31: Digital metamorphosis of territories

Cur­rent­ly, Prof. East­away is seek­ing answers to the sen­si­tive ques­tion “What are the pil­lars for reha­bil­i­ta­tion of Spain, in the after­math of the cri­sis? This is one aspect of a research project con­duct­ed joint­ly by the Uni­ver­si­ties of Barcelona, Valen­cia and Leri­da. To be more spe­cif­ic, Prof. East­away is study­ing the impact and orga­ni­za­tion of so-called “cre­ative neigh­bour­hoods”, notably in terms of gov­er­nance and net­work­ing. “We have clear­ly under­stood, that more than just com­ing up with a sin­gle recipe, we had to pay spe­cial atten­tion to the strengths a d weak­ness­es of a giv­en city, its his­to­ry, its eco­nom­ic tis­sue … to deduce and iden­ti­fy pos­si­bil­i­ties for devel­op­ments that would be solid­ly ground­ed and not just super­fi­cial”, she insists. 

One recipe for each territory

She also insist­ed that impor­tant as it is for a city, for a dis­trict or a neigh­bour­hood to attract exter­nal tal­ents, it must also ensure that it can pro­duce its own new tal­ents, new skills and review the pro­grammes, if need­ed, of teaching/training estab­lish­ments. “The strengths of a giv­en city are unique; we must be able to detect and encour­age them to build a more cre­ative city”, says econ­o­mist East­away. This leads to the con­cept of one recipe for each ter­ri­to­ry. To illus­trate, Montser­rat Pare­ja East­away explains how Barcelona inte­grat­ed design — a strong his­toric fea­ture of the city — in its inno­va­tion dis­trict, along­side media agen­cies, ener­gy com­pa­nies, ICT start-ups and biol­o­gy inten­sive insti­tu­tions. In con­tradis­tinc­tion, when Barcelona helped Medellin in Colum­bia, South Amer­i­ca to set up its cre­ative dis­trict, the Cata­lan cap­i­tal went beyond just dupli­cat­ing its own expe­ri­ence, adapt­ing the pro­pos­als and plans to take the local con­text into account. 

“22@” in Barcelona

If we decide to invent a sin­gle recipe for each city, the ingre­di­ents are well-known, viz., the rela­tion­ships that already exist between aca­d­e­m­ic, polit­i­cal and eco­nom­ic spheres that we need to detect and deploy. “The notion of network(ing) is very impor­tant. The inter­con­nec­tions between these three spheres are pri­mor­dial when it comes to build­ing up inno­v­a­tive new cities or urban dis­tricts. We must there­fore cre­ate spaces where these con­nec­tions can be gen­er­at­ed and ani­mat­ed. For each ter­ri­to­ry there will be a net­work-head to ani­mate the oper­a­tions”, recalls Montser­rat Pare­ja East­away. In Barcelona, the so-called “22@” dis­trict cov­ers 200 hectares of indus­tri­al waste land. As one of the most sig­nif­i­cant urban reha­bil­i­ta­tion pro­grammes in Barcelona, “22@” called for 180 Meu­ros in pub­lic invest­ment. The city author­i­ties man­aged this dossier, and assumed the role of local inno­va­tion-inten­sive net­work head. They orga­nized such sim­ple things as fre­quent col­lec­tive break­fasts, pub­lic lec­tures, meet­ings and exchange pro­grammes. Phys­i­cal eye-to-eye meet­ing is very impor­tant here: going dig­i­tal is one thing but it boils down to recog­nis­ing that almost every­thing rely on human con­tact. Moments like these help to keep the inno­va­tion process mov­ing, with an iden­ti­fi­ca­tion of com­mon inter­ests between enter­prise and research sci­en­tists, to whom the city author­i­ties are grad­u­al­ly hand­ing over the reins of lead­er­ship of 22@, under­scores the econ­o­mist East­away. And in order for these com­mon inter­ests to be able to one day turn out some con­crete projects, the city author­i­ties have also read­ied and made avail­able a focal cen­tre to con­duct experiments. 

Regional planning to avoid overlapping projects

In order for these inno­va­tion inten­sive dis­tricts to remain inter­est­ing, we must avoid “over­selling” the prod­uct. “Ever since the eco­nom­ic cri­sis, every­one wants to have their own inno­va­tion dis­trict giv­en that sec­tors that con­nect into inno­va­tion and knowl­edge appear to sur­vive bet­ter than oth­ers. How­ev­er, it is not advis­able that sev­er­al such dis­tricts co-exist in the same region, unless they are spe­cial­ized in dif­fer­ent types of activ­i­ty. That is why region­al plan­ning is pri­mor­dial” con­cludes Montser­rat Pare­ja Eastaway. 

