology could be used to help individuals reconnect
audio and video recordings, and text messages that the
with memories of a past life and with loved ones who no
deceased created before they passed away
longer exist
Grief bots can be instrumental in helping people proceed
Maturity: Emerging
through the grief stages and alleviate initial distress that
comes with the death of a loved one Future impact (on the lives of audience): High
Concerns include whether or not the data we leave be- Impact time: 15y
hind can form an accurate portrayal of who we were as
people and there is also the potential to prolong the grief
A subscription for baby food?

Influenza has killed 3 unvaccinated Sask.
preschoolers so far this season: public health officials
Author: Jennifer Quesnel

Source: CBC News
Abstract:
Unless children have been vaccinated, they have low
immunity to the H1N1 influenza A virus which hasn’t been
seen in Saskatchewan since 2010
Only 1/3 of toddlers in Saskatchewan have received
the flu shot this year. For children between 5 and 8, the
number is as low as 20%
Keywords/Tags: vaccinations, influenza, child healthcare
Implications:
• Increase in preventable diseases due to lower rate of
vaccination
Maturity: Mature
Future impact (on the lives of audience): high
Impact time: currently
14
Our Cities are Designed for Loneliness
Author: Ankita Rao these areas, qualities such as social interactions, life
purpose, and lifestyle factors are critical to their
Source: Vice
emotional and physical health
Published Date: December 11, 2018
Keywords/Tags: community, mental health, built envi-
Abstract: ronment, loneliness, social isolation, intergenerational
Social isolation is a public health problem - it makes peo- housing, community gardens
ple more susceptible to disease, decreases life expec- Implications:
tancy, and increases the chances of being diagnosed with
As we face an increasing population of older adults, the
mental health conditions such as depression
Government of Ontario has put forth a recommendation
Loneliness or social isolation is pervasive as well and encouraging seniors to age in place (i.e. at home instead
young adults between 18-22 have been found to be the of institutional living such as long-term care homes). But
loneliest of all as society becomes more lonely, there are potential
This reality is a symptom of the built environment we all negative implications on seniors’ health and well-being if
live in. There is a scarcity of public space where people they are not able to socialize and interact with others
can bump into each other and catch up as well as the There are also mental health and wellbeing implications
continuation of urban sprawl which encourages living in for an entire generation of people who are more vir-
isolated communities in suburbia. tually connected than ever but are increasingly finding
Community gardens are increasing in popularity as a way themselves more lonely. This could place a burden on
to bring people together and inject nature into our daily an already strained mental health care system as well as
routine at the same time have more wide-ranging economic costs due to missed
time at work, etc.
Intergenerational housing is also being examined as a
solution to curb loneliness in both young people as well Maturity: Emerging
as older adults Future impact (on the lives of audience): Medium
Research looks to so-called “Blue Zones” which are the Impact time: 5-10y
places in the world where people live the longest lives. In
The Dark Truths Behind Our

Obsession With Self-Care
Author: Shayla Love young. There is not a good enough answer to what is
being done to help this population when they realize they
Source: Vice
need professional assistance
Published Date: December 12, 2018
Self-care can only go so far. The mental health care
Abstract: system needs to be adapted so that it meets the needs of
Self-care is becoming increasingly popular and includes those with mental health problems.
many behaviours including eating well, getting enough Keywords/Tags: self-care, mental health, mental health
sleep, meditating, yoga/exercise, and more treatment
Self-care itself is not the problem since these behaviours Implications:
are conducive to a healthy lifestyle. Rather it is the com-
• Self-care is a trend that will continue to grow but what
modification of these behaviours and the fact that entire
may be even more long-lasting is the idea that individu-
industries are selling this idea of self-care which is the
als are responsible for treating their own mental health
problem
conditions. How will this impact mental health care and
Underneath all of that, there is the reality that mental treatment in hospitals, doctors offices, and therapist
health problems are increasing with anxiety and depres- offices?
sion being the most prevalent mental health conditions
• Because many these self-care products are marketed
worldwide. In the US, this increase has not been met with
as being luxury items, the associated cost is high. What
the appropriate increase in psychologists and psychia-
happens to those who this self-care movement excludes
trists and instead, their numbers are dwindling
most notably, those with less disposable income? Will
The self-care phenomenon is seen as a canary in the coal mental health care become more exclusively for those
mine of mental health coverage. Instead of giving people that are most well-off?
the help they need - through therapy and treatment -
Maturity: Mature
the health care system is choosing not to intervene and
Future impact (on the lives of audience): High
instead feeding into the self-care trend and “outsourcing
public health care” Impact time: >5y
Alongside this explosion in self-care, there is a large, Certainty (of assessment of future impact): high
help-seeking, undiagnosed population that is largely 15
87 days of smog: Southern California just saw its
longest streak of bad air in decades
Author: Tony Barboza lems”, even at levels that are lower than the regulatory
limits
Source: LA Times
Health impacts of high ozone levels include asthma at-
Published Date: September 21, 2018
tacks, missed school days, emergency room visits, prema-
Abstract: ture deaths
LA region violated federal smog standards for 87 consec- Keywords/Tags: air quality, healthy air, smog, asthma,
utive days lung diseases
Exceeded federal health standard of 70 parts per billion Implications:
from June 19 - Sept 14, 2018
• Growth in health conditions related to poor air quality
“The bad air spell follows an increase in smog over the last
Maturity: Mature
few years that has bucked a long-term trend of improving
air quality…” Future impact (on the lives of audience): High
There is more and more research “linking ozone and other Impact time: Current
regional air pollutants to a wider array of health prob-
Insulin’s High Cost Leads to Lethal Rationing
Author: Weekend Edition Saturday

Source: NPR
Published Date: Sept 1, 2018
Abstract:
Diabetes patients are skipping insulin treatments because
they cannot afford them, dying of diabetic ketoacidocis
One vial of insulin, after insurance, in 2018 was $80 -
costs approximately $1300 a month for some patients
Keywords/Tags: high cost of healthcare
Implications:
• Increase in preventable deaths due to high cost of
medicine/access to healthcare in a privatized and
capitalistic system
Maturity: Growing
Future impact (on the lives of audience): high
Impact time: 2y
Certainty (of assessment of future impact): Medium
16
Let’s make 2019 the year Canada finally
gets pharmacare
Author: Globe Editorial The real challenge will be with disrupting the status quo. It
is not a matter of whether people want drug coverage or
Source: Social Policy in Ontario
not. Rather, the question is if citizens are willing to adopt
Published Date: January 11, 2019 a new system
Abstract: Keywords/Tags: Pharmacare, pharmaceuticals, universal
Pharmacare is going to be coming to Canada soon, most health care, Canadian health care system, coverage
likely sometime before the next election Implications:
Most Canadians have some sort of drug coverage through Changes to provincially provided health insurance cover-
workplace insurance but that is tied to keeping their jobs age as well as private drug insurance
and can sometimes come with expense co-pays and
Maturity: Mature
annual limits
One of the biggest opportunities pharmacare offers Can-
ada is a huge savings in the money the country spends on Impact time: 2-5y
medication. Canada’s per capita spending on drugs was
43 percent above the OECD average in 2011
Apple is in talks with private Medicare plans

about bringing its watch to at-risk seniors
Author: Christina Farr

Source: CNBC
Published Date: Jan, 16, 2019
Abstract:
Apple is working with private Medicare providers to get
people over the age of 65 to use the Apple Watch to
monitor their health
Health experts explain that the data from Apple Watch
could help reduce doctor visits
Apple has already signed deals with Aetna and United
Healthcare to reduce the cost of the watch
Keywords/Tags: health monitoring, insurance monitoring,

wearable tech
Implications:
• Healthcare companies have more access to their users’
health data
Maturity: Emerging
Impact time: 5y
17
Indoor air quality: The hidden threats
Author: Panasonic Malaysia a complete and holistic indoor air quality solution that in-
cludes air intake, filtration, cooling, circulation, ionisation,
Source: Edge Prop
exchange and exhaust is the way forward
Published Date: January 18, 2019
Keywords/Tags: indoor air, pollution, clean air, plant
Abstract:
Implications:
The average person breathes in 18kg of air daily
increase of the number of deaths associated with indoor
People notice the poor air quality when outdoors air quality
Six million deaths were associated with outdoor and in- Restrictions of materials and components of household
door air pollution (World Health Organization 2016 report) products and items
It is estimated that we spend about 90% of our time Maturity: Growing
indoors
Sources of indoor air pollutants are various and insidious
Impact time: Current
- from chemicals in wood products and furniture, house-
hold chemicals, mildew, mould and bacteria Certainty (of assessment of future impact): high
Flexible drug delivery microdevice to advance

precision medicine
Author: The Korea Advanced Institute of Science

and Technology
Source: PHYS ORG
Published Date: August 14, 2018
Abstract:
Flexible drug delivery microdevice
Controlled drug delivery devices help timely drug admin-
istrations
Administration of exact dosages at desired times.
Technology limited before, especially in organs with
curved surface, such as the brain and the eye
Keywords/tags: Theragnosis, drug delivery, health
Implications:
• Maximize curing effects with minimal side effects
Maturity: Growing
Future impact (on the lives of audience): medium
Impact time: 10y
18
A breathalyser test could revolutionise
cancer diagnosis
Author: Sean Morrisson Keywords/Tags: breath, early diagnose

Source: Evening Standard Implications:
Published Date: January 3rd, 2019 Simpler, cheaper method of spotting cancers at an early
stage
Abstract:
Maturity: Emerging
Breath Biopsy device is designed to detect cancer hall-
marks in molecules exhaled by patients. Future impact (on the lives of audience): High
Scientists hope use of the device will lead to a simpler, Impact time: 10y
cheaper method of spotting cancers at an early stage
Certainty (of assessment of future impact): low
Sticking to your diet? This tooth-mounted

food sensor could transmit the truth
Author: Beth Mole Implications:

Source: Ars Technica • Links between dietary intake and health
Published Date: March 24, 2018 • Automatic / reliable tracking of consumed calories
Abstract: • Tracking of alcohol consumption for safety purposes
tooth-mounted sensor that can wirelessly transmit data Maturity: Emerging
on sugar, salt and alcohol about the foods we are eating
Impact time: 20y
Keywords/Tags: dietary intake, health, real-time tracking,
food
FoodMarble Launches World’s First Personal

Digestive Tracker
Author: FoodMarble allergies, wellbeing, digestive problems

Source: CISION PR Newswire Implications:
Published Date: December 4, 2018 • Self-diagnosis may not bring attention to a serious
health issue
Abstract:
• Data may allow fast and/or remote treatment if provided
Device and app to identify foods contributing for diges-
to physicians
tive issues through breath
Maturity: Emerging
Breath testing for digestive issues has only been available
in hospitals or medical clinics Future impact (on the lives of audience): Medium
Hydrogen breath testing Impact time: 10y
Keywords/Tags: health, real-time tracking, breath, food Certainty (of assessment of future impact): Medium
19
BELIEVING
PATIENTS
The rise of several different health care trends
leading to better healthcare advocacy and access.
Health data collection technologies as it exists, and
overview
could exist, further diversification of those in the
medical and research field and the lessening of stig-
matization of illness could lead to a more inclusive
system of healthcare. Currently, studies show that
healthcare continues to perpetuate racialized, sex/
gendered, and sexuality based myths resulting in a
lower quality of healthcare for racialized persons,
women, and members of the LGBTQ+ community.
Disability/Feminist/Queer/Indigenous/Race
signals
advocacy and diversity in healthcare. 1,2,3,4
Growing pervasiveness of wearbles,

biohacking and personal DNA testing.5,6,7
Emerging and fictionalized technologies used to

measure pain in patients. 8,9,10,11
Patients have access to a wider understanding
implications
of their ailments and personal healthcare needs,
through data tracking are given better tools and
information for self-advocacy.
Doctors supplied with recorded data, and potential

technologies to better understand patient pain
and experience.
A less biased healthcare system which more

effectively serves people with fewer barriers to
access to care
More accurate data for diagnosis and treatment

could lead to more effective patient care, creating
less of a burden on an overloaded healthcare system,
and healthcare providers. 12,13
Image Sources: Eletu, A. (n.d.). Man looking at marketing analytics [Digital Photograph]. Reduction of risk of misdiagnosis, no diagnosis,
Retrieved from https://unsplash.com/photos/unRkg2jH1j0 and human/practitioner error.
Unknown. (3rd Century BC). Terracotta nude female statuette, perhaps Aphrodite.
Retrieved from https://www.metmuseum.org/art/collection/search/248606
FitBit. (n.d.). Fitbit Ionic Charcoal Fitbit Developer Clock Face Apps Drink Counter.
Retrieved from https://s2.q4cdn.com/857130097/files/doc_downloads/ionic/large/Fit-
bit_Ionic__Charcoal_Fitbit_Developer_Clock_Face_Apps_Drink_Counter.png Jacquie Shaw · SFIN-6021-001 Foresight Studio · Project 1 Signals
20
21
1) Adler, K. W. (2017, April 25). Women Are Dying Because Doctors Treat Us Like Men. Retrieved 7) Preventive Health Assessments | Molecular You. (n.d.). Retrieved February 1, 2019, from https://
January 31, 2019, from https://www.marieclaire.com/health-fitness/a26741/doctors-treat-women- molecularyou.com/
like-men/
8) McCarthy, C. (2018). Black Museum. Black Mirror. Endemol UK.
2) Billock, J. (2018, May 22). Pain bias: The health inequality rarely discussed. Retrieved February
1, 2019, from http://www.bbc.com/future/story/20180518-the-inequality-in-how-women-are-treat- 9) Keshavan, M. (2015, June 11). Measuring pain: Device objectively tells you how much it
ed-for-pain hurts. Retrieved January 31, 2019, from https://medcitynews.com/2015/06/objectively-measur-
ing-pain-device/
3) Kiesel, L. (2017, October 9). Women and pain: Disparities in experience and treatment.
Retrieved January 31, 2019, from https://www.health.harvard.edu/blog/women-and-pain-dispari- 10) Limón, J. L. M., Collazo, J. S., & Staff, B. (2017, November 8). The Teen Who Developed a
ties-in-experience-and-treatment-2017100912562 Breast Cancer-Detecting Bra. Retrieved February 1, 2019, from https://broadly.vice.com/en_us/
article/evbpan/breast-cancer-detecting-bra-eva
4) Study: Oncologists Want More Education About LGBTQ Issues. (2019, January 22). Retrieved
February 1, 2019, from https://www.cancer.org/latest-news/study-oncologists-want-more-educa- 11) Mandavilli, A. (2019, January 23). Your Sweat Will See You Now. The New York Times. Re-
tion-about-lgbtq-issues.html trieved from https://www.nytimes.com/2019/01/18/health/wearable-tech-sweat.html
5) Biohackers Are Implanting Everything From Magnets to Sex Toys. (2018, October 19). Retrieved 12) The Canadian Press. (2018, October 10). Burnout, depression and even suicidal thoughts
from https://www.bloomberg.com/news/articles/2018-10-19/biohackers-are-implanting-every- reported in survey of Canadian doctors. CBC. Retrieved from https://www.cbc.ca/news/health/
thing-from-magnets-to-sex-toys canadian-doctors-burnout-depression-1.4856875
6) Cullis, P. (2015). The Personalized Medicine Revolution: How Diagnosing and Treating Disease 13) The Supply of Physicians in Canada: Projections and Assessment. (2018, January 18). Retrieved
Are About to Change Forever. Vancouver: Greystone Books. February 1, 2019, from http://bit.ly/2FPFGeH
Privatization of health care perpetuating privileged

in STEM and Medical post secondary education.
Rising income inequality leading to less diversity
The pervasiveness of systematic marginalization
patients (affecting most marginalized groups
Increase in health literacy and advocacy for
diagnosis and treatment of patients.
Human bias and error lessened in
(non-intersectional research).
data for healthcare.

5 – 20 years
the most)
growing
extrapolations counter trends
NURSE
ALEXA
+ Integration of Healthcare into the
Internet of Things
This trend depends on the 3-way hybridity of
overview
combining the rise of personalized health tracking
and treatment combined with the growing normality
of smart objects, Internet of Things and smart homes,
and AI and robots for care people. The combination
of these technologies and systems could lead to the
integration of healthcare into smart homes, with
AI assistance.
Virtual healthcare 1,2,3
signals
IoT and wearable tech health data tracking 5,6,7,8
robotic/AI caretakers/medical “practitioners” 9,10,11 e
Better access to care to those in remote areas,

implications those requiring cognitive or physical support for
mobility, those too ill to leave the home.
Lower cost (opportunity, capital, time) for in

home health care/caretaker needs.
Less risk of spreading contagious diseases.
Image Sources: Amazon.com Inc. (n.d.). Echo Plus, Charcoal, Back Side.jpg. Retrieved
from http://media.corporate-ir.net/media_files/IROL/17/176060/09202018/Alexa-En-
abled/Amazon%20Echo%20Plus/Echo%20Plus,%20Charcoal,%20Back%20Side.jpg
team, O. (2010). World War II nurses [Photo]. Retrieved from https://www.flickr.com/
photos/timefornurses/5129762916/
V., F. (2018). Keyboard, robot, instrument and playing. Retrieved from https://unsplash.
com/photos/U3sOwViXhkY Jacquie Shaw · SFIN-6021-001 Foresight Studio · Project 1 Signals
22
counter trends extrapolations
emerging
Maturity: 10 – 20 years
increase my IV dosage”
making integration difficult or costly.

up to IoT healthcare at risk of hacker attacks.
Patents and privatization of medical treatments

using personalized tracking and data. Ex. “Alexa,
migrane > reduces in home trigger” “Alexa notices

to help treatment of illness “Alexa detects signs of
signs of asthma triggers > turns on air purification”

Treatments for illnesses can be carried out at home
Smart home able to react to environmental changes
Data security and hacking increases putting hooking

