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I was thrilled to have been invited to address the 2015 Graduating Class at the University of North Carolina School of Government -CGCIO program in Chapel Hill the other day!

IMG_7102It was part of a full day program which led to their graduation ceremony; I was invited in to challenge them to think of the opportunities and challenges they face as they go forward into the future at the start of their day.

Attendees were from a broad spectrum of local and municipal governments, as well as school boards and legal bodies; particularly responsible for information technology and infrastructure.  I’ve previously spoken to many such groups, including a keynote for 3,000 folks at the annual Government Finance Officers Association annual conference in Austin, Texas; 2,000 mayors and civic officials for the Texas Municipal League annual conference in Dallas, Texas; and 500 at the Utah League of Cities and Towns annual event in Salt Lake City (among many other events.)

Certainly the challenge for government today is pretty big;I opened with this quote:

“Increasingly, citizens are demanding that governments provide the same level personalized service that they receive from business organizations.” International Innovations in Public Sector External Service Delivery, 
Brock University, March 2010″

That certainly became evident with the rollout of the Web site for the Health Care Reform Act (aka “Obamacare”); with a failed implementation, it became clear that the expectations of society are that any government should provide the same degree of online service as Amazon, FedEx or others. I spoke of what people expect in terms of online interaction today, using the example of pension benefits:

  • extreme personalization
  • extreme simplification
  • complete interaction history
  • pro-active delivery by new platforms (i.e. instant text messages when pension plan changes occur)
  • Web interaction > call center (i.e. chat / video / Skype/ Google Hangout?)
  • and mobile!

Yet the problem for many government organizations is that they have to try to provide this service within the reality of the existence of a creaky, lumbering, complex back-end information technology platform. I use a simple picture to illustrate the problem (which brought down the house with laughter; they know all too well that the problem is very, very real.)


But then I continued : that’s not the biggest challenge; it’s the fact that they very definition of technology and infrastructure — their area of responsibility — will be subject to rapid change.

My intent was to put into perspective that as CIO’s for government organizations, they had better be ready to assume responsibility for a lot more than just citizen facing service systems and other existing infrastructure. It’s the new, rapidly evolving technology and trends which will see them becoming responsible for even more technology — and it could all happen pretty quickly.

There were several themes:

  • Big, disruptive ideas: we all know big change is happening in every industry. How quickly will we see online voting; text message based democracy, and other new forms of technology based citizen democracy? I wrote about this in my “25 Trends for 2025” document — take a look at the trend, “Poll-democracy takes flight“, in which I suggest that “the mobile generation, weaned on the technology of text messaging and social networks, finally convinces a few brave countries to consider the idea of real time 
citizen-voting.” It’s not a question of if it will happen; it’s a question of when it will happen.
  • Infrastructure of 2025: it’s emerging now, and its happening fast. In cities and towns, we’ll see  local business and citizen groups using mobile energy shared insight apps to actively monitor and manage local lighting usage; global community vs. community challenges become common as gaming generation comes to manage their ‘personal energy infrastructure usage’ ; deep analysis capabilities move cities to prognostic maintenance of traffic, electrical, lighting, wastewater and water infrastructure systems. Wow!
  • Moore’s Law everywhere: Of course, the Internet of Things. Opportunities involving the virtualization of health care; seniors community care networks that allow seniors to live in their homes instead of seniors care facilities, supported through vast, interconnected medical devices ; intelligent LED networked streetlights with proximity sensors that indicate open parking spots; payment technology embedded into cars that will link and pay through smart meters.
  • Grand challenges: there are big challenges with civic infrastructure today. 16% of the water supply in the US is lost due to leaky pipes, and goes back in the ground!Put it another way: utilities lose enough water every six days to supply the nation for a day! Only 7% of the communities in the US recycle wastewater. Compare that to Israel: more than 80% of household wastewater is recycled, 1/2 going to irrigation. Of course, someone will solve this challenge with technology — perhaps this company. “Nexus eWater, maker of the world’s first home water and energy recycler, today announced that it is the first company ever to receive certification to the NSF/ANSI 350 global standard for residential grey water treatment for its ‘NEXtreater’ home water recycler. (Nexus eWater is World’s First Company to 
Obtain Certification for Residential Grey Water Treatment 13 March 2015, Business Wire). Their goals? reducing city water into the home by up to 40%; reducing sewage from the home by 70%; reducing water heating energy by 75% ; reducing home energy use by 15-25%; generating total savings of up to $50-$200 per month per home for water, sewer and electric bills. Oh, and harvesting rainwater. Pretty bold goals, but that’s the type of world we live in today
  • The next generation: My sons are now 21 and 20. I pointed out that they have never known a world without the Internet, and have never known a world for the last decade without some type of mobile device. They simply will not expect to deal with a government that is not prepared to service them quickly, efficiently and effectively through mobile.