“In the com­ing years, some­where between 30 and 50% of all employ­ment posi­tions will be replaced by machines and auto­mat­ed process­es. The ensu­ing pro­duc­tiv­i­ty gains will be enor­mous, way beyond those due to imple­men­ta­tion of Tay­lorism. Notwith­stand­ing, from ware­house han­dlers to sur­geons, unem­ploy­ment will also take on huge pro­por­tions that will even lead to the ques­tion of short-term solv­abil­i­ty of Fordist com­pa­nies. We must start think­ing about new dis­tri­b­u­tion pat­terns for wealth”, feels Bernard Stiegler, who will short­ly be pub­lish­ing a book on the sub­ject, under the title « La société automa­tique » [Auto­mat­ed Soci­ety]. What the philoso­pher pro­pos­es to counter such changes is to invent a “con­tribu­tive income”, on the same mod­el as that used to pay part-time show world work­ers, which would make cit­i­zens val­orise the tile they have at their dis­pos­al, a time that will nec­es­sar­i­ly increase as Soci­ety becomes more and more auto­mat­ed. “ In par­al­lel, we must set up insti­tu­tions to devel­op and val­orise knowl­edge ad to rein­vent an eco­nom­ic mod­el that would be based notably on con­tribu­tive projects”, he sur­mis­es, invit­ing the lis­ten­ers to think about these ques­tions today inas­much as these will become more acute to answer in the next decade. 

Contributive neighbourhoods or “smart cities”?

“This is a work area which also involves UTC, to the extent that we must pre­pare teach­ing cours­es and launch research in line with the future con­text. Ter­ri­to­ries, urban dis­tricts and neigh­bour­hoods must also become con­tribu­tive and here tech­nolo­gies will have a major role to play, with the pro­vi­so that they are under the con­trol of over­ar­ch­ing poli­cies. Fail­ing to do so, the sce­nario we see in Sin­ga­pore may repeat itself with remote man­age­ment of urban process­es under the con­trol of multi­na­tion­al com­pa­nies. Devi­a­tions like this, inte­grat­ed to the con­cept of smart cities is dan­ger­ous”, warns Bernard Stiegler. Automa­tion is so to speak at the door of neigh­bour­hoods to con­trol, for exam­ple, their water, trans­port or pow­er sup­plies, among oth­ers. “Digi­tised urban­i­ty (and automa­tion in gen­er­al) are major soci­etal chal­lenges to the extent that it will tend to destroy our auton­o­my (or self-reliance)”, adds philoso­pher Stiegler. From dri­ver­less vehi­cles to big data eco­nom­ics, automa­tion will anni­hi­late deci­sion mak­ing by humans and indi­vid­u­als. We must there­fore take care to use tech­nolo­gies to give back their roles to the indi­vid­u­als, as cit­i­zens, con­sumers, mem­bers of a fam­i­ly, a com­pa­ny, etc., and not to quash any ini­tia­tives they might envis­age. “This is the task under­tak­en by May­or Jean-François Caron, I his town of Loos-en-Gohelle (French Region Nord – Pas-de-Calais). “The ener­gy per­for­mance sen­sors installed by the Town­hall are mon­i­tored by the May­or and his staff and not con­nect­ed to a data pro­cess­ing cen­tre that would man­age ener­gy con­sump­tion on behalf of the inhab­i­tant-con­sumers. It is the lat­ter who demo­c­ra­t­i­cal­ly take the rel­e­vant, decid­ed steps in meet­ing orga­nized for this very pur­pose. Tech­nol­o­gy we see here can also serve col­lec­tive intel­li­gence, rather than destroy it”. 