1) Maple: Online Doctors, Virtual Health & Prescriptions in Canada. (n.d.). Retrieved February 1, care Interoperability -. Retrieved February 1, 2019, from https://thejournalofmhealth.com/
2019, from https://www.getmaple.ca/ the-role-of-wearable-technology-in-healthcare-interoperability/
2)Medeo Virtual Care - Empowering Providers | Connecting Patients. (n.d.). Retrieved February 1, 9)Aronson, L. (2017, December 20). The Future of Robot Caregivers. The New York Times.
2019, from https://medeohealth.com/ Retrieved from https://www.nytimes.com/2014/07/20/opinion/sunday/the-future-of-robot-care-
givers.html
3) Safavi, K., & Dare, F. (2018, April 3). Virtual Health Care Could Save the U.S. Billions Each Year.
Harvard Business Review. Retrieved from https://hbr.org/2018/04/virtual-health-care-could-save- 10) Malcolm, F. (2018, March 28). Aging Japan: Robots may have role in future of elder care.
the-u-s-billions-each-year Reuters. Retrieved from https://www.reuters.com/article/us-japan-ageing-robots-widerim-
age-idUSKBN1H33AB
5) Biohackers Are Implanting Everything From Magnets to Sex Toys. (2018, October 19). Retrieved
from https://www.bloomberg.com/news/articles/2018-10-19/biohackers-are-implanting-every- 11) Mendez, I. (2018, December 15). How robots are helping doctors in the Canadian North |
thing-from-magnets-to-sex-toys Globalnews.ca. Global News. Retrieved from https://globalnews.ca/news/4758562/robot-medi-
cine/
6) Haghi, M., Thurow, K., & Stoll, R. (2017). Wearable Devices in Medical Internet of Things: Scien-
tific Research and Commercially Available Devices. Healthcare Informatics Research, 23(1), 4–15.
https://doi.org/10.4258/hir.2017.23.1.4
7) Smiley, S., & Timms, P. (2018, August 28). Swedish biohacker says bio-implants movement
growing globally [Text]. Retrieved February 1, 2019, from https://www.abc.net.au/news/2018-08-
28/swedish-biohacker-says-bio-implants-movement-growing-globally/10170326
8) The Journal of mHealth. (2018, October 23). The Role of Wearable Technology in Health-
23
GENDER VARIAN
POST-GENDER C
Wider understanding and acceptance of transgend
diversification of healthcare for trans/non-cis pers
The acceptance and further representation
overview
of non-cisgender (including trans, intersex, non-
binary) identities and bodies could lead to better
understanding of trans and intersex bodies. This
understanding could lead to less medical barriers
— personal, mental, and systemic — to care for
non-cisgender bodies, earlier recognition of
non-cisgender identities. With further acceptance
and knowledge of non-cisgender identities more
specific healthcare needs can be researched
and addressed.
high profile/public representation of transgender
signals
persons from celebrities to politicians.1,2
Banning of conversion therapy in Canada

and other countries. 3 e
Non-binary gender markers begining to be

recognized by governments 4,5
Better mental health rates amongst LGBTQ2S+
implications
individuals and communities. 6
Better personalized care and access to care for those

with non-cisgender bodies (ex. men seeking uterus
care, non-binary gender affirming surgeries/care) 7
Agency of self-identity and needed care for

non-cisgender people available at younger ages 8,9
Image Sources: Allen & Ginter. (1889). Plate 9, from the Fans of the Period series (N7) for
Allen & Ginter Cigarettes Brand [Commercial Color Lithograph]. Retrieved from https://
www.metmuseum.org/art/collection/search/406989
Fortuny, M. (1869). Victory: a naked youth standing facing left holding a statue of winged
Victory in his right hand. Retrieved from https://www.metmuseum.org/art/collection/
search/656644
Lee, K. (2018). Flag, gay parade, gay flag and rainbow. Retrieved from https://unsplash.
com/photos/bdAcC3_OTTA
Library, B. (2013). Image taken from page 163 of “A magyar nemzet története. I. kötet
írta Bodon J. és Dr. Szalay J. (II.-IV.) kötet, írta Dr. Szalay J.) [With portraits.]” [Photo].
Retrieved from https://www.flickr.com/photos/britishlibrary/11272653806/
Unknown. (1500). Figurine [Ceramic Sculpture]. Retrieved from https://www.metmuseum.
org/art/collection/search/324302 Jacquie Shaw · SFIN-6021-001 Foresight Studio · Project 1 Signals
24
emerging
der identities,
sons & bodies
CARE
through culture.
NCE &
Religious and belief led movements.
Populism in politics and the emboldening

of the right, and gender essentialist ideologies
linking body/physical health care with gendered
of colonized people, and the care that is enabled

Postgenderism not as gender erasure, but no longer
assumptions. Understanding of pre-colonial genders
1) Blitz, E. (2019, January 16). Bangladesh Parliament to have first transgender MP. Retrieved Feb- 7)For nonbinary patients, seeking health care can be a painful task. (n.d.). Retrieved February 1,
ruary 1, 2019, from https://www.weeklyblitz.net/news/bangladesh-parliament-to-have-first-trans- 2019, from https://www.nbcnews.com/feature/nbc-out/nonbinary-patients-seeking-health-care-
gender-mp/ can-be-painful-task-n941341
2) Transgender Hollywood – Variety. (n.d.). Retrieved February 1, 2019, from https://variety.com/t/ 8)Miller, S. (2018, November 29). California becomes first state to condemn intersex surgeries
transgender-hollywood/ on children. Retrieved February 1, 2019, from https://www.usatoday.com/story/news/na-
tion/2018/08/28/intersex-surgeries-children-california-first-state-condemn/1126185002/
3)Murphy, J. (2018, December 21). One country’s push to ban “gay cures.” Retrieved from https://
www.bbc.com/news/world-us-canada-46562130 9)News, & Canada. (2019, January 18). Who gets to decide when a 14-year-old wants to change
gender? The child, the hospital, the battling parents? | National Post. Retrieved February 1, 2019,
4)BC Government News. (2018, November 2). ‘X’ gender identity now recognized on government from https://nationalpost.com/news/canada/who-gets-to-decide-when-a-14-year-old-wants-to-
ID. Retrieved February 1, 2019, from https://news.gov.bc.ca/releases/2018HLTH0079-002116 change-gender
5) Sonde, K. (2018, June 22). These states are driving the charge toward gender-inclusive licenses.
Retrieved February 1, 2019, from https://www.motherjones.com/politics/2018/06/these-states-
are-driving-the-charge-toward-gender-inclusive-licenses/
6)Avery, A. M., Hellman, R. E., & Sudderth, L. K. (2001). Satisfaction with mental health services
among sexual minorities with major mental illness. American Journal of Public Health, 91(6),
990–991.
25
PERSONALIZED
PREVENTION
Following the holistic model focus on healthcare, t
preventive/maintenance for the general populatio
focus in healthcare.
so
re
cial
a
f-c Non-pharmaceutical preventative care begins to
overview
int
l
se take precedence in day-to-day health care. With
er
ac
more “social” prescriptions to deal with mental

tio
health, further research into effective nutrition plus

ns
personalized medicine and DNA tests patients are

able to create lifestyles centred on personalized
health needs.
DNA disease prediction 1,2,3
signals
Changing diets and food production 4,5,6
Rising prices of curative medicines/health care 7,8 e
Rising understanding and practices of self-care 9
Growing understanding of holistic health 10
Less strain on urgent care systems
implications Improved personalized medical literacy
Improved agency in personalized healthcare
Requires lessened stigmas of needing help and care
Image Sources: Alpha Stock Images. (2015). Apple. Retrieved from http://www.picserver.
org/a/apple.html
Internet Archive Book Images. (1891). Image from page 140 of “Medical symbolism in con-
nection with historical studies in the arts of healing and hygiene” (1891) [Photo]. Retrieved
from https://www.flickr.com/photos/internetarchivebookimages/14576988048/
Monroy, V. (n.d.). Opioid-therapy.ashx [Digital Photograph]. Retrieved from https://www.
health.mil/-/media/Images/MHS/Photos/Opioid-therapy.ashx
pngimg.com. (n.d.). DNA PNG. Retrieved from http://pngimg.com/download/48593
Rawpixel. (n.d.). Infographic, graphic, mobile and graph. Retrieved from https://unsplash.
com/photos/EspXDd5Gu-c Jacquie Shaw · SFIN-6021-001 Foresight Studio · Project 1 Signals
26
emerging
on becomes a
tech enabled
(ex. Anti-Vax movements)
against a shift to preventitive care

care regarding prevention and ongoing care.
Data security threats putting storing personal

A holistic understanding of healthcare leading to
medical data potentially at rick to hacker attacks

Misinformation on prevention of disease and illness
better preventive care of preventable illnesses. Data
Privatization of healthcare, and big pharma lobbying

informed care allowing patients more agency in their
1) Cullis, P. (2015). The Personalized Medicine Revolution: How Diagnosing and Treating Disease 7) Gillies, T. (2018, April 22). Why health care costs are making consumers more afraid of medical
Are About to Change Forever. Vancouver: Greystone Books. bills than an actual illness. Retrieved February 1, 2019, from https://www.cnbc.com/2018/04/22/
why-health-care-costs-are-making-consumers-more-afraid-of-medical-bills-than-an-actual-ill-
2) Preventive Health Assessments | Molecular You. (n.d.). Retrieved February 1, 2019, from https:// ness.html
molecularyou.com/
8) Malito, A. (n.d.). Rising health-care costs are eating away at your wages and you may not even
3) Smith, F. (2019, January). How personalized medicine is transforming your health care. realize it. Retrieved February 1, 2019, from https://www.marketwatch.com/story/the-hidden-ways-
Retrieved February 1, 2019, from https://www.nationalgeographic.com/magazine/2019/01/person- rising-health-care-costs-affect-you-2018-10-10
alized-medicine-transforming-your-health-care/
9) Love, S. (2018, December 12). The Dark Truths Behind Our Obsession With Self-Care. Retrieved
4) Are Pills and Powders the Future of Food? (2017, August 10). Retrieved February 1, 2019, from February 1, 2019, from https://www.vice.com/en_uk/article/zmdwm4/the-young-and-the-uncared-
https://www.thefoodrush.com/articles/are-pills-and-powders-the-future-of-food/ for-v25n4
5)’Planetary health diet could help save lives and the planet - CNN. (n.d.). Retrieved February 1, 10)Clarke, P. N., & Bleich, M. R. (2018). Holistic Leadership—Nursing’s Unique Contribution to
2019, from https://www.cnn.com/2019/01/16/health/new-diet-to-save-lives-and-planet-health- Healthcare. Nursing Science Quarterly, 31(2), 134–138. https://doi.org/10.1177/0894318418755744
study-intl/index.html
6)Plant-based proteins as a future nutrition and opportunities for food startups. (2017, October
25). Retrieved February 1, 2019, from https://www.foodinnovationthinktank.com/2017/10/25/plant-
based-proteins-as-a-future-nutrition-and-opportunities-for-food-startups/
27
28
29
30
31
32
33
34
35
Planetary Health
Implications & Extrapolations
The connections between As the health impacts of climate change increase, there may
be a cultural and societal value shift towards taking better
health concerns and care of the natural environment. As stronger environmental
policy could follow this shift, there may be a responsibility of
environmental health are all industries to follow the principle of the triple bottom line:
people, profit, and planet. This could result in a new definition
becoming more prominent. of wealth and the destruction of current consumption habits.
In the healthcare industry, doctors will also be treating more
health issues that stem from the impacts of climate change. As
science shows that humanity can prevent some of the impacts
on climate change to some degree, healthcare practitioners
may take on a of advocacy focused role against climate
Description change in order to prevent many of these looming diseases
As the impacts of climate change and humanity’s negative and conditions. This may result in the healthcare industry
impact on the planet become more severe, these impacts taking a role as doctors for our planet and our environment,
are beginning to have increasingly detrimental effects on our as well as for human conditions, as the two will become more
health. Doctors are raising awareness about climate change intertwined with the rise of climate change.
and environmental health in relation to how it impacts human
health and well-being. The health impacts of climate change
will be felt first and hardest by individuals who lack the ability References
to access proper sanitation and medical treatment, and those 1. Christensen, J. (2019, January 16). 250,000 deaths a year from climate
that lack the resources to relocate to avoid climate impacts. change is a ‘conservative estimate,’ research says. CNN. Retrieved from
https://www.cnn.com/2019/01/16/health/climate-change-health-emergency-
study/index.html.
2. Odriozola, V. (2015, April 17). Nine Healthcare Institutions Pledge to Reduce
Signals Carbon Footprint. Philanthropy News Digest. Retrieved from https://
philanthropynewsdigest.org/news/nine-healthcare-institutions-pledge-to-
• Scientists suggest that 250,000 deaths per year due to reduce-carbon-footprint.
climate change is a conservative estimate and that climate 3. Azad, A. (2018, October 12). How climate change will affect your health.
change could pose a threat to the gains made in human CNN. Retrieved from https://www.cnn.com/2018/10/12/health/climate-
longetivity.1 change-health-effects/index.html.
4. Barboza, T. (2018, September 21). 87 days of smog: Southern California
• In the lead up to the 2015 UN Conference on Climate just saw its longest streak of bad air in decades. LA Times. Retrieved from
Change, nine healthcare institutions around the world https://www.latimes.com/local/lanow/la-me-smog-streak-20180921-story.
pledged to reduce their carbon footprint, noting the html.
5. Carrington, D. (2019, January 11). Air pollution ‘as bad as smoking in
impacts of climate change on public health.2 increasing risk of miscarriage’. The Guardian. Retrieved from https://www.
• Research shows that climate change could cause in theguardian.com/environment/2019/jan/11/air-pollution-as-bad-as-smoking-
increase in disease, including bacterial infections, mental in-increasing-risk-of-miscarriage
health concerns, and respiratory problems.3
6. Trend provided by Kathryn Cramer.
• Scientists suggest doing more to fight poor air quality and 7. Trend provided by Asia Clarke.
ozone levels as more evidence shows it can lead to asthma 8. Trend provided by Karli Ferriolo.
attacks, premature deaths, and miscarriages.4, 5
Photo by Alex Gindin on Unsplash.
36
S T E E P V
Maturity: Growing
Related Trends
• “Climate Change and Mortality”: Climate
-
change will increase the mortality rate and
reduce longevity in vulnerable populations.6
• “Planet Earth Saved by Educated Girls”:

Population growth can be reduced educating
women on their reproductive health and
providing them with access to affordable
reproductive healthcare.7
• “Plant Based Diets for All”: Governments and

businesses are relying on plant-based food
-
sources and diets to feed a growing population
while reducing the severity of environmental
impacts from food production.8
Riley McCullough
37
Increasing Equity
There is an increase in medical This may lead to an increase in health service providers
representation of groups that that have more specialized service offerings, based on
demographics. This trend is driven by changes in society
have been historically under- related to acceptance and tolerance, and could play out in the
science role in a meaningful way in the near future as more
represented or marginalized. research will clearly demonstrate the importance and success
of specialized care.
For example, we may see an increase in family doctors tailored

to individuals and families with similar lived experiences. In
countries like Canada that are accepting large numbers of
new immigrants, we may see specialized healthcare that
Description caters to the needs of immigrant communities, and there
With an increase of acceptance of individuals with diverse may be a larger emphasis on the use and role of language in
backgrounds, communities that have been historically under- medical care. Demographic-based healthcare may become
represented and marginalized are becoming more widely the standard expectation for individuals whose health needs
represented in society - from politics to healthcare. This has or personal lifestyles have been largely ignored or dismissed
been seen in the rise of specialized healthcare practitioners, by the healthcare community. This trend could create new
such as women’s clinics and clinics that specialize in LGBTQ markets in the healthcare industry and destroy the current
health. notion of one size fits all healthcare.
Signals References
• Bangladesh will have a transgender Member of Parliament 1. Weekly Blitz News Team. (2019, January 16). Bangladesh Parliament to have
first transgender MP. Weekly Blitz. Retrieved from https://www.weeklyblitz.
for the first time in the country’s history, providing the trans net/news/bangladesh-parliament-to-have-first-transgender-mp/.
community with a voice in a country where many of the 2. Ventura, J. & Rueter, A. (2018, May 20). Indigenous health care workers
laws are still hostile towards the LGBTQ community.1 use language to build trust and break down barriers. CBC. Retrieved from
• In British Columbia, Canada, indigenous healthcare workers https://www.cbc.ca/news/indigenous/indigenous-language-health-care-
workers-1.4660009.
are using the language and culture of their patients to build 3. Das, R. (2018, April 12). Women’s Healthcare Comes Out Of The Shadows:
trust and provide better healthcare.2 Femtech Shows The Way To Billion-Dollar Opportunities. Forbes. Retrieved
• There is a rise in women’s health clinics and a growing from https://www.forbes.com/sites/reenitadas/2018/04/12/womens-
healthcare-comes-out-of-the-shadows-femtech-shows-the-way-to-billion-
industry in femtech to invest more in solving women’s dollar-opportunities/#46a09fe66159.
health needs beyond pregnancy and gynecology.3 4. Xu, G. (2016, December 18). Marginalization in health care. UBC Medical
• There is an increased awareness of the struggles of Journal. Retrieved from https://ubcmj.med.ubc.ca/marginalization-in-
marginalized communities in the healthcare sector, with health/.
Canada Health noting that these communities often 5. Trend provided by Harmon Kaur.
“receive treatment that does not adequately meet their 6. Trend provided by Jacquie Shaw.
needs, or [are] less satisfied with healthcare services than 7. Trend provided by Samantha Matters.
the general population”.4 Photo by Hush Naidoo on Unsplash.
38
S T E E P V
Maturity: Emerging
Related Trends
• “Cancer Care for LGBTQ”: Cancer care in the
LGBTQ community is largely ignored and
LGBTQ patients report higher dissatisfaction
with cancer care treatment.5
• “Gender Variance/Post-Gender Care”: There

is a wider understanding and acceptance of
transgender identities, and a diversification of
healthcare for trans and non-cis persons and
bodies.6
• “Health Femovation”: Empowered women

are driving innovation in health as their desire
for women-focused products and services
heightens.7
Riley McCullough
39
Burnout Generation
A bigger emphasis on work If continued, this could lead to an overall decrease in
and personal excellence has productivity as individuals experience more burnout, an
increase in the suicide rate, and a decrease in population
led to increased burnouts growth as individuals choose to forgo having children in order
to focus on their careers.
and mental health problems.
On the other end of the spectrum, it could also lead to an
increased acceptance of a work and personal life balance on
a cultural and societal level. It could create a better sense of
mindfulness and destroy the current wok standard of a 9-5 job
It may also change society’s perception of success and value.
Description This societal shift could be reinforced by broad policy changes
Milennials have higher expectations of themselves and have that help nudge individuals to have a better mental health
increased pressure placed on them. As a result, they are balance with their professional lives. This could be a restriction
working longer hours and to an increasingly unhealthy state in working hours allowed, a shortening of the work week, or
more often as they feel the need to take everything on. This even arguments in favour of universal basic income.
has lead to an increase in burnouts, depression, anxiety and
other mental health complications. A main driver of this is
the current tumultuous climate, an uncertain future, and the
inability to afford basic costs with one job. References
1. Petersen, A.H. (2019, January 5). How millennials became the burnout
Signals generation. BuzzFeed News. Retrieved from https://www.buzzfeednews.
com/article/annehelenpetersen/millennials-burnout-generation-debt-work.
• Recent financial crises have led to lasting financial 2. The Canadian Press. (2018, October 10). Burnout, depression and even
insecurity and a competitive economy that has led to a suicidal thoughts reported in survey of Canadian doctors. CBC. Retrieved
from https://www.cbc.ca/news/health/canadian-doctors-burnout-
culture of overworking and burnouts.1 depression-1.4856875.
• The concept of burnout is being seen in the medical 3. Morris, D. (2017, January 1). New French law bars work email after hours.
field, with at least 25% of doctors reporting symptoms of Fortune. Retrieved from ttp://fortune.com/2017/01/01/french-right-to-
disconnect-law/.
burnout, depression or suicidal thoughts in a survey.2 4. Folk, J. & Folk, M. (2019, January 1). Why Is Mental Illness On The Rise?
• A law in France requires employers to identify times in AnxietyCentre.com. Retrieved from https://www.anxietycentre.com/FAQ/
which their employees are not responsible for responding why-is-mental-illness-on-the-rise.shtml.
to work-related emails or calls in an attempt to decrease
5. Trend provided by Angie Fleming.
burnout and ensure employees are fairly paid for their 6. Trend provided by Liin Nur.
work.3 7. Trend provided by Liin Nur.
• Research shows that increase in societal pressures and 8. Trend provided by Karli Ferriolo.
norms, including increased performance pressure, have
Photo by JESHOOTS.COM on Unsplash.
taken a heavier toll on our psychological and emotional
health.4
40
S T E E P V
b.
Maturity: Peaking
Related Trends
• “Optimal Burnout”: A high effort to live a
health life is causing burnout, stress and
anxiety.5
• “Failure to Connect”: People are lonlier than

ever, despire the increase in social networks.6
• “Self-care: The Canary in the Coal Mine”:

There has been a rise in self-care strategies
with the rise of mental illness.7
• “Using Technology for Mental Health”: Virtual

reality and wearable technologies have been
used in the treatment or alleviation of anxiety.8
Riley McCullough
41
(Once) Illegal Drugs
Drugs that were once With the legalization of cannabis in Canada, and in turn the
classified as illegal are reduction of stigma surrounding a once illegal drug, there may
be a societal or cultural shift that takes a more accepting view
becoming more popular for of certain drugs, particularly psychedelics and similar drugs or
substances that have promising health benefits.
medical treatment.
A more positive cultural viewpoint and increasing scientific
research on the benefits of certain drugs will feed into each
other, prompting more research and wider acceptance among
the population, potentially eventually leading to policy
changes allowing certain drugs and substances for medicinal
Description purposes, or full legalization. The research of these drugs and
There is increased discussion around the legalization of certain their policy approvals could lead to new treatments of diseases
drugs and substances that show promising effects when and disorders, and new markets and business opportunities.
used for medicinal purposes. In the case of cannabis, it was It could destroy society’s current understanding of and
legalized for medicinal use only first, before being brought relationship with drugs like psilocybin.
onto the legal market for recreational use. As banned drugs
and substances are becoming more common in medical
communities, much of the stigma surrounding them is also
reduced, sometimes leading to full legalization. References
1. Rense, S. (2019, January 9). How Psilocybin—A.K.A. Shrooms—Could
Become the Next Legalized Drug. Esquire. Retrieved from https://www.
Signals esquire.com/lifestyle/health/a25794550/psilocybin-mushrooms-legalization
medical-use/?utm_medium=social-media&src=socialflowTW&utm_
• In several states in the U.S., there is a push for the source=twitter&utm_campaign=socialflowTWESQ.
legalization of psilocybin (the active substance found in 2. Burns, J. (2018, September 17). Coca-Cola Is Considering CBD For Infused
“shrooms”) as research shows possible applications for the Beverage Line. Forbes. Retrieved from https://www.forbes.com/sites/
janetwburns/2018/09/17/coca-cola-is-considering-cbd-for-its-infused-
treatment of depression.1 beverages/#4ffb6f851aab.
• Coca Cola is considering the development of a CBD infused 3. Dyck, E. (2018, August 17). Psychedelic drugs are making a medical
drink. CBD is the non-psychoactive cannabinoid chemical comeback over 50 years after the heyday of research on them — here’s wha
that often helps its users find relief from anxiety and changed. Business Insider. Retreived from https://www.businessinsider.com/
psychedelic-drugs-making-comeback-medical-science-research-2018-8.
depression.2 4. Flaccus, G. (2018, December 2018). Legal marijuana had an exceptional
• There is a rise in research on the medical effects of year in 2018 - and not just in Canada. Global News. Retrieved from https://
psychedelic drugs such as LSD, mushrooms, and peyote globalnews.ca/news/4795826/marijuana-legalization-2018-canada-world/.
cactus.3
5. Trend provided by Samantha Matters.
• After being legal for medicinal purposes in some places 6. Trend provided by Lisa Taylor.
for several years, cannabis is now being legalized for 7. Trend provided by Angie Fleming.
recreational use across the world at a growing rate.4
Photo by Thought Catalog on Unsplash.
42
S T E E P V
Maturity: Emerging
Related Trends
• “The Non-Drug (Counter)Revolution”: A shift
n- in multiple areas indicates a growing trend
toward a more natural approach to healthcare,
for better or worse.5
• “Ending the War on Drugs”: With the slow

shift moving towards recognition of the
at health issues related to addiction, it appears
that legalization in Canada and other
countries of all drugs might occur.6
• “East Meets West”: Western medical

practitioners are finding evidence for more
holistic practices in healthcare, including
Eastern practices and some prohibited drugs
and substances.7
Riley McCullough
43
THE POWER OF BREATH
STEEPV
TEC HN OLOGY
Health diagnosis through breath might become a reality,

from cancer investigation to metabolism and diets control.
A shift from blood and other conventional diagnostic tests to breath analysis may start to occur
our future1.
Through our breath diseases could be discovered and spotted at earlier stages.
Additionally, our breath may advance current health tracking wearable technologies with incre
accuracy and capabilities contributing to healthier lifestyles by helping with diets and fitness go
SIGNALS IMPLICATIONS
• “A breathalyser test could revolutionise cancer • A non-invasive and cheaper method of spotting di
diagnosis”2 - A breath biopsy device designed to detect at an early stage which can maximize cure and ra
cancer hallmarks in molecules exhaled by patients is currently reduce costs of treatments. This trend may impact
being trialed in the UK. The concept behind the test is that public policies related to health care and data col
cancer can cause noticeable alterations in the pattern of vol-
atile organic compounds exhaled. Scientists hope the use of it • Diet adjusted to daily and personal needs may pr
will allow both simpler and cheaper method of spotting can- better health.
cers at an early stage, which can maximize cure and reduce • Different relationships between patients and health
costs associated with the disease. titioners. Adittionally, this may impact how we inte
• “I tried the keto diet that’s sweeping Silicon Valley with the government, for example, police asking u
with help from a gadget that tracks your prog- a breathalyser may provide more data than we w
ress”3 - With the rise of ketogenic diets, which involve eating like to give.
foods that are high in fat and protein, while keeping carbo-
• A new way to connect with the health care system
hydrates to a minimum, a startup called Keyto launched a
the latest technology may disrupt the current medi
device and app. Its goal is to measure through breath the
ketones within the body, produced when the body burns system.
stored fats instead of recently eaten carbs, and therefore a
EXTRAPOLATIONS
Strategic Foresight - Winter 2019
successful consequence of a correct ketogenic regimen.

• “FoodMarble Launches World’s First Personal Di- • Smart homes may incorporate breath analysis into
gestive Tracker”4 - Through a breath testing the device
Igor Bueno Antunes
daily analysis to perform recommendations or eve

and app identify foods contributing for digestive issues, some-
matically schedule doctor appointments.
thing that previously has been available only in hospitals or
medical clinics. • 3D food printers may use breath analysis to adjus
• “Lumen: The first device to hack your metabolism nutrients required by a user.
and lose weight”5 - Through the breath, the device and
app measure at real-time the metabolism and recommend
• User data may be sold and utilized by the pharma
meal plans to reach weight loss and fitness goal. With a cal industry or any other industry to detect market
single breath, the device finds the CO2 concentration which mands at early stages. Hackers or non-authorized
indicates if the body is using fat or carbs to produce energy. ties may obtain the same data.
44
r in
eased
oals.
iseases
adically
current
llection.
romote Emerging Growing Peaking Declining
Trend current maturity

h prac-
eract
us to do RELATED TRENDS
would • “Wearable Health Tech replacing Doctors”, “Believing
Patients”, “Nurse Alexa”, “Food for Thought”.
m with
ical • Contribute to “Stay Home and Get Well”.
• “Data Revolution” may impact data from breat analysis.
Figure adapted from Güntner et al. J Mater Chem B 2016, 4: 5358. Published by the
Royal Society of Chemistry. Retrieved from https://phys.org/news/2017-10-blood.html
o their 1
Bergamin, F. (2017, October 10). Breath instead of a blood test. Retrieved from PHYS
en auto- ORG: https://phys.org/news/2017-10-blood.html
2
Morrisson, S. (2019, January 3). A breathalyser test could revolutionise cancer
diagnosis. Retrieved from Evening Standard: https://www.standard.co.uk/news/uk/can-
cer-breathalyser-test-set-to-revolutionise-diagnosis-launches-in-uk-a4029226.html
st food 3
Farr, C. (2019, December 22). I tried the keto diet that’s sweeping Silicon Valley with
help from a gadget that tracks your progress. Retrieved from CNBC: https://www.cnbc.
com/2018/12/21/ketogenic-diet-christina-farr-tries-with-keyto-device-to-track-progress.html
aceuti- 4
FoodMarble. (2018, December 4). FoodMarble launches world’s first personal digestive
t de- tracker. Retrieved from CISION PR Newswire: https://www.prnewswire.com/news-releas-
es/foodmarble-launches-worlds-first-personal-digestive-tracker-300759518.html
d par- 5
Nedashikivska, T. (2018). Lumen: The first device to hack your metabolism and lose
weight. Retrieved from Spinoff: https://spinoff.com/lumen
45
STEEPV
ECON OMIC
ENVIRONMENT HOME CLEAN AIR AFFORDABILIT
Indoor air pollution might become a significant health issue
without effective and available solutions suitable for all.
From gases and volatile organic compounds (VOCs) that escape from carpets and furniture to eve
day activities producing chemical mixtures, the indoor air pollution may severely affect our lives. A
from respiratory conditions, indoor air pollution can also cause heart disease and cancer1.
Currently, smart air quality monitoring devices measure environmental conditions inside a home b
not treat the air, only give recommendations and by a high price. Additionally, many of the house
items are sources of VOCs2 and not every family can pay for safer alternatives or even know that
• “Scientists participate in month-long experiment • More diseases may happen due to VOCs and oth
to study indoor air pollution”3 - Most Americans pollutants in our homes due to the lack of awaren
spend 90 percent of their time in indoor environments. solutions.
Previous researches focused on the presence or absence
of the radioactive gas radon and on VOCs that escape • Public policies may become more strict regarding
from carpets and furniture. But everyday activities pro- ing materials and designs, and products compositi
duce chemical mixtures that can vary and transform in • Relationships with family and friends may be impa
response to light, temperature and air flow. for example, if we do not live in a “clean air home
some people might not want to visit me.
• “Indoor air quality: The hidden threats”4 - With
the sources of indoor air pollutants being various, the • Manufacturing of products may change to accomm
way forward is a complete and holistic indoor air qual- pollutant free approaches.
ity solution that includes air intake, filtration, cooling,
circulation, ionisation, exchange, and exhaust. Addition- • Challenge of home as a safe place, and disruption
ally, the awareness of indoor air pollution is low among cleaning industry.
Malaysians, often considering, as usual, the smell of
EXTRAPOLATIONS
chemicals and paint in newly-completed buildings. Nor

we think of the air in our kitchens and bathrooms, which
• Smart homes may monitor and filter the air, adjust
are usually with high levels of contaminants.
Igor Bueno Antunes
perature and humidity, and any other component

• “Fight air pollution and save your lungs with prove indoor air quality and alert whenever the si
this plant which can clean indoor air”5 - In re- is prejudicial to human health.
sponse to not too much attention to hazardous organic
compounds in homes, researches developed a modified • The clean indoor air becomes an obligation: with
version of a typical indoor plant (Pothos Ivy) which scenario, air monitoring technologies might start to
cleans indoor air. Experiments have shown that the required by the government. The data generated r
concentration of pollutants like chloroform and benzene ing your home air quality may allow the governme
decreased due to the presence of the plant. apply fines or rescues approaches.
46
TY
e
ery-
Apart
but do
eholds
t.
her
ness or
build- Emerging Growing Peaking Declining

ion.
acted,
e”
RELATED TRENDS
modate • This trend may affect the trend “Stay Home and Get
Well”.
n of the Image retrieved from One Green Planet: https://www.onegreenplanet.org/environ-
ment/toxin-alert-common-household-items-to-avoid-for-better-indoor-air-quality/
1
Gupta, S. (2018, June 5). Indoor Air Pollution – The Health Hazard Nobody’s
Talking About. Retrieved from India Times: https://www.indiatimes.com/health/
healthyliving/indoor-air-pollution-the-health-hazard-nobody-s-talking-about-253480.
html
t tem- 2
Henn, C. (2015). Common Household Items to Avoid for Better Indoor Air Quality.
to im- Retrieved from One Green Planet: https://www.onegreenplanet.org/environment/
toxin-alert-common-household-items-to-avoid-for-better-indoor-air-quality/
ituation 3
Hinnefeld, S. (2018, June 19). Scientists participate in month-long experiment
to study indoor air pollution . Retrieved from PHYS ORG: https://phys.org/
news/2018-06-scientists-month-long-indoor-air-pollution.html
this Panasonic Malaysia. (2019, January 18). Indoor air quality: The hidden threats.
4
Retrieved from Edge Prop: https://www.edgeprop.my/content/1463312/in-

o be door-air-quality-hidden-threats
regard- 5
Indo Asian News Service. (2018, December 21). Fight air pollution and save your
lungs with this plant which can clean indoor air. Retrieved from Hindustan Times:
ent to https://www.hindustantimes.com/health/fight-air-pollution-and-save-your-lungs-with-
this-plant-which-can-clean-indoor-air/story-MU1cyKrbjPvl3Cffj9j0LL.html
47
PRECISE DRUG DELIVERY
STEEPV
TEC HN OLOGY
Better drug delivery systems might maximize cure and red

side effects.
With the advance of smart microrobots able to adapt to their surroundings and pass
through narrow blood vessels, or flexible devices that can be attached to organs, th
medicine may be able to deliver drugs directly to diseased organs or tissues.
With this step into the future, treatments may become more precise and reduce side
fects currently faced by patients.
• “Smart microrobots that can adapt to their sur- • With a maximization of cure and reduction of side
roundings”1 - Researches developed biocompatible fects, the trend may impact the science environmen
microrobots that are highly flexible and able to swim how religions perceive these treatment options.
through fluids and modify their shape when needed.
Thus, they can pass through narrow blood vessels and • Our relationships with doctors and health care ma
intricate systems without compromising on speed or ma- change due to a more efficient approach and the
neuverability and deliver drugs directly to diseased tis- bility of remote treatments.
sues or organs. Inspired by microorganisms that change
shape as their environmental conditions change, the • The way in which the health care systems manufac
scientists are working on improving these microrobots their treatments may shift more to nanotechnology
performance for swimming through complex fluids like
those found in the human body. • With an innovative drug delivery, the trend may d
and challenge the current pharmaceutical industry
• “Flexible drug delivery microdevice to advance
precision medicine”2 - A Korea Advanced Institute of EXTRAPOLATIONS
Science and Technology research team has developed a

flexible drug delivery device with controlled release for • Genetic testing showing a high risk of developing
Igor Bueno Antunes
personalized medicine, a step toward theragnosis which ticular type of disease may be followed by a micro
is an advance precision medicine with simultaneous diag- vice implant to monitor the area and treat in adva
nosis and therapeutics. This microdevice is flexible allow- reducing the risk of developing the disease.
ing the application, for example, to smart contact lenses
or brain disease drug delivery implants. Additionally, • Powered wirelessly microdevices may allow the ad
when powered wirelessly, it will represent a platform for tration of exact dosages at desired times, which m
personalized medicine by carrying out exact dosages at fect our need to go to hospitals or doctors appoin
desired times. in order to be monitored and treated.
48
duce
s
he
ef-
e ef-
nt and
Emerging Growing Peaking Declining

ay
possi- Trend current maturity
RELATED TRENDS
cture
• “Smart pills/Ingestible Sensors” may contribute with this
y.
trend.
destroy
Image retrieved from École Polytechnique Fédérale de Lausanne:
y. https://actu.epfl.ch/news/smart-microrobots-that-can-adapt-to-their-
surround/
1
Pessina, L.-A. (2019, January 2019). Smart microrobots that can
adapt to their surroundings . Retrieved from École Polytechnique
a par- Fédérale de Lausanne: https://actu.epfl.ch/news/smart-microrobots-
ode- that-can-adapt-to-their-surround/
ance, 2
KAIST. (2018, August 14). Flexible drug delivery microdevice to
advance precision medicine. Retrieved from PHYS ORG: https://phys.
org/news/2018-08-flexible-drug-delivery-microdevice-advance.html
dminis-
may af-
ntments
49
CONNECTED, BUT LONELY
STEEPV
SOCIET Y
The increase of tech solutions designed for elders might no

eliminate loneliness in seniors.
Age-related changes in one’s physical condition, the reduction of social circles and li
ed mobility to meet friends and family contribute to a more solitary life for seniors.
Tech products have been launched with the goal of helping care elders and reduce i
tion, but they may not reduce loneliness in seniors after all.
• “Combatting the Epidemic of Loneliness in Se- • The loneliness may contribute to other healt
niors”1 - Despite communications tech, we are loneli- sues affecting, even more, the physical cond
er than we have ever been. With age, several changes
of seniors.
may contribute to a more solitary life: physical condi-
tions, shrink of social circles and limited mobility. Sad- • The role of the family may continue to be es
ly, many seniors experience a decline in the number
sential to reduce loneliness in seniors. The s
and quality of their relationships as they age, whether
it is self-imposed or due to outside forces. importance may rely on relationships with e
• “Smart home tests first elder care robot”2 - A • The way elders connect with others and spa
robot created by Washington State University scientists es may need to facilitate physical connectio
uses sensors to determine where residents are, what
through communities, areas, mobility and tr
they are doing and when they need assistance with
daily activities. The robot navigates within the house to portation design.
find people on its own, provides video instructions on
EXTRAPOLATIONS
how to do simple tasks and reminders. This technology

can help seniors to live independently and have need- • Artificial intelligence (AI) and smart home a
ed assistance.
Igor Bueno Antunes
proaches may interfere in seniors’ lives in o