It was a fun talk; and certainly inspired a lot of thinking, with a solid 1/2 hour of Q&A.

I’m extremely impressed by the level of insight provided by a program such as that at UNC. We should do more to encourage innovators in government to take on and assume more responsibility for some of the grandest opportunities of our time!

I’m on stage in New Orleans – it’s 730am, and 4,500 people have showed up for my keynote on Healthcare 2020:


The session description used for the keynote:

Today’s Trends – Tomorrow’s Opportunities
Futurist Jim Carroll will give us a brief overview of the innovations affecting business and what they will mean to our economy and that of the world.  His unique views… will provide a smorgasbord of what businesses will succeed in the coming decades and the types of skills workers will need in the future….no matter what the business.  There is no doubt that the delivery of health care is influenced by the state of our economy .   As Jim takes us on a voyage of what health care will look like in 2020, he won’t even mention the phrase ‘health care reform’.  He’ll address what key innovations will affect health care and health care delivery, as well as how we are going to pay for it.  In doing so, he will challenge the usual assumptions we make as trustees with respect to the future.  There is no doubt that we are transitioning from a system which “fixes people after they’re sick” to one of that is focused on preventative, diagnostic and genomic-based medicine. Join us for this thought provoking and mind expanding presentation.

I’m getting a tremendous number of bookings and inquiries from groups throughout the healthcare, pharmaceutical, medical and other sectors for a keynote that looks at the concept of Healthcare 2020: which takes a look at the real scientific, demographic, social, technological and other trends that are providing for real health care transformation.

People are sick to talking about and listening to others talk about Washington-centric health care reform, and want to know what’s really going to happen. That’s why I come in.

Jim Carroll speaks to 4,500 pharmacists at IdeaShare 2011 in San Francisco, on the theme of “changing opportunities, changing roles.” His job was to encourage innovative thinking as to how they can seize opportunities in the health care system, by thinking about the major trends which are changing the system out to the year 2020.

Contact me today — or followup through the speakers bureau that sent you to my Web site — to learn how I can help you with your own transformative thinking. And in addition, check out the Healthcare Trends section of my blog for some fascinating posts regarding what I’ve been doing in this sector.

I’ve recently done a number of very high profile talks in the health care, pharmaceutical and related industries, including opening the recent World Pharma Innovation Congress in London, England.

Just last week, I was the opening speaker for a very early start at 730AM in New Orleans for over 4,500 people at the International Foundation 57th U.S. Annual Employee Benefits Conference – always a fascinating experience to have that many people out in N.O. for an early keynote!

The organizations selected me specifically because I could give them an overview of future health care trends, without taking at look at the political issue of health care reform. After all, the real trends that will provide the real solutions to some pretty massive challenges in the world of health care will come from the world of science, hi-tech and pure research — not from an ongoing, relentless, annoying and ultimately useless amount of hot-air from politicians, regardless of their political stripe.

For New Orleans, the keynote description emphasized this : which is perhaps why so many showed up!

“Jim Carroll, one of the world’s leading futurists, will share his thoughts on transformative trends that will define the road ahead in the critical area of health care. The fact is we will witness more change in health care in the next ten years than we have seen in the last 200. Hear Mr. Carroll forecast what paradigms will change as health care is transformed through the next decade, far beyond the impact of health care reform.

At events such as this one and the keynote in London, I take a look at the future of health care from the perspective of medical science, social and demographic trends, the impact of increasing velocity of knowledge and other major trends that have absolutely nothing to do with the political debate around health care reform. You can’t wish a problem into a solution — you need pure research and innovation to make things real.

And certainly one of the trends that is going to provide tremendous opportunities for innovation in the sector will come about as Silicon Valley sets its sights on health care. Years ago, a senior executive at Intel noted that “we have the potential to aim our innovation engine at the age wave challenge and change the way we do health care from a crisis- driven, assembly-line, hospital approach to a personal-driven approach, with people taking care of themselves with help from family, friends and technologies.” At the time they were speaking of health care being one of their top five sources of revenue in the years to come.

That’s why one of the biggest growth markets we are beginning to witness now is emerging as Silicon Valley and the hi-tech industry begins to get involved in the world of health care in a whole variety of different ways.