Innovation, somewhere between utopia and a fight to survive

On a wider scale, Prof. Stiegler analy­ses at the exam­ple pro­vid­ed by big data process­es in finan­cial spheres: fol­low­ing the sub­prime cri­sis, Alan Greenspan, for­mer Chair of the Board of Gov­er­nors of the Fed­er­al Reserve Bank (FED) admit­ted that eco­nom­ic mod­el­ling alone would not pro­vide all the answers and that we need­ed to use it only to sup­port and serve eco­nom­ic the­o­ry. Automa­tion, what­ev­er, the sec­tor where it is intro­duced, increas­es the local sys­tem entropy, viz., its lev­el of dis­or­der, going as far as destroy­ing it. “Thus, Google lin­guis­tic robots lead to a loss of seman­tic diver­si­ty, as has been demon­strat­ed by Frédéric Kaplan, research sci­en­tist work­ing with the Ecole Poly­tech­nique Fédérale de Lau­sanne (EPFL). Increased entropy cre­ates in indif­fer­en­ti­a­tion and final­ly to the death of the sys­tem. In reverse, negen­tropy gen­er­ates sin­gu­lar­i­ties and more val­ues. The future of inno­va­tions leads to two era options: entropocene or a negen­tropocene” adds Bernard Stiegler refer­ring to entrop­ic con­cepts. And, to con­duct the human species on a path that would enable a few spec­i­mens with their free will intact to sur­vive, we must use the time gained through auto­mat­ed process­es to fight the gen­er­at­ed loss of autonomy. 

‘Territory-schools’

Soci­ety tomor­row must pro­duce a lot of col­lec­tive intel­li­gence. Automa­tion autho­ris­es a degree of auton­o­my, as is proven in the case of pianists – they can only per­form by free­ing them­selves from learn­ing automa­tisms they first had to acquire by mod­i­fy­ing nat­ur­al automa­tisms è- in this way they can cre­ate, impro­vise and inter­pret in a “sin­gu­lar” man­ner. Physi­cists must use and free them­selves from what they have already learned in order to make new dis­cov­er­ies and enrich the sys­tem. A race-course dri­ver is a machine, to the extent that he can ‘dis­auto­mate’ him­self for a frac­tion of a sec­ond to avoid a crash or to win the trace. ‘Dis­automa­tion’ is only pos­si­ble if the indi­vid­ual has pre­vi­ous­ly auto­mat­ed an enor­mous quan­ti­ty of move­ments, reflex­es, knowl­edge”. In order to reach this degree of auton­o­my, we must accept to under­take exper­i­ments, at every lev­el of our orga­ni­za­tion. We must give indi­vid­u­als, the uni­ver­si­ties, the ter­ri­to­ries, the right to exper­i­ment. This indeed is the only way to test and retain appro­pri­ate solu­tions to face up to the major changes ahead. “That is why I am cur­rent­ly work­ing on the notion of ter­ri­to­ry-schools, where young PhD stu­dents car­ry out con­tribu­tive research tasks to study, for exam­ple, how one could dis­trib­ute con­tribu­tive incomes to replace social ben­e­fits. This research work also involves the inhab­i­tants, the eco­nom­ic spheres, the polit­i­cal and aca­d­e­m­ic milieus … all of whom are dri­ven by the right to inno­vate. To antic­i­pate on future changes, the Euro­pean Union should launch and encour­age such experiments” 

The assigned objec­tive is to adapt new tech­nolo­gies to health care pro­to­cols. “Smart­phones for exam­ple can be used in the case of chron­ic ill­ness­es that require con­stant mon­i­tor­ing. For Parkin­son, it turns out to be more prac­ti­cal for the patents to inte­grate data in their phone, car­ried con­stant­ly, than to have them writ­ten down in a note­book, which we note at the last minute, with errors and bias”, illus­trates Cécile Mon­teil. Thus, with­out intrud­ing in the patien­t’s pri­vate sphere, the smart­phone records the data in a high­er qual­i­ty for­mat and allows the prac­ti­tion­er to mon­i­tor the case more efficiently.

More accurate information for chronic ailments

Con­nect­ed objects also bring spe­cif­ic ben­e­fits: with an ill­ness like eczema, where itch­ing can wake up per­sons in the mid­dle of the night, induc­ing a high lev­el of fatigue, a bracelet can be used to record ‘wake’ peri­ods and com­pare these with nor­mal patien­t’s rhythms. In the area of car­di­ol­o­gy, a con­nect­ed object can record heart pulse rate and the asso­ci­at­ed smart­phone app will invite the patient to indi­cate his/her cur­rent phys­i­cal activ­i­ties if and when heart-rate increas­es abnor­mal­ly. “This data rep­re­sents infor­ma­tion that doc­tors sim­ply could not access before. But of course they are mean­ing­less out­side a giv­en con­text: if a heart pulse rate of 170, when a car­diac patient is going up a flight of stairs, it if not at all a seri­ous as if the same pulse was not­ed while watch­ing TV”, adds Cécile Mon­teil. Ad Sci­en­ti­am is work­ing with the world leader iHealth to devel­op these health ser­vice relat­ed con­nect­ed objects, with aca­d­e­m­ic research to analyse the symp­toms care­ful­ly using new tech­nolo­gies as well as will enter­pris­es in the phar­ma­ceu­ti­cal sec­tor to mon­i­tor the effects of the med­i­c­i­nal drugs used under real conditions.