• “This tech for your aging parents fights isola- to reduce loneliness.
tion, boosts awareness”3 - Several technologies
that we, at first, may not associate with seniors were • For example, noticing that a senior is feeling
on display at CES 2019. From virtual reality, artificial the AI will contact a family member or frien
intelligence, robots and motion sensor, it is hoped that suggest approaches to help the elder, this m
these technologies may help elders to feel less isolated bring questions such as: whether or not are
and, in some cases, live independently for longer. lowed and free to be sad or any other feeli
50
Y
ot
imit-
isola-
th is-
dition
Emerging Growing Peaking Declining

s-
same
elders.
RELATED TRENDS
ac- • “Failure to connect”.
on
• May advance and become counter trends: “AI & Mental
rans-
Health”, “Using Technology for Mental Health “, “Mak-
ing Connections: Senior Edition”.
Image by rawpixel.com retrieved from Pexels: https://www.pexels.com/pho-

to/selective-focus-photography-of-left-hand-on-top-of-right-hand-on-white-pants-
ap- 1305302/?utm_content=attributionCopyText&utm_medium=referral&utm_
order source=pexels
1
Botek, A.-M. (2018, March 5). Combatting the Epidemic of Loneliness in
Seniors. Retrieved from Aging Care: https://www.agingcare.com/articles/
loneliness-in-the-elderly-151549.htm
g sad, 2
Washington State University. (2019 , January 14). Smart home tests first el-
nd and der care robot. Retrieved from Science Daily: https://www.sciencedaily.com/
may releases/2019/01/190114130913.htm
3
Al-Heeti, A. (2019, January 17). This tech for your aging parents fights iso-
e al- lation, boosts awareness. Retrieved from CNET: https://www.cnet.com/news/
ings. this-tech-for-your-aging-parents-fights-isolation-boosts-awareness/
51
52
Part 2
Scenarios
53
54
Process
Our process consisted of three main techniques, each relying on the

other to build a holistic picture of our potential futures: Manoa method,
2x2 Matrix, and Backcasting.
We began the exploration of our topic, personal health tracking and

data, using the Manoa method as an exploratory and generative pro-
cess. The members of our group are generative by nature, so we chose
to start with this method to not only understand the trends but to also
understand the implications of each of the trends and how they may
operate in a systematic way. We used three main trends to build out the
Manoa method: the rise of biodevices, the decentralization of health-
care, and climate change mortality. Using the information generated by
this process, we chose two main themes to map on our 2x2 Matrix: Data
Control and Climate Change. We decided on these two themes as they
were strongly represented in our Manoa activity, and because we wanted
to choose one theme that we felt was closely aligned with our topic and
one that was, at first thought, less aligned, in order to create a more rich
version of our scenarios.
We positioned these two themes on the two axes with one being Indi-
vidual Control of Data and Corporate Control of Data, and the other
being No Climate Action and Strong Climate Action. We then used the
ideas generated in the Manoa method and mapped them against the 2x2
to built our four futures. As all our futures were predicated on the idea
that biodevices would be commonly used, we discussed the possibility
of our matrix being a 2x2x2 matrix with the third axis representing the
availability or non-availability of biodevices. As our research showed that
biodevice development was highly likely and that there was a low possi-
bility that biodevices would not be adopted commercially, we opted to
remain with a 2x2 matrix.
After developing the themes for the four scenarios, we gave them
working titles and assigned one scenario to each member of the group.
Individually, we each began backcasting exercises to understand the
processes and events that would need to occur in order for our future
scenarios to exist. We then merged our independent research and did
a group backcasting exercise to ensure that we were bringing different
perspectives and more insight into the exercise. From this point, we then
split up again and each independently generated our scenarios, meeting
at multiple points in this process to discuss each scenario and help build
them out as a team. Our four finalized scenarios are outlined below.
55
individual owned data
data over flowers greener on the

other side
climate action
climate action
no
big brother + green giant
corporate + gov’t owned data
56
scenario overviews
data over flowers greener on the other side

• Countries and corporations have stopped • Government of Canada adds personal data as a
acting on climate change, leading to an increase protected intellectual property. Data intellectual
in climate-related disasters in Canada. properties protections grant Canadians the right
to individually controlled data as a right.
• Internal health trackers come on the consumer
market as a more accurate version of wearable • The UN has declared data protections a human
devices. This stems from non-diabetics using right. This pushes globally the practice of ethical
CGMs to track everything from diet, exercise, and transparent data collection and use, in order
and energy levels to reduce data exploitation but private or public
actors.
• The 2030s sees a rise in these devices paired
with a rise of companies focused on giving back • Due to aggressive actions started by companies
control of personal health information to the and local governments in the 2020s, global climate
individual. Blockchain becomes the most common change action movements grow quickly with the
platform for data management and everyone with goal of averting the predicted climate crisis of the
a tracker has real-time access to their data 2040s. This is done from mass divesting from fossil
fuels in the 2020s and 2030s, a shift from mass
• Changes to the legislation allows citizens in consumption and ownership economies, and the
Canada to sell their health data information to rise of green city developments.
public and private companies. This allows research-
ers to purchase the data from thousands of people
and a 5 year international study finds that climate
change has detrimental effects on human health.
This leads countries to renew their commitment to
mitigating the effects of climate change and plans
for a new Climate Change Agreement are underway.
big brother + green giant

• Countries and corporations have stopped • All health data generated by citizens is owned
acting on climate change, leading to an increase by corporate and government entities.
in climate-related disasters in Canada and intense
summers and winters. • Forced environmental actions over the past
• Wanting to be more proactive on monitoring • twenty years have led to increased climate
public health, and after substantial lobbying from stability and less environmental degradation.
the health and pharmaceutical industries, the gov-
ernment of Canada began funding the development
of commercial biodevices, implantable technology
that monitors all aspects of an individual’s health.
• As biodevices are widely used, Canada’s traditional

healthcare infrastructure has largely disappeared.
• Data produced by biodevices are accessible by

the companies that develop them, and they are
free to sell this data to their partners. The
government is also able to monitor all data
produced by biodevices.
• Individuals can opt to allow employers to

access their health data from their biodevices
for incentives at work.
57
58
big brother +
no-climate action; corporate + gov’t owned data
Article from The Economist March 2045
The far reach of health data in Canada

How the device in your hand came to put your most intimate data
in everyone else’s hands
Riley McCullough
When biodevices became commercially available over 15 years ago, we

jumped on the opportunity to monitor our health in real time. Long gone
were the days of manually entering your meals, counting your steps or
going to the lab for blood tests - everything was at your fingertips (or
rather, in your fingertips).1 But how did this come to be? And what does
the Paris Agreement and a preschool in Manitoba have to do with it?
2021 - The Beginning
To truly understand the evolution of our Fitbit Nanos and our Microp-
no climate action; corporate + gov’t owned data

ort Links, we need to go back to 2021. This was ground zero - the year
that everything began to change. Following the leadership of United
States President Donald Trump and Brazilian President Jair Bolsonaro,
countries withdrew from the Paris Agreement en masse.2 By 2023, only
three countries remained - Latvia, Switzerland and Morocco. By the late
2020s, major cities like Montreal and Toronto were experiencing un-
precedented heat waves, flooding and winter storms that brought the
number of environment-related deaths to an all-time high. It was these
natural disasters that led insurance companies and the government
began searching for better ways to monitor the health of individuals and
the general public.3
2021 was also the year that saw an entire preschool class in Lockport,
Manitoba die after a measles outbreak. The fallout from the Lockport
Crisis was reminiscent of the Walkerton Water Crisis in 2000, with en-
raged Canadians across the country calling on the government to take
stronger action on public health issues.4 These two events, triggered in
2021, along with incredible levels of lobbying from the healthcare and
pharmaceutical industries, led the federal government to invest in the
development of biodevices for commercial use from 2023 to 2030.5
From Corporate Data to Government Surveillance
This funding allowed companies like Fitbit and Microport to emerge in
big brother +
the new market of commercial biodevices, but it also allowed for them
to play a pivotal role in the development of rules surrounding their de-
vices. Under the Medical Tracking Act of 2026, companies that develop
your biodevices are permitted to monitor and store your health data, as
well as sell it to their “medical community partners” - big pharma names ≥
trends:
1. Technological advancements leads to implantable biodevices that monitors personal health.
2. The actions needed to prevent major climate changes have not happened.
3. Government and insurance companies play a more active role in monitoring health of the popu-
lation in order to prevent deaths due to climate change or environment-related disasters.
59
like Pfizer, Johnson & Johnson, and Bayer. Additionally, when you opt for
non-generic drugs, many of those same big pharma companies are able
to monitor scrubbed versions of your data to determine how their drug
is interacting with your body.6
In 2028, in the wake Montreal’s Summer of Death which saw the death
of 168 individuals after an incessant heat wave that lasted five weeks, the
federal government realized it was missing an opportunity to monitor
public health and wellbeing through the biodevices that it had funded.
In 2032, the government quietly passed the Healthy Canada Act that
requires any company selling biodevices in Canada to provide all data to
the newly created Ministry of Health Management. By 2035, the informa-
tion provided by the Healthy Canada Act led to a shift of the country’s
medical system away from the traditional model of the 1900’s and early
2000’s, and towards one with less doctors offices and nearly no labs or
clinics.7 Although biodevices were not yet mandatory, it was incredible
difficult to receive medical care the traditional way by the late 2030’s.
Those who had held out on biodevices, and were instead completing the
tedious annual task of manually reporting their health data on the cen-
sus, were beginning to opt in with great reluctance.
Employers Getting in on the Action
As biodevices became more common, and following initiatives launched

by Fitbit with their wearables in the early 2000’s, employers began part-
nering with biodevice companies to provide monitors to their employ-
ees free of charge. Employees were encouraged to participate in the
initiatives as a company-wide push for health, and employers began to
strongly push for the program as it allowed them to access details about
their employee’s health and adjust their company insurance plans ac-
cordingly.8 Although illegal, some companies went as far as to require the
mental health data of prospective employees to ensure they were only
hiring the “strongest” candidates. On the other side of the coin, other
employers highlighted the advantages of using a biodevice so that they
could better understand and accommodate you if you needed a mental
health or stress-related break from work.9
In recent years, a small group of activists have been pushing for the ban
of biodevices monitoring, or at least the transparency of medical data
derived from biodevices. Critics highlight that most biodevices are not
equipped with the functionality to tell you exactly where your data is
going and how it is being used, and that it is unethical to allow consum-
ers to provide this data at such an unknowing level. On the other hand,
big brother +
proponents of biodevices highlight the gains in medical development

that they have developed, as well as the lives they have saved through
the government’s public health monitoring system. They also point out
that it’s too late to go back - we’ve lost the traditional infrastructure
to support a medical system without biodevices, so instead, we should
continue to forge forward. Regardless of your position, it’s impossible to
ignore the health benefits and the ease of a healthy life that has come
with the biodevice revolution. ≠
trends:
4. Increase of disease outbreaks
5. Biodevice formation is driven by the pharmaceutical and healthcare industries, with government support.
6. The health data industry, driven by companies selling patient data to other companies, continues to grow
7. Healthcare becomes more dispersed and long-distance healthcare becomes more common, especially in rural communities.
8. Employers are actively engaged in the fitness and health tracking of their employees.
9. Employer monitoring of employee health and mental health, and new workplace health plans and incentives
60
Interview from The Economist March 2045
How do you use your biodevice?

An interview with En (Age 52), a Bio School Monitor
How do you feel about biodevices? How have they impacted your every-
day life?
I’m a huge fan of my Fitbit Nano. I remember the days before biodevices
were on the market and I was in my early twenties. I had so much energy
and I felt so healthy. I lost that as I began to get older, but with my
biodevice, I constantly feel young again. It’s so great to be able to wake
up in the morning and have my biodevice app tell me exactly what my
energy levels are, and have my coffee and breakfast prepped with the
vitamins and nutrients needed to balance my health and body. I have my
biodevice set up to create meal plans for each individual day based on
my macro, nutrient and vitamin levels, and then each meal is 3D printed
and ready to go before I leave for work. My biodevice is also linked to my
calendar, so if it knows I have an incredibly stressful day or week, it will
make sure there is some CBD or psilocybin in my meals. My Nano tells
me everything from how much I should sleep each night to whether my
bowel movements are in order. It’s so great and I have so much energy
now. I always feel like I have that healthy glow of my early 20s - I would

never go back to life before my Nano.
Have you opted to share your biodevice data with your employer?
Yes! I know some people are concerned about the security impacts
but its just data. I think I might reconsider when biodevices are able to
treat you as well as just monitor your health but for now I don’t care. My
employers offers incentives and bonuses for its “elite employees”, the
healthiest in the company. It means we get better offices and working
hours, and we’re first in line for vacation days. I’ll walk to work as much
as possible in the shoulder seasons to keep my step count and heart
rate high. In the winter and summer when the weather is too extreme to
walk, I actually have a bicycle desk installed in my office so I’m constantly
moving.
Your job has been borne out of this biodevice age. Can you tell us a bit
about that?
Although a lot of jobs have been replaced by tech, the Toronto District
School Board has had a recent push to bring a human element back in
to work alongside the technology. There’s been some uproar about the
technology monitoring kids, so this is their attempt to bring balance
back into the picture, and I get to learn from all this advanced software
big brother +
which is really cool. My job is essentially to watch the software scan the
biodevices of everyone who enters the school. If they are unhealthy, the
software automatically determines an action, and my job is to monitori
the software to confirm that the directed action is actually completed.
For example, last week, a fourth grader was showing early signs of the
common cold. Nothing too serious, but we wanted to make sure that ≥ his
61
school lunch was fortified with extra Vitamin C and nutrients. So we were
able to watch the software pull up his biodevice information and see
that he was low in about five different nutrients. This information was
then sent to the 3D lunch printers, and the extra nutrients were then
printed into his lunch. For the duration of the day, my team was tasked
with monitoring his vitamin and nutrient levels to ensure that everything
was going according to plan.
Do you see any downsides to biodevices?
My partner was recently quarantined by the government after his device

- he has the Microport Link - reported that he was experiencing the ear-
ly symptoms of the trichnolo virus. Since the government doesn’t have
enough information on the spread of this disease yet, they’ve taken him
away to be quarantined until he is recovered. I feel a little uncomfortable
knowing that the government is monitoring all of our bodies like that, but
I also know it’s for the best of the population. If we can avoid anything
like the Lockport disaster or the Calgary dengue outbreak, I’m all for it.
Epidemics just break out so fast these days, you know, we can’t be
too careful. ≠
1. Technological advancements leads to implantable biodevices that theguardian.com/environment/2018/oct/08/global-warming-must-

monitors personal health. not-exceed-15c-warns-landmark-un-report
Supporting Class Trend: The Healthscare System by Sreemoyee Roy- 3. Government and insurance companies play a more active role in
choudhury monitoring health of the population in order to prevent deaths due to
Supporting Class Trend: A Peek Inside by Sara Qarizada climate change or environment-related disasters.
Supporting Class Trend: Big Pharma Tech by Moritz Miethke Supporting Class Trend: Planetary Health by Riley McCullough
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redcat-blog/lab-chip-monitor-health/ change
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happened. ca/dhw/populationhealth/
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big brother +
Additional Resources: National Environmental Public Health Tracking Program: Bridging the
Jones, T. (2019, March, 6). Green New Deal Support May Cost Politi- Information Gap. Environmental Health Perspectives. doi: https://doi.
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https://www.investors.com/politics/green-new-deal-ibd-tipp-poll/ Reichel, C. (2019, January 22). The current and project health risks
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theguardian.com/environment/2018/dec/05/trumps-disbelief-wont- mate-change-research-review/
stop-dangerous-climate-change Scott, M. (2018, May 31). Insurers Will Be Hard-Hit By Climate Change
Siciliano, J. (2019, February 13). Coal plant closures need to be “rad- But They’re Not Investing in the Low-Carbon Economy. Forbes. Re-
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Examiner. Retrieved from https://www.washingtonexaminer.com/ insurers-in-the-front-line-of-the-fight-against-climate-change-
policy/energy/coal-plant-closures-need-to-be-radically-accelerated- shoot-themselves-in-the-foot/#4204903a40fa
to-meet-climate-change-report-finds
Watts, J. (2018, October 8). We have 12 years to limit climate change 4. Increase of disease outbreaks.
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Supporting Class Trend: Vaccine Hesitancy by Kathryn Kramer thestar.com/news/investigations/2019/02/20/medical-record-soft-
Additional Resources: ware-companies-are-selling-your-health-data.html
Centres for Disease Control and Prevention. (n.d.). What Would Happen Thielman, S. (2017, January 10). Your private medical data is for sale -
If We Stopped Vaccinations? Centres for Disease Control ad Prevention. and its driving a business worth billions. The Guardian. Retrieved from
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Global News. (2019, March 8). Hundreds of children dead after Mada- ta-multibillion-dollar-business-report-warns
gascar measles outbreak. Global News. Retrieved from https://global-
news.ca/video/5036265/hundreds-of-children-dead-after-madagas- 7. Healthcare becomes more dispersed and long-distance healthcare
car-measles-outbreak becomes more common, especially in rural communities.
Healio. (2018, April). US measles outbreak catalyzed by vaccine hes- Supporting Class Trend: The Long-Distance Doctor by Sara Qarizada
itancy. Infectious Diseases in Children. Retrieved form https://www. Supporting Class Trend: Reversing the Flow by Trishia Nashtaran
healio.com/pediatrics/vaccine-preventable-diseases/news/print/
infectious-diseases-in-children/%7B8073077c-43e9-407a-8766- 8. Employers are actively engaged in the fitness and health tracking of
4752884bb162%7D/us-measles-outbreaks-catalyzed-by-vaccine-hes- their employees.
itancy Supporting Class Trend: Population Health Management by Andrew
Krans, B. (2018, December 2). This is What Happens When Children Walls
Don’t Get Vaccinated. Healthline. Retrieved from https://www.health- Additional Resources:
line.com/health-news/this-is-what-happens-when-children-dont-get- Dignan, L. (2018, September 19). Fitbit launched Fitbit Care platform for
vaccinated healthcare plans, expands Humana partnership. ZD Net. Retrieved from
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sles outbreaks, health experts warn. The Globe and Mail. Retrieved form for-health-care-plans-expands-humana-partnership/
https://www.theglobeandmail.com/canada/article-canada-could-see- Lovett, L. (2018, May 3). With sales in decline, Fitbit looks to part-

large-amount-of-measles-outbreaks-health-experts/ nerships, digital health for the future. Mobi Health News. Retrieved
from https://www.mobihealthnews.com/content/sales-decline-fit-
bit-looks-partnerships-digital-health-future
5. Biodevice formation is driven by the pharmaceutical and healthcare McCaughan, D. (2010, October 6). How Japan’s Toilets Have Become
industries, with government support. Symbolic of Cultural Norms. AdAge. Retrieved from https://adage.com/
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Walls Tippen, B. (2016, June 7). Fitbit Introduces “Fitbit Group Health” for
Additional Resources: Corporate Wellness, Weight Management Programs, Insurers and
The Irish Times. (2017, September 4). New Euro 8 million biodevices Clinical Research. Business Wire. Retrieved from https://www.busi-
laboratory opens at Ulster University. The Irish Times. Retrieved from nesswire.com/news/home/20160607005759/en/Fitbit-Introduc-
https://www.irishtimes.com/business/health-pharma/new-8m-biode- es-%E2%80%9CFitbit-Group-Health%E2%80%9D-Corporate-Wellness
vices-laboratory-opens-at-ulster-university-1.3208209
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Retrieved from https://www.newswire.ca/news-releases/biomedi- Supporting Class Trend: Burnout Generation by Riley McCullough
cal-industrys-leading-companies-to-present-breakthrough-technolo- Supporting Class Trend: Using Technology to Sense Anxiety by Karli
gies-at-biodevice-2014-513953821.html Ferriolo
UBM China. (2014, April 2). The Feature of Biodevice 2014: Authoritative Additional Resources:
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Retrieved form https://www.newswire.ca/news-releases/the-fea- Employee Health and Pregnancies. Popular Science. Retrieved from
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Goldstein, R. (2018, September 7). The Benefits of Fitness and Activ-
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Supporting Class Trend: Access to Health Data by Andrew Walls ness-and-activity-trackers-in-the-workplace/#540381f269cf
Supporting Class Trend: Big Pharma Tech by Moritz Miethke Miller, B. (2017, January 30). Avoiding Mental Health Discrimination int
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63
Data Over Flowers
no-climate action; individual owned data
Article from The Economist digital weekly edition
How our body bots just might save the planet

We ignored scientists and their multiple warnings. So why now?
Liin Nur | March 18, 2045
When Cape Town declared that they would be reaching “Day Zero” in
April 2018, they had become the first major city in the world to poten-
tially run out of water.1 Although Cape Town was able to postpone this
event for a few more years,2 a severe drought would eventually lead
to the city completely running out of water in 2022. Within five years
following this event, Cairo would become the second city in the world to
run out of water.3 By 2040, 20% of the world’s major cities had either
no water or were projected to run out of water in the next six months.
Since then, we have seen this percentage continue to grow. Around the
globe, countries are reporting new weather phenomena such as days of
drought alternating with days of acid rain. This unpredictable weather
has led to mass migration from countries that are facing the biggest
effects of climate change.
In many resource-rich countries, these refugees have been met with

strong resistance and, in some cases, violence. In response to these
changes, on January 15, 2042, the United Nations declared climate
change displacement as the biggest challenge facing the world in this
next quarter century. We should not be so surprised though; after all,
this was predicted by scientists decades ago. But even though the po-
tential catastrophic effects of climate change were first identified over
50 years ago,4 minimal action was taken in response. In the absence of
a unified agreement to address climate change, we watched as the air
around us grew more polluted, the temperature continued to rise, and
new climate change related diseases emerged. After years of inaction,
the wakeup call that has started to spur countries into action came from
the least likely of places: a tiny robot inside of us.
Internal Health Trackers, or body bots as they have come to be more

commonly known, were first approved for medical use in Canada as
Continuous Glucose Monitors (CGMs) for diabetics in 2016.5 At the same
time, personal fitness and health wearable trackers were readily available
on the consumer market and could track anything from heart rate to
data over flowers
steps and sleep. The challenges with these wearable devices were their
accuracy, limited health information, and the fact that in order to track
information they had to be worn somewhere on the body. However, a
rise of do-it-yourselfers saw the accuracy and increased health informa-
tion available on the CGMs and were intrigued by the prospects.6 What
started as a few people buying CGM devices on Amazon soon turned into
a brand new market. To better meet this emerging need, start-ups like ≥
64
Sano Intelligence partnered with existing wearable device technology
companies to bring ‘invisible’ and more accurate health trackers to the
consumer market.7,8 However, as more and more people purchased
these medical devices for non-medical use, concerns around who owns
the health data being collected grew.
In 2020, a number of health tracking companies such as Fitbit, Xiaomi,

and Dexcom faced a massive data breach that left close to 1.5 billion
people’s personal health information exposed. In direct response to
the backlash these companies faced, new privacy-oriented health data
organizations emerged in the mid-20s with the promise to give back
control of the data to the individual. This did little to appease concerns
as the data was still housed on a cloud-based software open to potential
attacks. However by 2030, blockchain became the most common tool
for data management and with the added privacy, grew into the plat-
form of choice for personal health information.9 Reassured by the high
security and interested in having instant access to an endless amount
of personal health information, sales for the new and improved Inter-
nal Health Trackers grew immensely. By the mid-2030s, the majority of
North America and Europe’s population had a tracker the size of a dime
roaming around inside their bodies. Access to the trackers for the entire
population was made possible by the passing of two key Acts on June 13,
2039. With this, the Government of Canada committed to capping the
cost and providing subsidies for these devices.

So what exactly does this have to do with climate change? Well, the vast
amount of accurate personal health information that gives individuals
agency to make informed choices was also the key scientists needed to
highlight the dangerous effects of climate change. March 5, 2036 is per-
haps the most important and overlooked date in the history of climate
change action. It was on this day that the Government of Canada al-
lowed individuals to sell their personal health information to private and
public companies. Almost immediately after this happened, a research
partnership between the University of Toronto and the United Nations
purchased thousands of health data from Canadians across the country.
As other governments passed similar legislation to allow individuals to
sell their data, more and more research institutions followed suit and
collected and analyzed the data of their citizens. Individuals who par-
ticipated in this study were followed for five years which gave scientists
detailed information on their health during this time. When the results
from this international study were published on October 19, 2042, the
verdict was clear: climate change is killing us.
Five years after this milestone study, the response has been swift.
The United Nations renewed international talks on climate change and
data over flowers

through citizen pressure, countries have expressed interest in signing a
new Agreement. With the 2045 United Nations Climate Change Con-
ference only a few weeks away, the question on the minds of many is
whether or not this time there will be action taken. But what makes this
different than all of the previous attempts is that we have all been em-
powered by our friendly neighbourhood body bots to demand change.
After all, this issue is now personal. It is a matter of life and death. ≠
65
One evening in December 2034 when Fartun was just 2 weeks old, her
parents Adam Duale and Asha Farah were rushing to the hospital. Their
newborn daughter stopped breathing and the terrified parents weren’t
sure what was happening.
“They told us that she was a healthy baby when she was born so this was
completely unexpected”, recalls Farah. After that first visit to the hos-
pital, the family would spend countless days and nights in and out of the
emergency department. As they would later come to understand, Fartun
had a disease that was previously only seen in adults called Chronic Ob-
structive Pulmonary Disease (COPD).
“The doctors said her lungs were blocked which is why she was having
difficulty breathing”, says Duale. They show me a scan of Fartun’s lungs
when she was 2 weeks old and I find it hard to believe that these are the
lungs of an infant. Her dad chuckles and tells me, “That’s exactly what
we said! The doctors said that these lungs looked like they came from an
adult who had smoked 5 packs a day for 40 years.”
Looking at Fartun now, it’s not hard to notice that she isn’t as healthy as
other 11-year-olds. I ask about what a typical day in her life looks like and
the bright-eyed, soft-spoken young girl tells me that there isn’t such a
thing as a typical day. “When I wake up, the first thing I do is check my
phone for my readings. If my lung capacity is green, I make my way to the
bathroom and then downstairs to eat breakfast.” Farah chimes in to clar-
ify that the lung capacity reading is used to determine whether Fartun
can get out of bed or not and that Farah checks air quality once she sees
her daughter having breakfast to determine whether or not she can go to
school. “For example, Fartun hasn’t been able to leave the house since
last Tuesday which is terrible because she should be able to go to school
and see her friends”, says Duale.
But Fartun, the family admits, is one of the luckier children. As soon as
she turned one, she was implanted with an Internal Health Tracker so
that her parents could continually track her vital information. Shortly
after, her parents signed her up for the joint University of Toronto and
the United Nations longitudinal study on the health effects of climate
change. “When the results of the study came out showing that climate
change has had severe effects on our health, even shortening our
data over flowers
lifespan, I can’t say Adam and I were surprised”, says Farah. I ask Fartun,
Asha, and Adam one last question: if you could say anything to the world
leaders gathering in New York a few weeks from now, what would you
say? This time it’s Fartun who speaks up, “I would ask them to consider
saving the planet before there isn’t anything left to save” ≠
66
Trends from the class that informed the development of this scenario dicted Warming: Scientists. Livescience. Retrieved from: https://www.
were: livescience.com/25367-first-ipcc-climate-report-accurate.html
A peek inside by Sara Qarizada
Access to health data by Andrew Walls Dexcom. (2016, November 14). With Health Canada approval, Dexcom
Biohacking for do-it-yourself medicine by Lisa Taylor G5® Mobile CGM System is the First Medical Device in North Amer-
Climate-change mortality by Kathryn Cramer ica for Making Daily Diabetes Decisions Without Painful Fingersticks.
Democratizing healthcare by Moritz Miethke dexcom.com. Retrieved from: https://www.dexcom.com/news/
Do-it-yourself health by Liin Nur health-canada-dexcom-g5-mobile-approval
Planetary health by Riley McCollough Sifferlin, A. (2017, March 16). Why Perfectly Healthy People Are Using
Diabetes Monitors. Time. Retrieved from: http://time.com/4703099/
Additional resources: continuous-glucose-monitor-blood-sugar-diabetes/
City of Cape Town. (2017, November 15). Day Zero: when is it, what is
it, and how can we avoid it? Cape Town Government, Retrieved from: Turton, W. (2017, February 9). Nobody Needs This Silicon Valley-Made
http://www.capetown.gov.za/Media-and-news/Day%20Zero%20 Blood Sugar Tracker for ‘Wellness’ and Lifestyle. Gizmodo. Retrieved
when%20is%20it,%20what%20is%20it,%20and%20how%20can%20 from: https://gizmodo.com/nobody-needs-this-silicon-valley-made-
we%20avoid%20it blood-sugar-track-1791564339
Petersen, T. (2018, June 28). No Day Zero for 2019 – City of Cape
Town. News24. Retrieved from: https://www.news24.com/SouthAfri- Farr, C. (2018, January 5). To catch Apple, Fitbit invests in a company
ca/News/no-day-zero-for-2019-city-of-cape-town-20180628 that makes a small patch to track blood sugar for diabetics. CNBC.
Retrieved from: https://www.cnbc.com/2018/01/05/fitbit-invests-in-
Zhenmin, L. (2018, October 14). Opening Remarks 1st Cairo Water sano-diabetes-tech-start-up-to-catch-apple.html
Week - “Water Conservation for Sustainable Development”. United
Nations. Retrieved from: https://www.un.org/development/desa/ Katalyse.io. (2018, July 7). Why Blockchain Is The Future Of Data Stor-

statements/mr-liu/2018/10/water-conservation-for-sd.html age . CryptoDigest News. Retrieved from: https://cryptodigestnews.
com/why-blockchain-is-the-future-of-data-storage-b5636b823293
Parry, W. (2012, December 9). 20-Year-Old Report Successfully Pre-
data over flowers

67
Greener on the other side
climate action; individual owned data
Article from CBC Politics March 2045
Canada passes data protections act

Jacquie Shaw | March 18, 2045 5:00 PM EST
OTTAWA, Canada — Canada’s Prime Minister Kalkáy Dawson announced

today the passing of Bill-H45, Canada’s Data Protections Act. The Data
Protections Act designates all personal data generated by Canadians as a
protected intellectual asset.
“This is a step forward in facing a pervasive issue of the 21st century,”

said Green Party Member of Parliament and Minister of Digital Affairs,
Hon. Sasha Martin, to the press following the announcement, “Giving
Canadians full rights over their data ensures the protection against ex-
ploitation and shows Canada’s commitment to digital human rights.”
Canada’s Data Protection Past

Data privacy and rights have been a hot button issue for Prime Minister
Dawson and the Green Party over the last two years following her elec-
tion. Several election platform touchpoints for Prime Minister Dawson
during the 2043 campaign focused on the global trend of data privacy
concerns, the then proposed Bill-H45 was promised to institute policies
to ensure more comprehensive data rights for citizens while protecting
Canadians from hacking and digital terrorism attacks.
The urgency for data protections as Canada prepares to enter the sec-
ond half of the 21st century has only escalated, as the negative effects
of lacking protections have been globally demonstrated over the last
two-decades. Although global shifts over the past 15 years towards
blockchain enabled data encryption have progressed, lessening the
chance of massive data breaches and digital terrorist attacks which
plagued the late 2020s, these anti-hacking and digital security measures
have proven to not be enough to protect people globally from digital
data exploitation by shady actors.
greener on the other side
The Canadian government has acted previously to ensure data pro-

tections for Canadians. In 2037 anti-private data sales legislation was
passed following the mass 2036 insurance and credit scandal in the
United States, with five major banks caught selling personal spending
data to insurance companies. This revealed that the data of spending
habits and purchases affected the insurance rates and coverage offered
to individuals.
The amount of data created and recorded has helped define the 21st
century and our current world. As populations continuously create and
share massive amounts of data ranging from entertainment and spending
68
habits, to sensitive and individual biomedical and environmental infor-
mation, they’re also put in more vulnerable and precarious positions
without protections.
This new legislation has not come without its fair share of controversies
and complications. The Data Protections Act has been delayed for over a
year due to a long process of policy consultation and revisions following
concerns of the bill’s implications regarding Canadian health services,
data rights of minors, and the effects on the Canadian sharing economy.
Since it’s first proposal two years ago during the 2043 election, Bill-H45
has received push back from several different parties including health-
care industry workers, parents groups, and members of government.
Concerns about Healthcare
Throughout the two years of proposal and development of Bill-H45

much of the critique and concern have come from provincial health
ministries, and the national interest group Canadians for Access for
Health Practitioners and Research (CAHPR). CAHPR formed quickly after
then MP Kalkáy Dawson announced the proposal for a data protections
and privacy act focusing on individual intellectual asset ownership of all
personal data. CAHPR presented concerns regarding how patient owned
data could drastically affect Canadian healthcare systems, which rely

on the data collected by Canadian’s internal health trackers, along with
other health care data such as x-rays, scans and test results. Another
main concern primarily from healthcare providers within CAHPR were
potential health risks if data intellectual asset ownership would mean
that patients could withhold or revoke medical information from both
human and AI health practitioners.
“It’s been a long process to get Bill-H45 to a place where we feel it best
suits the needs of Canadians as we enter the second half of the 21st
Century,” Minister of Health, Hon. Abel Joseph-Marquéz stated during
a parliamentary meeting yesterday afternoon, “We’re confident that by
taking the time to rigorously consult not only with provincial health min-
istries, but also with the Canadians who work in and use the healthcare
systems, this new legislation works to protects Canadians against data
attacks and exploitation, while granting further access to their health
information with no disruption to the current healthcare system.”
After Minister Joseph-Marquéz’s remarks Minister Martin also further

spotlighted the necessity to continue through action and legislation the
priority of the protection of Canadians through the Data Protections
Act, “Throughout the 21st century we have gone from data collection
for research being an arduous and time consuming process, to one
that is instantaneous and inseparable from our daily lives. Canada has
been able to develop and understand the needs of citizens through the
collection of data. From our 21st century data collection we’ve been
able to research and understand what was previously impossible. From
understanding climate change and environmental impacts on the health
of Canadians across the country and even abroad, to providing incred-
ibly accurate and timely telemedicine to previously underserved com-
munities. We want to make sure we best protect the people who make
research, and these breakthroughs possible.” ≥
69
A Global Leader in Human Rights
Throughout the 21st century Canada has acted as a global leader on

legislation that promotes and protects human rights. Near the turn of
the century in 2005, Canada became the first non-european country to
legalize same-sex marriage. Canada again made global history in 2030
as the first large oil producing country to announce a federally backed
national commitment and incentives to divest completely from fossil
fuels by 2042. Citing a commitment to human environmental rights, the
move toward fossil fuel divestment followed the success of municipality
backed efforts of fossil fuel divestment movements which started in the
early 2020s.
Many other countries are now looking to Canada as they continue to

pursue legislation that places individual human rights above the interest
of external actors.
“Canada continues its 21st century commitments to furthering human

rights, not only for current, and future Canadians, but by taking action
as a global example of what it means to take care of each other.” Prime
Minister Dawson, closed her announcement. ≠
70
Column taken from Afar March 2045 issue
Ask Aiko: What is going to happen to my remote

family’s data!?
Hi Aiko,
My family and I have been living remotely for about 5 years after moving
back home to the Heiltsuk Territory. I never imagined moving back, but
the vibrancy and growth the area has experienced with investments in
green energy and land and cultural reconciliation makes me proud to call
this place home again. It’s been amazing living back on Heiltsuk Territo-
ry and having my son grow up amongst our culture, while my husband
works along the coast as a tidal energy engineer. But I’m worried that we
might not be able to stay much longer because of Bill-H45.
We originally moved to be closer to my aging mum as she lives with

rheumatoid arthritis which at times can be debilitating. Originally we
were thinking we’d have her move with us to the city to be less remote,
but advancements in remote healthcare access and AI care mean that
we were able to move back to Bella Bella instead of worrying about
living in a city as a multigenerational family, just to be close to medical

specialists. The biggest change in being able to monitor and care for my
mum was when we finally convinced her to get an internal health track-
ing device. She was resistant, but my husband — who has always been an
early health tech adopter since growing up in Hong Kong and seeing the
benefits of the required air quality sensors as a kid — finally convinced
her that by adopting continuous health tracking we’d be able to have her
set up with an in-home digital assistant, meaning even with her RA she’s
able to keep much of her independence.
I’m often running around the community, but I’m also the man who
keeps the house running. I use the data that I collect from my family to
do everything from keeping our medical records up to date, to more
day-to-day tasks like knowing what nutrients we’re missing after a busy
week and pizza dinners, or our in-home air and water quality without me
having to think too much about it.
My main concern is what happens to my family’s medical records when