Motivation, monitoring and prevention

In the long term, patients will ben­e­fit from this research. To illus­trate, in the case of Parkin­son or dia­betes, bet­ter mon­i­tor­ing ensures bet­ter treat­ment. We can imag­ine an “app” that con­nects to the pill-box dis­penser and which sends out a sig­nal if the patient has for­got­ten open it. Apps on smart­phones rein­force the mon­i­tor­ing and improve accom­pa­ni­ment between two appoint­ments, which in turn increas­es moti­va­tion and keep the morale up”, explains Cécile Mon­teil. Anoth­er exam­ple is when there is an impend­ing heart fail­ure, with the symp­tom of water gath­er­ing abnor­mal­ly in the ankles and which usu­al­ly ends up in the emer­gency ward. To avoid this, the patients only need to weigh them­selves every day: if the weight increas­es abnor­mal­ly their GP can call them in for an urgent check-up. The ques­tion is: can solu­tions like these be adapt­ed to every case? “Yes”, replies Cécile Mon­teil. “Smart­phone tech­nolo­gies are con­stant­ly improv­ing and the “apps” can be made suf­fi­cient­ly acces­si­ble to be under­stood by all, using, for exam­ple, pho­tos of the med­i­c­i­nal drugs to be tak­en. Patients do not like intru­sion, so if they use their smart­phone, it is ‘their’ acquires tech­nol­o­gy and not a new machine. In the frame­work of our research, we have not­ed a very high lev­el of sat­is­fac­tion, even among the elder­ly persons.” 

Will “apps” be reimbursed by social security system?

The poten­tial here will become a real­i­ty if the tools are co-designed by engi­neers and med­ical prac­ti­tion­ers. “There are cur­rent­ly only a few inter-con­nec­tions between these two worlds. The doc­tors know their med­ical fields, but they often ignore the pos­si­bil­i­ties offered by new tech­nolo­gies. The role of Ad Sci­en­ti­am is to crate bridges between the engi­neer­ing med­ical pro­fes­sions”, under­lines Cécile Mon­teil who has draft­ed the research pro­to­cols that allow an inter­ac­tion of new tech­nolo­gies and the patients’ spe­cif­ic needs. This new area of research rais­es a series of ques­tions. If the pro­tec­tion of per­son­al data is guar­an­teed by dras­tic reg­u­la­tion, the ques­tion of reim­burse­ment of med­ical appli­ca­tions has not yet been set­tled in France. “In the USA and the UK, cer­tain apps are reim­bursed by their social ser­vices. But it should be seen that they can induce con­sid­er­able amounts of sav­ings — if only avoid­ing per­sons being tak­en to emer­gency admis­sion ser­vices”, under­lines Cécile Mon­teil, but who rec­og­nizes that there can be devi­a­tions via “well-being” or “quan­ti­fied-self” apps in which med­ical data can be mis­used, or sup­port hypochon­dri­ac behaviours. 

There will still be doctors

If I have not com­plet­ed enough steps in my day, or of I refuse to share the calo­ries ingest­ed dur­ing my last din­ner, I become sus­pi­cious … these very appli­ca­tions could dis­con­nect peo­ple, in as much as they become too attached to their data and algo­rithms. This devi­a­tion is a risk that must be con­sid­ered care­ful­ly since data tak­en out of con­text can be inter­pret­ed in many dif­fer­ent man­ners”. This is why there will always be doc­tors. “Inter­pret­ing data and mon­i­tor­ing patients will remain essen­tial — an appli­ca­tion will nev­er announce to a patient that they have a can­cer, for exam­ple. The role of the prac­ti­tion­ers will evolve towards a more human approach: new tech­nolo­gies will set time free that can prove use­ful for expla­na­tions and accom­pa­ni­ment of the patients”. 

Le magazine

Novembre 2023 - N°61

Activité physique, nutrition & santé

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