the DPA comes into effect. Will I no longer be able to access my mother,

my husband, or my son’s medical data? What data does my son control
as a ten-year-old boy? Can he hide important information? Remote living
has really only been made possible for us with all our data going into the
family cloud and out to services.
I just want to know how this new bill will affect running my home, espe-
cially as a parent of a busy 10-year-old, and the child of an independent
but aging mother.
Signed,
Data Dependent Dad
71
Oh Data Dependent Dad,
It sounds like coastal life is not as laid back as many people think it to be,
but like you said, it’s all made easier with the great data-based services
that make remote living just as connected and rewarding. Part of the
remote living movement was definitely made possible because of the ac-
cess to services such as food and healthcare being more affordable with
driverless vehicles, accurate needs data, and digital home assistance.
The DPA shouldn’t affect any of the access you have for your fami-
ly members and the information you need to run your household as a
working father. What you should do though is make sure that you double
check all your sharing permissions! For small things like nutrients and
home air quality it can be done by asking your home assistant, it’ll run
you through the step-by-step process for your integrated life. For more
sensitive data such as medical records (since it sounds like you already
run your family affairs through data), nothing will change.
Just a quick overview of the law as it affects children and minors: Par-
ents are secondary data owners until a person reaches the federal voting
age of 16. This doesn’t mean that you’re privy to all the data (as we know
being a teen can come with some embarrassing moments), but it does
mean that health and environmental data is easier for you to gain access
to without paperwork.
Don’t worry Data Dad! Your household will most likely keep working just
as smoothly as before, if not even smoother as we see the rollout of
Bill-H45 and the Data Protections Act.
Aiko
Aiko Torres is Afar’s expert-in-remote. Each issue she answers readers’

questions about the remote living movement. She’s written two books on
the remote living movement “Tiny Homes, Great Big Country”, and “Far-
off Families: Remote living with your kin”. ≠
72
Trends and resources used to inform the development of scenario: Trends from the class that informed the development of day in the life:
Nurse Alexa by Jacquie Shaw Nurse Alexa by Jacquie Shaw
Human Services Data Sharing Revolution by Lisa Taylor Biohacking for do-it-yourself medicine by Lisa Taylor
DNA Dictating Diet and Exercise by Lisa Taylor DNA Dictating Diet and Exercise by Lisa Taylor
Big Pharma Tech by Moritz Miethke Big Pharma Tech by Moritz Miethke
Democratizing Healthcare by Moritz Miethke Democratizing Healthcare by Moritz Miethke
Planetary Health by Riley McCollough Planetary Health by Riley McCollough
Smart Pills/ Ingestible Sensors Are Offering Access To The Inside Of Our Bodies Like Never Smart Pills/ Ingestible Sensors Are Offering Access To The Inside Of Our Bodies Like Never
Before by Sara Qarizada Before by Sara Qarizada
Telemedicine Is On The Rise As More Areas Of Healthcare Are Incorporating Digital Systems To Telemedicine Is On The Rise As More Areas Of Healthcare Are Incorporating Digital Systems To
Their Practices by Sara Qarizada Their Practices by Sara Qarizada
Access to Health Data by Andrew Walls Connected, But Lonely by Igor Bueno
Home Clean Air Affordability by Igor Bueno
Other References Used: Dial-a-Doc by Patricia Wong
Berti, B. (2015). What are the universal Human Rights. Retrieved from https://www.youtube.
com/watch?v=nDgIVseTkuE
Carrington, D. (2018, July 12). Ireland becomes world’s first country to divest from fossil fuels.
The Guardian. Retrieved from https://www.theguardian.com/environment/2018/jul/12/ire-
land-becomes-worlds-first-country-to-divest-from-fossil-fuels
Fry, E., & Mukherjee, S. (2018, March 19). Tech’s Next Big Wave: Big Data Meets Biology. Re-
trieved March 17, 2019, from http://fortune.com/2018/03/19/big-data-digital-health-tech/
Government of Canada, I. (n.d.-a). A guide to copyright - Canadian Intellectual Property Office

[Guides]. Retrieved March 17, 2019, from https://www.ic.gc.ca/eic/site/cipointernet-interne-
topic.nsf/eng/h_wr02281.html
Government of Canada, I. (n.d.-b). Understand the basics [Reports]. Retrieved March 17, 2019,
from http://www.ic.gc.ca/eic/site/cipointernet-internetopic.nsf/eng/wr03585.html
Kulik, T. (n.d.). A Kick In The Assets: The Big Deal About Big Data & IP. Retrieved March 17, 2019,
from https://abovethelaw.com/2017/11/a-kick-in-the-assets-the-big-deal-about-big-data-
ip/
Marcus, M. (2019, March 5). Invitation to tender: Study of the economic and social returns
of ‘Open standards for data’ – The ODI. Retrieved March 17, 2019, from https://theodi.org/
article/invitation-to-tender-study-of-the-economic-and-social-returns-of-open-standards-
for-data/
Open Data Institute. (n.d.). About the ODI – The ODI. Retrieved March 17, 2019, from https://
theodi.org/about-the-odi/
Patient Data Ownership and Data Property Rights Emerge as a Theme at Leading Pharma Exec-
utive Event. (2019, March 15). Retrieved March 17, 2019, from https://www.businesswire.com/
news/home/20190315005107/en/Patient-Data-Ownership-Data-Property-Rights-Emerge
Right to Privacy in the Digital Age. (n.d.). Retrieved March 17, 2019, from https://www.ohchr.
org/en/issues/digitalage/pages/digitalageindex.aspx
UN environment. (n.d.). What are your environmental rights? Retrieved March 17, 2019, from
http://www.unenvironment.org/explore-topics/environmental-rights-and-governance/what-
we-do/advancing-environmental-rights/what-0
data over flowers

United Nations. (2016, August 30). Human Rights. Retrieved March 17, 2019, from http://www.
un.org/en/sections/issues-depth/human-rights/
73
Green giant
no-climate action; corporate + gov’t owned data
Article from The Economist March 2045
How our health data saved the planet

Your body bots are helping climate stability. But for how long?
Igor Bueno | March 18, 2045
A YEAR AFTER the measles outbreak in the Philippines1, with around

15,000 confirmed cases and 250 deaths, the measles appeared in Toron-
to, marking the city’s worst tragedy in the 21st century. The 2022 Toronto
measles outbreak led Canada to establish forced vaccine protocols in
exchange for tax credits and other benefits in 2025. Although the proto-
cols were opposed by some citizens, the vast majority of public opinion
supported the government and asked for stronger policies, leading to
the government’s 2027 legislation that saw public schools requiring vac-
cination records to reduce the risk of new epidemics.
With the increased value of health data, employers followed

suit and began requiring immunization records for employment. By
2030, it was common to have employers requiring access to health data
from wearable personal health trackers which were commonly used by
employees. Although data from personal health trackers had improved
no climate action; corporate owned data
significantly over the past ten years, the same can’t be said regarding
the public health database. The rich value of vaccination records cou-
pled with a weak data system allowed numerous data breaches and the
emergence of a black market where doctors and hackers faked govern-
ment health data and immunization records upon request. As a way to
crackdown on the black market and increase data security, the govern-
ment implemented partnerships with corporations in the mid-2030s to
intensify the funding of Internal Health Trackers, now commonly known
as Body Bots. After five years, Body Bots were largely available on the
consumer market, with the profit going to the corporations, and the data
jointly owned by the corporations and the government.
The adoption of Body Bots was significant in its early years, surpassing
all forecasts. Body bots were marketed as the most effective way to
track personal health and they did away with the annoyance commonly
observed with other trackers, smartwatches, biodevices or home-based
voice controlled devices, such as the need to keep a full battery or re-
membering to actually input or record your data.
But how did this health data evolution support environmental action?
green giant
Many analysts say that it all started with the new Green Deal signed by
the United States in 2025. This event triggered other countries to follow
suit and begin to gradually shift away from fossil fuel use and increase
their incentives for the sharing economy. This led to a reduction in re-
source use and an increase in “green” companies. Green innovation
74
funding hit its peak in 2035, coinciding with the government’s increased
role in health data security and tracking. Thus, Body Bots incorporated
capabilities such as payment abilities and GPS location that could inform
the government of citizens actions and impacts on the environment. In
2040, when Body Bots were readily available, the government began of-
fering incentives to individuals whose Body Bots reported that they were
using green products or contributing to greener ways of living.
Nowadays, some analysts say the green cities model linked with Body
Bots may collapse in the future if people begin to care less about the
benefits provided by making green choices. However, proponents of
Body Bots reinforce that the data sharing from these devices goes be-
yond government’s incentives to sustainable purposes, it also allows ac-
cess to education and health systems and allows employers to assess the
health and other data generated by the devices. Finally, the convenience
of having a Body Bot and the ease of life that comes along with it, in
addition to the health gains and positive environmental impact, remain
significant reasons as to why individuals continue to use and endorse this
technology. ≠

green giant
75
Taken from Gizmodo March 2045
WHILE SEARCHING for a new job on LinkedIn, Mark Smith noticed that
his Body Bot was no longer helping him pursue his career goals. Three
years ago, when he bought his current Body Bot 3S, he did not have the
money to upgrade to the better version with capabilities to follow daily
glucose and blood pressure. Now, he is missing the ability to track this
data and it is required to be a perfect match for a position at the LCBO.
“I wanted to change from my current job to a better position, but I don’t

have the data requirements for the positions that interest me. I guess I
have to change my Body Bot before I start applying”, said Mark Smith,
The data requirements for new jobs attracted both positive and negative
feedback on social media, with many Canadians arguing that it is impos-
sible to upgrade to a new Body Bot to apply for new jobs if your current
job doesn’t pay you enough to have money leftover at the end of the
month.
We contacted the LCBO who explained that the lack of data require-
ments does not mean that a candidate would not be considered for the
position. Moreover, the company said that in the case of hiring a candi-
date lacking data requirements, the company can provide funds to allow
for a Body Bot upgrade.
However, as the hiring processes continue to be secretive, it is impossi-

ble to guarantee that you are going to have the same chance as someone
with all the data requirements. With this in mind, many people are opting
to take out debt in order to have the most recent Body Bot. ≠
green giant
76
Trends that informed the development of this scenario:
Access to Health Data by Andrew Walls
Population Health Management by Andrew Walls
The Healthscare System by Sreemoyee Roychoudhury
Dial-a-doc by Patricia Wong
Precise drug delivery by Igor Bueno Antunes
A Peek Inside by Sara Qarizada
Healing by Nature by Harmnajot Kaur
Vaccine Hesitancy by Kathryn Cramer
Counter-trends:
Planetary Health by Riley McCullough
Human Services Data Sharing Revolution by Lisa Taylor

green giant
77
78
Part 3
Innovation Strategy: Fitbit
Excerpts from Strategy Development Final Documents
79
Strategy
+ Innovation Portfolio
80
For the Strategy Development course, we developed an innovation
strategy for Fitbit. Our process to develop this strategy began with an
in-depth analysis of Fitbit’s current strategy. To do so, we began with
an exploration ofthe industry as well as a competitive analysis of Fitbit
in this space. We also used the Strategic Choice Cascade and Porter’s
Five Forces in order to determine whether the choices Fitbit was making
were strategic and to better understand the company’s competitive en-
vironment. After this analysis, we concluded that Fitbit is currently mak-
ing good choices, but they are not strategic choices. Instead, we found
that these choices were obvious responses to the changing environment
and not proactive enough. Furthermore, in an attempt to diversify their
business, some of Fitbit’s choices, such as moving into the headphones
space, were confusing. Overall,we determined that Fitbit’s current
strategy was struggling with four tension areas. These were: 1. Delivery of
Fitbit Health Solutions is unclear; 2. Fitbit Health Solutions doesn’t have
a streamlined approach; 3. Fitbit lacks a strongtarget audience; and, 4.
Fitbit’s future business model is based on sharing the data of users.
With this current state assessment complete, our team decided to

develop a 15-year innovation strategy for Fitbit. To ensure that Fitbit was
well-positioned for the future, we took a look at the trends driving the
future of health management. There were many trends in this area, so
we chose to focus only on those that may impact the field of personal
health management in the next 15 years. At the end, we pulled from 14
different trends to understand what the future landscape of this area
may look like. The trends show that in the next 15 years, Fitbit will be op-
erating in an environment that is determined by the increase in technol-
ogy-assisted medicine, advanced health tracking techniques, user-cen-
tered and at-home care, and a new relationship with health data from
both patients and healthcare practitioners.
With an understanding of what the future operating environment for Fit-

bit could look like in the next 15 years, we began to construct an innova-
tion intent. The new innovation intent for Fitbit is as follows: Within the
next 15 years, we will be recognized as one of the world’s top five inno-
vative companies across all sectors and the #1 most innovative company
in the health sector by reimaging the possibilities of health tracking to
allow our customers to monitor and improve every aspect of there here.
We then recreated the Strategic Choice Cascade so that all the choices
aligned with this new innovation intent and we developed four new focus
areas for Fitbit to support the intent. The focus areas are: Development
of Health Tracking; Understanding Everyday Health; The Medical Middle-
man; and the Internet of Health.
We developed two to three initiatives for each of these focus areas and
we used the benchmark for a mid-stage technology firm to distribute
these initiatives across the Ambition Matrix. Therefore, the innovation
portfolio of activities contains 45% core initiatives, 44% adjacent initia-
tives, and 12% transformational initiatives. These were then prioritized
on an Impact/Effort Matrix and sequenced over the 15-year timeline so
those that were High Impact and Low Effort were done within the first
five years of the strategy. For this Dossier we have included excerpts
from our final strategy and innovation portfolio.
81
Fitbit’s Current Strategy
Fitbit’s Current Strategy
ations
Where Will We Play?
der in
ing.
How Will We Win?
er living In the health tracking
e. wearables space, in the
smartwatch space, and in the Capabilities
corporate wellness space. Capabiliti
the Provide solutions to personal
health management across a
Fitbit’s products are sold in
spectrum of needs - from Processes and Systems
stores and online in 86
providing you with your
different countries.
exercise levels to connecting Method for users to access
Method for users to
you with health solutions. data (software).
Fitbit is targeting casual Manufacturing data
and (software).
users or those involved in distribution partnerships.
Full integration with all Physical stock and places to
fitness for health Physical stock and
smartphones through the sell products (both brick-
maintenance, not sell products
Partnership strategy for (both
Fitbit app. and-mortar and online).
professional trainers. and-mortar
corporate wellbeing and onl
program.
Leverage corporate wellness Access to health monitoring

In the healthcare provider Access
Partnerships with to health m
hospitals
programs to provide Fitbit technology.
space, through partnerships and healthcaretechnology.
providers.
products to the workforce en
with hospitals and insurance
masse. Data management systems.
companies to monitor Data management
patients’ health stats to
Partner with insurance Continued research and
reduce the need of Continued research
providers and hospitals. Gain development for health
treatment. development for he
the trust of the medical management.
management.
community.
82
ent Strategy
ll We Win?
Goals and Aspirations
Where Will We Play?
To be the market leader in

ons to personal
personal health tracking.
ement across a How Will We Win?
eeds - from
To encourage healthier living In the health tracking
with yourand an active lifestyle. wearables space, in the
smartwatch space, and in the Capabilities
s to connecting
To make everyone in the corporate wellness space.
h solutions. Provide solutions to personal
world healthier. health management across a
Fitbit’s products are sold in
spectrum of needs - from Processes and Systems
n with all stores and online in 86
providing you with your
through the different countries.
exercise levels to connecting Method for users to access
you with health solutions. data (software).
Fitbit is targeting casual Manufacturing and
users or those involved in distribution partnerships.
porate wellness fitness for health
Full integration with all Physical stock and places to
provide Fitbit smartphones through the sell products (both brick-
maintenance, not Partnership strategy for
Fitbit app. and-mortar and online).
he workforce en professional trainers. corporate wellbeing program.
Leverage corporate wellness Access to health monitoring

In the healthcare provider Partnerships with hospitals
programs to provide Fitbit technology.
space, through partnerships and healthcare providers.
nsurance products to the workforce en
with hospitals and insurance
hospitals. Gain companies to monitor
masse. Data management systems.
e medical patients’ health stats to
Partner with insurance Continued research and
reduce the need of
providers and hospitals. Gain development for health
treatment.
the trust of the medical management.
community.
83
Current Strategy Assessment:
Porter’s 5 Forces
THREAT
THREAT OF NEW ENTRANTS
OF SUBSTITUTES THREATPOWER
BUYER OF SUBSTITUTES
THREAT OF NEW ENTRANTS SUPP
THREAT OF HIGH MODERATE

MODERATE HIGH HIGH UNKN
NEW ENTRANTS
Fitbit is operating in a growing Trends are showing a movement
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market a movement
that has seen nearly 20% There
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is chips,
wide is and
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aren’t needed often activit
New entrants
Wearables aren’t need access
needed to capital,
as often when you can track a lot of your
There is a demand for more features
but the lack of proprietary health information through your
when you can track a lot of your at a lower Newpriceentrants need access
and for overall lower to capital,
A com
technology leaves the industry open phone.
health information through your prices. but the lack of proprietary produ
to any company that has access to
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There is a high leavestothe
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is currentlythat
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small players The perceived level of difference
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dominate the remaining market. between wearable health trackers
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less than half makeofup
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and alternative methods is high.
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of substitutes is market. and To
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is thought about
to be the
more accurate
products than wearable
available.
The performance of substitutes is trackers like Fitbit.
still unknown, but is thought to be

There is a growth in the area of
more accurate than wearable
sensor-enabled clothing.
trackers like Fitbit.
THREAT OF
SUBSTITUTION There is a growth in the area of
sensor-enabled clothing.
84
POWER BUYER POWER SUPPLIER POWER SUPPLIER POWER COMPETITIVE RIVALRY
COMPETITIVE RIVALRY
HIGH UNKNOWN HIGH

UNKNOWN HIGH
There is a wide variety of price points There are now many different There are three major players in the
svariety
a wide of
variety
priceand
of
points
price points
options. There are now many differentvendors that could be used to supply There are three major players
market in theApple, and Fitbit),
(Xiaomi,
ions. vendors that could be used toactivity
supplytrackers. market (Xiaomi, Apple, andwith
along Fitbit),
many small players.
There is a demand for activity
more features
trackers. along with many small players.
sand
a demand
for morefor at a lower
features price
more features and for overall lower A company called Flex reportedly Apple is targeting the high price
prices. produces about 75% of the world’s smartwatch and activity tracking
er
andprice
for and
overall
for lower
overall lower A company called Flex reportedly Apple is targeting the high price
wearables. market, and Xiaomi is targeting the
produces about 75% of the world’s smartwatch and activity tracking
There is a low to moderate switching low-price market with wearables
wearables.
cost. Fitbit is currently in the middle Due to the complexity of Fitbit’s market, and Xiaomi is targeting
available thelow as US$15.
for as
soamoderate
low to moderate
switching
of theswitching
road for price comparisons in low-price market with wearables
structure, there’s plenty of options
urrently
bit is currently
in the middle
in the
2019. middle
Fitbit’s Due to the
Iconic smartwatch is complexity of Fitbit’s available for as low as
for substation of parts coming from US$15. are becoming key in
Partnerships
oad
pricefor less than
comparisons in halfin
price comparisons the pricestructure,
of an Applethere’s plenty of options
different manufacturers. That said, differentiation between companies.
Watch. they use big tech names like Bosch
onic
tbit’ssmartwatch
Iconic smartwatch
is is for substation of parts coming from Partnerships are becoming key in
and Toshiba for their sensors. Fitibit experiences low customer
he
n half
pricethe
ofprice
an Apple
of an Apple different manufacturers. That said, differentiation between companies.
Buyers are well educated about the loyalty, unlike Apple.
products available.
they use big tech names like Bosch
and Toshiba for their sensors. Fitibit experiences low customer
There is a low cost of change
are
educated
well educated
about the about the loyalty, unlike Apple. between providers.
ble.
s available.
There is a low cost ofThe performance of competitors’
change
products is thought to be the same
between providers.
or better than Fitbit.
The performance of competitors’

products is thought to be the same
or better than Fitbit.
85
The Future Landscape for Fitbit
The future landscape that Fitbit will be

operating in will be one that is
determined by the increase in
technology-assisted medicine,
advanced health tracking techniques,
user-entered and at-home care, and a
new relationship with health data from
both users and healthcare
practitioners..
86
87
Innovation Intent
Within the next 15 years, we will

be recognized as one of the
world’s top 5 most innovative
companies across sectors and the
#1 most innovative company in
the health sector by reimagining
the possibilities of health
tracking to allow our customers
to monitor and improve every
aspect of their health.
88
89
Fitbit’s Future Strategy Fitbit’s Future Strategy
tions Goals and Aspirations
Where Will We Play? Where Will We Play?
op 5 Be one of the world’s top 5

anies. most innovation companies.
In the healthcare space by How Will We Win? In the healthcare space by
tive providing health tracking Be the #1 most innovative providing health tracking
sector. services to four main target company in the health sector. services to four main target
audience categories: Capabilities audience categories:
or
Capabiliti
lities of By developing new forms of Reimagine the possibilities of
w our The Digital Natives health tracking to allow our The Digital Natives
Digital natives have an Digital natives have an
and customers to monitor and Processes and Systems
expectation that technology will expectation that technology will
of their be integrated into every part of By focusing on new ways that improve every aspect of their be integrated into every part of
their life. health. their life..
our users can understand and An innovation strategy that
An innovation strat
The Chronic Patient interact with their health permeates all levels of the The Chronic Patientpermeates all level
Research and Development
Chronic patients have a need data. organization. Chronic patients have a need
for continuous health forpartnerships andorganization.
continuous health
monitoring and treatment to methodologies.
monitoring and treatment to
By acting as the middleman A governance structure that
understand their illness. understand their illness.
A governance struc
between patients and encourages both internal and
The Aging Individual Partnerships encourages both in
with Internet of
healthcare practitioners. external collaboration. The Aging Individual
Aging populations have Things
Aging populations external collaborati
players.have
increased health problems and increased health problems and
require more visits to the doctor By integrating into everyday Funding and talent require more visits to the doctor
Partnerships with Funding and talent
to understand their health. life through the Internet of management to recruit the to understand
st their health.
professionals inmanagement
the to rec
Things. best talent.
The Medical Community healthcare
The best talent.
industry.
Medical Community
Doctors and healthcare Doctors and healthcare
practitioners will have new Metrics and rewards that practitioners will have new
opportunities to interact with
Metrics and reward
foster a sense of purpose and opportunities to interact with
their patients’ health through foster
their patients’ health a sense of pu
through
a drive for innovation.
data analytics. data analytics. a drive for innovatio
90
re Strategy
ll We Win?
new forms of
th tracking.
How Will We Win?
n new ways that
understand and
heir health Capabilities
By developing new forms of
he middleman Processes and Systems
nts and
By focusing on new ways that
actitioners.
our users can understand and An innovation strategy that
interact with their health permeates all levels of the
into everyday Research and Development
data. organization.
he Internet of partnerships and
methodologies.
By acting as the middleman A governance structure that
between patients and encourages both internal and
Partnerships with Internet of
healthcare practitioners. external collaboration.
Things players.
By integrating into everyday Funding and talent

Partnerships with
life through the Internet of management to recruit the
professionals in the
Things. best talent.
healthcare industry.
Metrics and rewards that

foster a sense of purpose and
a drive for innovation.
91
Focus Areas
Development of Health Tracking Understanding Everyday Health Data
Internet of Health The Medical Middleman
92
Development of Health Understanding Everyday
Tracking Health Data
Providing users with the ability to Using data analytics from our broad
monitor their personal health base of users, expanded individual
information on a regular basis health data can be analyzed to
without the need for doctors visits provide easy-to-understand insights
and lab tests. about users’ health compared to
baseline health information.
Partner and develop products and Providing healthcare professionals

services for FitBit that more fully with the resources to allow them to
integrate into the Internet of Things monitor individuals’ health data
and digital health services. whenever those individuals allow.
93
Development of Health Tracking
OPPORTUNITY STATEMENT REASON TO BELIEVE FUTURE GLIMPSES

Providing users with the ability to Patients are interested in more Growing number of non-diabe
monitor their personal health accurate tracking of personal health using Continuous Glucose Mon
information on a regular basis information. (CGMs) to track blood sugar a
without the need for doctors visits energy levels more accurately.
and lab tests. Patients want more discreet, less
prominent devices for tracking their New developments in the area
health data. clothing and wearables that tra
personal health.
Shift towards connected, integrated,
and decentralized care. Trends include:
The Healthcare System by Mo
A Peek Inside by Sara
Precise Drug Delivery by Igor
94
cking
TO BELIEVE FUTURE GLIMPSES HEAD STARTS

are interested in more Growing number of non-diabetics Fitbit has begun to partner with and
tracking of personal health using Continuous Glucose Monitors acquire different companies such as
on. (CGMs) to track blood sugar and Sano to look beyond the device to
energy levels more accurately. think about holistic health solutions.
want more discreet, less
nt devices for tracking their New developments in the area of Pill-sized ingestible sensors are
ata. clothing and wearables that track currently available on the market to
personal health. measure pH levels, temperature, and
ards connected, integrated, medication regimens, among other
ntralized care. Trends include: things.
The Healthcare System by Moyee
95
Understanding Everyday Health Data

Using data analytics from our broad Currently over 300 million wearable There is a movement towards
base of users, expanded individual devices sold. human-centric approach to he
health data can be analyzed to data.
provide easy-to-understand insights Patients have increased access to
about users’ health compared to their electronic health records. Trends show there will be a
baseline health information. movement towards providing h
Data use in healthcare is leading to data that is easy to understand
more accurate diagnoses.
There will be an increase in the
Influences are changing individuals’ of AI to make sense of patient
relationship with their health. health, including in the diagno
process.
More than 75% of patients expect to
use digital service in the future. Trends include:
Access to Health Data by Andr
70% of adults track at least one The Healthscare System by M
health indicator. Believing Patients by Jacquie
AI in Diagnostic Health by Har
Using Tech to Sense Anxiety b
Human Services Data Sharing
Revolution by Lisa
96
alth Data

over 300 million wearable There is a movement towards a 23&Me allows you to access intimate
old. human-centric approach to health data about your personal genetics
data. and how they may impact your
have increased access to health.
tronic health records. Trends show there will be a
movement towards providing health Apple Health allows you to track a
in healthcare is leading to data that is easy to understand. wide variety of health data from a
urate diagnoses. built-in app on your phone.
There will be an increase in the use
s are changing individuals’ of AI to make sense of patients’ MyFitnessPal allows you to manually
hip with their health. health, including in the diagnostic track your food intake and provides
process. you data regarding nutrients and
n 75% of patients expect to macros.
al service in the future. Trends include:
Access to Health Data by Andrew Other personal health record (PHR)
dults track at least one The Healthscare System by Moyee apps let you store your health data
dicator. Believing Patients by Jacquie and choose who you share it with.
AI in Diagnostic Health by Harman
Using Tech to Sense Anxiety by Karli Sleep Number aggregates data on
Human Services Data Sharing its users sleeping habits to provide
Revolution by Lisa baselines and recommendations to
other users.
97
The Medical Middleman

Providing healthcare professionals Reducing the gap of health There is an increase in digital
with the resources to allow them to information that exists between healthcare and the number of
monitor individuals’ health data doctors and heal practitioners companies investing in it.
whenever those individuals allow. outside of traditional medical
appointments can improve the Technology is enhancing the
treatment of chronic diseases. accessibility of healthcare and
contributing to more user-cent
Delivering more sophisticated care healthcare.
coordination can be a win-win for
both patients and clinicians: The accuracy of diagnostics w
minimization of time and effort, improve with the increased
reduction of follow-ups, increase in availability of AI and data.
patients loyalty, increase of revenue.
Trends include:
Patients’ portals as they currently The Long Distance Doctor by S
exist still present a number of Believing Patients by Jacquie
limitations: portability of data, The Healthscare System by M
patient-generated health data Dial-a-Doc by Patricia
limited for a single episode of care, Reversing the Flow by Trishia
interoperability challenges Nurse Alexa by Jacquie
connecting systems. AI in Diagnostic Health by Har
There is a low adoption rate of Using Tech to Sense Anxiety b
patient portals among some patient
groups and the systems are largely
still not in place.
98
the gap of health There is an increase in digital Fitbit Care health coaching designed
on that exists between healthcare and the number of health for employee wellness programs.
nd heal practitioners companies investing in it.
f traditional medical Fitbit and Google have collaborated
ments can improve the Technology is enhancing the to accelerate innovation in Digital
t of chronic diseases. accessibility of healthcare and is Health and wearables.
contributing to more user-centred
g more sophisticated care healthcare.
tion can be a win-win for
ents and clinicians: The accuracy of diagnostics will
tion of time and effort, improve with the increased
n of follow-ups, increase in availability of AI and data.
loyalty, increase of revenue.
Trends include:
portals as they currently The Long Distance Doctor by Sara
present a number of Believing Patients by Jacquie
ns: portability of data, The Healthscare System by Moyee
enerated health data Dial-a-Doc by Patricia
or a single episode of care, Reversing the Flow by Trishia
ability challenges Nurse Alexa by Jacquie
ng systems. AI in Diagnostic Health by Harman
a low adoption rate of Using Tech to Sense Anxiety by Karli
ortals among some patient
nd the systems are largely
n place.
99
Internet of Health

Partner and develop products and As the Internet of Things (IoT) Integration of healthcare and h
services for FitBit that more fully market continues to grow , we’ll fitness and wellness tech in th
integrate into the Internet of Things continue to see the importance of
and digital health services. health tracking integrated into smart Enabling the use of personalize
living. health data in the future smart
and with healthcare profession
The IoT market is expected to double
by 2021, reaching $520 billion. There will be a continued evolu
of health tech in the home and
If This Then That (IFTTT) applets digital healthcare services with
further integrating Fitbit devices with changing models of access to
IoT by synching health and fitness
data with hundreds of other services. Potential rise of in home and s
home health assistants using t
continuous flow of data from fi
and health trackers.
Trends include:
The Healthscare System by Mo
Big Pharma Tech by Moritz
Nurse Alexa by Jacquie
Using Tech to Sense Anxiety b
Dial-a-Doc by Patricia
AI Diagnosis by Sara
100
ternet of Things (IoT) Integration of healthcare and health, Integration of Amazon Alexa and
ontinues to grow , we’ll fitness and wellness tech in the IoT. Google Home with Fitbit allowing for
to see the importance of smart home assistants to read out
acking integrated into smart Enabling the use of personalized health statistics.
health data in the future smart some,
and with healthcare professionals. Fitbit Aria 2 smart scale signals the
market is expected to double start of Fitbit branded IoT objects.
reaching $520 billion. There will be a continued evolution
of health tech in the home and
en That (IFTTT) applets digital healthcare services with
tegrating Fitbit devices with changing models of access to care.
nching health and fitness
hundreds of other services. Potential rise of in home and smart
home health assistants using the
continuous flow of data from fitness
and health trackers.
Trends include:
The Healthscare System by Moyee
Big Pharma Tech by Moritz
Nurse Alexa by Jacquie
Using Tech to Sense Anxiety by Karli
Dial-a-Doc by Patricia
AI Diagnosis by Sara
101
Innovation Initiatives
1.a 1.b 1.c 2.a 2.b
Development of Health Tracking Understanding Everyday Health Data

4.a 4.b 3.a 3.b
102
Development of Health Understanding Everyday The Medical
Tracking Health Data
Research and Development User-generated health Electronic H

1.a 2.a 3.a
for internal, continuous health baselines software fo
monitors practitioner
Line of fitness wearables for Curated and shareable health Curated me

1.b health tracking
2.b management system
3.b platform
Development of implantable
1.c bio-devices
rstanding Everyday The Medical Middleman Internet of Health

Health Data
User-generated health Electronic Health Record Formal relationships with IoT

3.a 4.a
baselines software for health partners
practitioners
Curated and shareable health Curated medical research Actionable smart home
management system
3.b platform
4.b synchronization
103
Research and Development for Line of fitness wearables for
1.a 1.b 1.c
internal, continuous health monitors health tracking
Fitbit should continue its Research As Fitbit is already invested in the

and Development (R&D) in the personal fitness industry, they
fitness technology space, and should focus their initial R&D efforts
should continue to acquire smaller on developing other forms of
companies already working in this wearable health tracking items, such
space. This R&D will allow them to as clothes.
operate on the forefront of
innovations in the fitness Suggested initiatives may include a
technology industry, eventually sports bra that measures heart rate,
allowing them to become the or partnerships with companies like
leaders and pushing the boundaries Nike to gather data from shoes.
of what technologies are available.
nt for Line of fitness wearables for Development of implantable

1.b 1.c
th monitors health tracking bio-devices
Riding the uptake of continuous

Research As Fitbit is already invested in the
glucose monitors and Fitbit’s
in the personal fitness industry, they
acquisition of Sanos, Fitbit should
e, and should focus their initial R&D efforts
continue to develop internal health
re smaller on developing other forms of
trackers as these are predicted to be
ng in this wearable health tracking items, such
the future trends in the health
w them to as clothes.
tracking industry. This is a separate
of
initiative from wearable tracking and
s Suggested initiatives may include a
R&D as it comes with its own set of
ntually sports bra that measures heart rate,
procedures and processes like
e the or partnerships with companies like
governmental approval and testing.
boundaries Nike to gather data from shoes.
available.
104
elines Curated and shareable health
2.b
management system
User-generated health baselines Curated and shareable health

2.a 2.b
vided by As Fitbit’s ability to monitor more management system
provide and more aspects of an individual’s
ed health data grows, there will be an
Using the data already provided by As Fitbit’s ability to monitor more
ers have a opportunity to curate and interpret
Fitbit’s users, Fitbit should provide and more aspects of an individual’s
status to health information in a way that is
anonymized and aggregated health data grows, there will be an
meaningful to its users. Instead of
baseline health data so users have a opportunity to curate and interpret
just showing a users’ Vitamin C
comparison of their health status to health information in a way that is
d into levels, for example, Fitbit can
other users. meaningful to its users. Instead of
g with provide an increased understanding
just showing a users’ Vitamin C
s of this data information that allows
This is already incorporated into levels, for example, Fitbit can
ms, but a the user to understand what a low
Fitbit’s app through sharing with provide an increased understanding
d off of Vitamin C level means and what
your friends, and through its of this data information that allows
allow they can do to increase their Vitamin
corporate wellness programs, but a the user to understand what a low
nd their C levels.
generic user baseline based off of Vitamin C level means and what
gainst
nearby geographies would allow they can do to increase their Vitamin
users to understand their and their C levels.
community’s health data against
medical guidelines.
105
Electronic Health Record software Curated medical research platform
3.a 3.b
for doctors
By offering an Electronic Health Going towards the need of the

Record (EMR) software, Fitbit can medical community of continuous
innovate in a segment essential for knowledge update, while capitalizing
the efficiency of the health on current partnerships offered to
community. researches, Fitbit can offer a curated
content according to the health
The initiative encapsulates the practitioner's areas of expertise and
connection of user data to the EMR interest.
according to user preferences. This
continuously generated data could The suggested initiative could be
allow patients and clinicians to more understood as “the Goodread of
personalized care and better healthcare”. A platform allowing
treatments improvements. health professionals to search for
researches, have a curated library
catalogue and keep track of a
reading list. At the same time, the
professional could be able to
connect with peers and have
discussions regarding new papers.
106
Formal relationships with Actionable smart
4.b 4.a 4.b
Actionable smart
IoT partners home synchronization
home synchronization
grows, As numerous
With the the internet of things
offerings (IoT) grows,
and With the numerous offerings and
he the market
integrations for smart
into smart objects
homes, the
FitBit integrations into smart homes, FitBit
o shouldwork with the IoT
be preparing is expected to
for integration should be preparing for integration
by grow
of health to aas$520
data a waybillion industry by
to create of health data as a way to create
ng 2021.integration
actionable With this quickly
between expanding actionable integration between
to market
users and theirFitBit should and
IoT objects be looking to users and their IoT objects and
and Smartpartner
home. and develop products and Smart home.
ly services for FitBit that more fully
al integrate
ex. When showing into the of
signs IoTover
and digital ex. When showing signs of over
healthaservices.
caffeination smart home being caffeination a smart home being
able to lock down a coffee maker. able to lock down a coffee maker.
Looking even further at a timeline Looking even further at a timeline

outside of the 15 year strategy plan outside of the 15 year strategy plan
extrapolations of remote healthcare, extrapolations of remote healthcare,
and in home healthcare assistants and in home healthcare assistants
may become a reality. Moving from may become a reality. Moving from
the idea of perhaps your health data the idea of perhaps your health data
being able to turn on or off a coffee being able to turn on or off a coffee
maker, to being able to control a maker, to being able to control a
personal home health assistant personal home health assistant
robot. robot.
107
Innovation Portfolio
Innovation Portfolio
TRANSFORMATIONAL
12
Where to Play | Market & Customers
NEW 4.b %
TRANSFORMATIONAL
12 %
Where to Play | Market & Customers
4.b
NEW
ADJACENT
44 %
3.b
ADJACENT
3.a
ADJACENT
44 %
3.b 1.a
ADJACENT
3.a 1.c
1.a 1.c CORE

1.b
44 %
EXISTING
2.b
1.b 2.a CORE
4.a
44 %
EXISTING
2.b
2.a
4.a EXISTING INCREMENTAL NEW
How to win | Products & Assets Be

EXISTING INCREMENTAL NEW M
Tech
How to win | Products & Assets
CORE ADJACENT TRANSFORMATIONAL
108
Initiative Prioritization
TIONAL
15 % In order to determine which initiatives to
prioritize, we looked at them in terms of three
15 % criteria: desirability, effort, and impact. Because a

user-centred approach was used early in the
strategy development process, we did not
develop any initiatives that would be undesirable
40 % for Fitbit customers.
We mapped all the desirable initiatives on a
40 % matrix that analyzed the effort that would be

required to implement the initiative and the
impact that the initiatives would have on Fitbit’s
users. Each quadrant is categorized in terms of
45 % how many initiatives should be pursued in that

quadrant.
Benchmark:45 %
After prioritizing the initiatives based on their
impact and effort, we then mapped the initiatives
Mid-stage as a system to understand which initiatives would

lead to other initiatives as they are all
Technology Firm
Benchmark: interdependent on each other.
Mid-stage
Technology Firm After understanding the effort and impact and
the relationship of all our initiatives, we provided
a high-level sequencing of when each initiative
should be rolled out.
109
Development of implantable bio-devices 1.c
Line of fitness wearables for health tracking 1.b
Research and Development for internal,

continuous health monitors 1.a
Actionable Smart
Home synchronization
4.b
Formal relationships with IoT partners 4.a
110
2.a User-generated health baselines
Curated and shareable health

2.a 2.bUser-generated health
management system
baselines

Electronic Health Record software

3.a for health practitioners
Electronic Health Record software

3.b 3.a medical
Curated research
for health platform
practitioners
3.b Curated medical research platform
DEVELOPMENT OF HEALTH TRACKING

UNDERSTANDING EVERYDAY HEALTH DATA
THE MEDICAL MIDDLEMAN
INTERNET OF HEALTH
THE MEDICAL MIDDLEMAN 111
INTERNET OF HEALTH
Development of implantable bio-devices 1.c
Line of fitness wearables for health tracking 1.b
Research and Development for internal,

do all HIGH
continuous health monitors 1.a
1.a 1.c
2.b
4.a 3.a
4.b do with support
Impact
Actionable Smart
3.b Home synchronization
4.b
1.b
2.a Formal relationships with IoT partners 4.a

do less or none
LOW
LOW
Effort HIGH
do some DEVELOPMENT OF HEALTH TRACKING

E ADJACENT TRANSFORMATIONAL INTERNET OF HEALTH
112
devices 1.c
2.a User-generated
Sequencinghealth baselines
1.b
a 2020 2025 2030 2035
Time
1.a 1.b
1.a 1.b
1.c
1.c
2.a
DATA
2.b * **
2.a 3.a 3.a
allows 3.b
b CURATED AND 2.b Electronic Health Record software
SHAREABLE 3.a* **
for health practitioners
3.a 3.a
INFORMATION
4.a 4.b
3.b
MEDICAL
tners 4.a 3.b INTEGRATION
Curated medical research platform
supports enhances
CORE ADJACENT 4.a 4.b
TRANSFORMATIONAL * development ** adoption INTERNET OF HEALTH
facilitates
INTERNET
OF HEALTH DEVELOPMENT OF HEALTH TRACKING
allows
NAL CORE ADJACENT TRANSFORMATIONAL * development ** adoption INTERNET OF HEALTH
INTERNET OF HEALTH
113
Capabilities & Roadmap Capabilities & Roadmap
Organization Approach
Resources & Capabilities Organization
Metrics &Resources
Incentives& Capabilit
Innovation strategy Financial and

Senior leadership non-
Funding
Senior leadership Funding
financial rewards
Senior leadership supports Develop an innovation strategy
A stable source of funding for Senior leadership supports
Foster a sense Aofstable source of funding for
pride and
initiatives and internal testing to create a related profile of
initiatives initiatives and internal testing
purpose for initiatives
staff working for
initiatives to pursue Fitbit beyond financial
compensation
Pipeline & portfolio

Governance Governance InnovationTalent manageme
metrics
managementTalent management
Determine a process
Form an internal committee with to amove
Build Form an internal committee
culture of collaboration, with Build
Create metrics usingathe
culture of collaboration
representation from different initiatives from ideas to action
transparency, partnership andrepresentation from different
innovation transparency,
intent and roadmappartnership
in and
seniority and different innovation the innovation innovation
seniority and different strategy
departments departments
Collaboration Process Innovation Tools Collaboration External attraction

Innovation Tools
Create a prioritization
Strengthen internal collaboration matrix
Select and
and master Strengthen internalWork
the innovation collaborationSelect andamaster
towards becoming marketthe innovat
with staff and external roadmap tools required to carry out with staff and external tools
leader to create required
prestige and to carry out
collaboration with healthcare healthcare as planned
planned and future initiatives collaboration with recognition and future initiatives
an innovative
partners partners company
Capabilities already in place
114
Capabilities & Roadmap
Organization Resources & Capabilities Metrics & Incentives
Financial and non-

enior leadership Funding
financial rewards
adership supports A stable source of funding for Foster a sense of pride and
s and internal testing initiatives purpose for staff working for
Fitbit beyond financial
compensation
overnance Talent management Innovation metrics
internal committee with Build a culture of collaboration, Create metrics using the
tation from different transparency, partnership and innovation intent and roadmap in
and different innovation the innovation strategy
ents
ollaboration Innovation Tools External attraction
en internal collaboration Select and master the innovation Work towards becoming a market
f and external tools required to carry out leader to create prestige and
ation with healthcare planned and future initiatives recognition as an innovative
company
115
2020 2025 2030
Time
1.a 1.b
2.a
2.b * **
3.a 3.a
3.b
4.a 4.b

APPROACH ORGANIZATION
THE MEDICAL MIDDLEMAN Innovation Senior leadership
INTERNET OF HEALTH strategy
Pipeline & portfolio

CORE Capabilities already in place Governance
management
ADJACENT
* Development Process Collaboration
TRANSFORMATIONAL ** Adoption
116
2035
1.c
RESOURCES & METRICS &

CAPABILITIES INCENTIVES
Financial and non-

Funding
financial rewards
Talent Innovation metrics

management
Innovation Tools External attraction
117
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124
BRIEFING NOTE
Date: April 9th, 2045

Prepared for: Attendees of the Confidential Meeting of the Ministry of Health Management
Prepared by: The Office of the Minister of Health Management
L
I. PURPOSE:
The purpose of this briefing note is to provide options and a recommendation on how to
proceed on the increasingly urgent matter of the Mannsville, Alberta heatwaves.
A
II. BACKGROUND:
TI
Following the events of the 2028 Montreal Summer of Death, the Ministry of Health
Management was formed to monitor the health and wellbeing of Canadians. Since its
formation, the majority of Canadians have opted to implant Internal Health Trackers (IHTs) into
their bodies. With the passing of the Healthy Canada Act in 2032, the Ministry now ongoing
EN
and real-time health data for 95.3% of Canadians. The Division of Ongoing Health Monitoring
is responsible for monitoring this information and alerting the Minister and her Office when
there may be an issue.
III. CURRENT SITUTATION:

D
The Division of Ongoing Health Monitoring first alerted the Minister and her Office of an issue
in Mannsville, Alberta on February 15th, 2045. The IHT reports showed early signs of heat
exhaustion for 25% of the population and projections indicated that this number was going to
FI
grow. The Minister advised the Division to continue to closely monitor this matter and stressed
confidentiality. Since then, the numbers have continued to worsen and all 2000 residents of
Mannsville are expected to die by December 2045 if action is not taken.
N
IV. OPTIONS
The options on how to proceed are:
O
1. Engage the Disaster Assistance Response Team (DART) to forcibly evacuate the residents
of the Town of Mannsville to Edmonton where there are cooling centers (Protocol 2045).
2. Do not intervene in this matter; continue to monitor the issue and increase the frequency of
C
public service announcements encouraging residents to take caution in the heat
V. RECOMMENDATION
The Ministry of Health Management recommends the immediate enactment of Protocol 2045.
125
126
Designed Future Script
script outlining the Big Brother+ Scenario
Roles:
Minister of Health (Riley)
#1 Assistant to the Minister of Health Management (Igor)
#2 Assistant to the Minister of Health Management (Grayce)
Minister of Energy (Liin)
Documenter/photographer (Jacquie)
_______________________________________________________________________
Class makes their way up to the 3rd floor via elevator
Once they arrive, they are greeted by Grayce & directed to the meeting
room. Grayce also asks the class to put their cell phones into the basket
once they arrive.
Class has the opportunity to get snacks and mingle, review their
briefs, etc.
[Igor stands at the front of the room]
Igor: Hello everyone and thank you for attending this emergency meeting
of the Ministry of Health Management. We’d like to remind you that this
meeting is top-secret and what is said in this room is to remain in this
room. If you haven’t done so already, please drop off your phones in the
basket that my colleague Grayce is carrying. Don’t worry, you will be able
to retrieve your device at the end of the meeting.
[people drop off their phones in the basket]
Igor: Thank you very much. Now without further ado, I am pleased
to welcome our Minister of Health Management, Riley McCullough.
[Igor sits, Riley walks to the front]
Riley: Thank you Igor and thank you all for coming together with such short
notice. I’m sure you must all be curious about what we will be discussing
and we will get to that in a moment. But before we talk about the matter
at hand, it is critical that we first take a few cues from our past.
[Slide deck appears]
Riley: Our Ministry emerged from a time of crisis. The 2028 Montreal
Summer of Death took the lives of over 4,0000 Canadians. The heat
wave seemed to come from nowhere but it killed our neighbours,
families, and friends. In the short span of 1 month, we watched
Montreal change from a place full of life and culture to a place of death. ≥
127
As has become our country-wide practice, I’d like to take a few
moments of silence to remember this tragedy.
[Hold for moment of silence. Riley closes her eyes]
Riley: Thank you. As a nation, we were left with many questions: “How
did we let this happen”, “Is this the beginning of the end?”, “Is there
anyway we could prevent this from happening again?”.
We were all filled with grief and fear of what would happen next and the
Great Riots of 2029 pushed our country into action. Luckily we had a
wonderful Prime Minister who lead the country and helped to bring an
answer to some of these questions. Prime Minister _______ introduced
the Healthy Canada Act which was eventually passed and is now law.
From that law emerged our Ministry, the Ministry of Health Management.
To prevent a tragedy like the Montreal Summer of Death, the Ministry
of Health Management was tasked with having oversight over the data
collected by the biodevices that live and breath in our bodies. Those tiny
little robots have lots of information to tell us what’s happening inside
our bodies. So in this Ministry, we can see the population health data for
ALL Canadians.
This brings me to the reason I have asked you all to join me for this
meeting. The Montreal Summer of Death is in our past but a new threat
is silently emerging.
[slide flips to the quiet little town of Mannville, AB]
Right now, as we sit here today healthy and happy, the people of Mann-
ville in Northern Alberta are under attack.
During our routine monitoring of population health data, we noticed

something odd in Mannville. In this small town of 2000 people, some-
thing didn’t seem right. As we know, the world we live in today is much
warmer than it’s been in the past. Now I’m sure you’ve all heard of
the rise of so-called climate related diseases and illnesses. In parts of
Canada we’ve seen entire communities fall ill with dengue while others
are dealing with the emergence of other, new infectious disease. In this
particular case, the enemy is the rising heat itself.
[slide flips to facts and figures slide + charts]
Let’s take a look at some of this data.

2 in 10 residents of this small town have already been hospitalized with
heat exhaustion.
128
Using the information from the biodevices, we know that this number
could grow to 7 in 10 by the end of next month.
The biodevices also show us that 6 in 10 residents have trouble regulat-

ing their body temperature in the face of this heat and that the young
and the elderly are most vulnerable. This is expected to grow to 9 in 10
by the end of next month.
Water reservoirs are diminishing in this community and we’ve already

started to see rising levels of anxiety and panic.
The community is also having difficulty getting to and remaining asleep.

8 in 10 residents are finding themselves trying to function on 4 hours of
sleep or less because of what we can conclude to be worry about their
health and wellbeing.
As you can see, these numbers are grim. If we project into the future
using the numbers from now, we can expect this entire community of
2000 people to die from the heat by December. But we can intervene
before things get any worse and save the lives of 2000 people.
The facts and figures I read out moments ago, along with the drought
conditions in the area surrounding Mannville has led us to believe that we
have a necessity, as a government, to enact Protocol 2045. This Proto-
col proposes a forcibly evacuation of the entire town of Mannville. Once
moved, we will relocate the residents of this town to Edmonton where
we have cooling centers already set up.
We have the to make sure this isn’t a repeat of the Montreal Summer of
Death. This is the first instance that we as a government are taking action
on forcible evacuation, and if, with your support, this process is a suc-
cess, this plan could be implemented in the future to save more Canadi-
an lives. We have the Disaster Assistance Response Team on the ground
in Alberta ready to move in on Mannville and begin the evacuation as
soon as our vote here is complete.
Esteemed members of the government and invited guests, I’m calling on

you all to vote on what the Ministry of Health Management should do in
the face of this crisis. Before we take this to a vote, I’m happy to take any
questions.
[Liin raises her hand]
Riley: Yes, Minister. ≥
129
Liin: I think I speak for many of us when I say that we have quite the
problem in our hands. I lost close friends to the Montreal Summer of
Death and I would like to avoid a repeat of that tragedy as much as
possible. But as the Minister of Energy, I am particularly interested in this
relocation as it would open the area around Mannville, which is now in-
capable of supporting its traditional farming practices, for additional oil/
gas drilling. We would have done this long ago but the local community in
Mannville has been opposed to this.
With this forcible evacuation you are proposing, I wanted to hear your
thoughts on additional benefits to enacting this Protocol?
Riley: Thank you for the question, Minister. You’ve caught on to one of
the many opportunities we see for this move. There is the obvious one
which is saving thousands of lives and what you’ve already mentioned
but I want to point out another opportunity. Mannville is a small town
with a large budget. As I am well aware, many of you are worried about
how we are going to keep our cities from crumbling under the pressure
of overpopulation and increasing debt. Redistributing the budget of
Mannville to the cities is something I implore you to consider when mak-
ing your decision today. The safety and security of the residents is top of
mind for my Ministry but I can see many opportunities that would benefit
each and every one of us in the room today.
Any other questions?
Riley: Okay let’s put Protocol 2045 to a vote. Igor, if you may.
Igor: The procedure to pass this protocol calls for a simple majority of
votes in the room. All in favour of saving 2000 lives in Mannville, Alberta
and implementing the protocol for a mandatory, permanent evacuation
to Edmonton please raise your hands. All against?
ENDING #1 - EVACUATION ORDERED
Riley: We’ve made the right decision here today. We’ve made the de-
cision to save 2,000 Canadian lives. Let’s dial in the DART team and let
them know that they have the green light.
[Phone rings]
Lieutenant: Hello, this is Lieutenant _____
Riley: Lieutenant, we’ve come to a decision. You are good to go. Please
begin the evacuation of Mannville, but do so with a delicate touch.
130
Stress levels are already high due to the heat, so we don’t want to send
anyone into shock. We will be monitoring all health data here and re-
porting to you if anything is alarming.
Lieutenant: Please to hear that. We will begin the evacuation as soon as

possible.
[Lights are dimmed. Message comes on screen: “You have just experi-
enced the scenario, Big Brother +. Thank you for participating”]
ENDING #2 - EVACUATION NOT ORDERED
[Lights go off, an announcement is made “6 months later”. Lights are

dimmed the whole time and they’re just hearing what’s happened]
*news sound plays*
Radio Announcer: We have an update for a story we’ve been following

for the past few weeks. Following the deaths of thousands in the town
of Mannville, Alberta, the Ministry of Health Management is now being
investigated by Canada’s Public Service Commission and the UN’s Human
Rights Council. Charges include failure to act, misuse of public data, and
criminal negligence. The disgraced Minister, Riley McCullough, revealed
today that her Ministry made the decision not to intervene as a result of
a confidential meeting of the Ministry of Health Management that took
place on April 9th. The details of this meeting remain unclear but the UN
and the Public Service Commission will attempt to piece together the
details as part of their investigation. For the time being, we are reminded
that we must remember those that have lost their lives in Mannville just
as we have come to remember the victims of the Montreal Summer of
Death.
[Message comes on screen: “You have just experienced the scenario, Big
Brother +. Thank you for participating”] ≠
131
Image taken from April 9th, 2045 meeting of the
Canadian Ministry of Health and Welfare. Minister
McCollough presents the dire health statistics of
Mannville, AB to meeting attendees.
Pictured: Minister Riley McCollough (Left) accompa-

nied by assistant Igor Bueno Antunes (Right).
132
After briefing the meeting was open to discussion
by attendees. Some ministers in attendance were
given directives to represent either a strong for,
or against stance during discussion. These directives
were included in their breifing packets. Concerns
were raised by attendees regarding the perceived
motives of expanding mining, and reducing rural
infrastructure and towns.
After discussion the motion to enact Protocol 2045

was a majority no vote.
133
Along with the meeting experience, our group thought with vitamins, going beyond the data and adding the
about how we could include an immersive component in notion of curated information for the user.
our scenario that would transport people to 2045 and
make them realize they also had a biodevice inside Because biodevices would be inside each participant
their bodies. body, the scanner should be able to recognize who was
going to interact with it in order to give a curat-
We decided to connect this thought to something com- ed text. Additionally, it should perform its readings
mon in meetings: a coffee and tea station. Because without anything physically attached to the partici-
biodevices would generate personal data, we conceptu- pants.
alize a scanner that would recommend a specific tea
134
With this concept in mind, we used available soft- which slide was going to appear on the screen and
ware and hardware to simulate the scanner experience. pretend the scanner was reading the biodevice.
We made, in the Maker’s Lab, a white acrylic cylin- In order to make the scanner more inclusive, we
der with an attached LED light module to be the part decided to include a voice reading over the message
where the participants would insert their hands. To presented, and for the voice, we used the Amazon
show the personalized message, we created a slide Polly service, which allowed us to code each one of
deck on Keynote with one slide per participant based the scripts including different words emphasis and
on the previous knowledge we had of each one of them. even breaths to create a more natural AI voice.
Furthermore, Keynote has an IOS application to remote
control a slide deck; thus we were able to choose
135
136
137
To build immersive continuity we designed nutrient
infused teas and drop additives. These reflected the
trends we saw earlier in the semester of personalized
nutrition, as well as microdosing of (currently
illegal) drugs/stimulants.
138
139
140

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