First and foremost, it’s happening in a very big way with consumer-oriented health care apps, particularly on the iPhone and Android. A recent survey indicated that:

  • 78% of consumers are interested in mobile health solutions
  • medical and health care apps are 3rd fast growing category for iPhone and Android phones
  • the Apple App store now has 17,000 health care related apps, 60% of which are aimed at the consumer

We will certainly see a huge amount of product innovation, such as the new iPhone based blood pressure monitor from Withings:

What is really significant is that with such personal medical monitoring and wellness technology, we are going to see very significant involvement by health care providers and professionals, insurers and others within the system to adapt to a new world in which a large number of patients become immersed in the world of interactive healthcare and wellness monitoring.

Then there is the world of bio-connectivity — a trend that will see the emergence of more sophisticated medical device technology that will let medical professional monitor their patients from afar. This is a topic that I’ve explored at length in a variety of posts on this site. Quite simply, in the years to come, the concept of a physical hospital is going to change as it goes virtual through the extension of bio-connectivity technologies and methodologies:

  • Imagine the hospital of 2020? I can 
  • The future of seniors care / assisted living: Big trends or crazy ideas? 

Silicon Valley will also play a huge role as it comes to develop real time health care predictive dashboards and other new forms of medical insight that will help the system to be better predictors of emerging health care risks and crisis situations. Big math, big computers, big analytics and health care – a match made in heaven!

  • Remember those kids who were really good at math? They own the future 

It doesn’t stop there. In the world of pharmaceuticals, the impact of Silicon Valley is going to have one of the most dramatic impacts on an industry that we have ever witnessed. For years, the sector has been busy exploring the opportunity for ‘pharmacogenetics’ — that is, how can we determine if a particular drug treatment is going to have its greatest impact on a group of people who share a common characteristic in their DNA.

This type of very specific genomic medicine has been around for years — but it is about to take off like a rocket as Moore’s law comes to have an impact. Quite simply, the cost to do what were once very expensive genetic tests are simply going to plummet.

  • Costs of DNA sequencing falling fast – look at these graphs 

I could go on ; there are dozens of examples where the impact of technology upon the health care system is going to be dramatic.

Suffice it to say, if you want to watch one of the trends that will have the most impact in the next decade, this is one of them.


People are getting sick to death of listening to politicians bicker about health care, and want to know where the real opportunities for change and  innovation.

".... data constantly generated by our bodies is monitored and informs better health and healthcare decisions..."

In light of this trend, I’ll find myself in October in New Orleans. I’ll be one of the keynote speakers for the 57th U.S. Annual Employee Benefits Conference. In the audience will be upwards of 5,000 trustees, administrators and professional advisors serving union and public sector benefit plans.

These folks have got some pretty tough issues on their plate, with dramatic challenges impacting state, municipal and federal spending; and certainly a lot of challenges in managing benefit costs into the future while providing the best support to their members.

My keynote will focus on opportunities for innovation through the transition to Healthcare 2020: and by riding the trends that will really influence healthcare through the next decade. I wrote a blog post on the theme some time back.

There has been a huge demand for this topic ; I’ve had many keynotes through the last year, involving situations where folks want to move beyond the health care reform debate, and are seeking insight into the scientific, structural, knowledge, skill set, technology, business models that will really impact health care. Just this month, I was the opening keynote speaker for the International Society of Medical Publications Professionals; last month, the opening keynote for a major seniors care conference.

And what’s been happening with these talks? When I began a recent keynote talk for the Minnesota Hospital Association CEO Summit, I announced that Ie wouldn’t even mention health care reform — and the audience of 300 senior executives cheered! Instead, I told the audience that I would take them on a voyage to the world of healthcare in the year of 2020, and provide them the insight they really need to deal with the challenges and opportunity of the future.

Everyone in a leadership position in the US health care system knows that even with health care reform, the challenges facing the US health care system are substantial and immense. That’s why innovation has quickly come to be one of the top issues that senior healthcare executives and medical professionals are thinking about. There is a realization that there is an urgent need to challenge the very philosophies upon which the system is built. They’re seeking insight into the major scientific, technological, consumer and social trends that will, by the year 2020, allow for some very dramatic change in the concept of health care delivery.

Where will we by the year 2020? We will have successfully transitioned the system from one which “fixes people after they’re sick” to one of preventative, diagnostic genomic-based medicine. Treating patients for the conditions we know they are likely to develop, and re-architecting the system around that reality. A system which will provide for virtual care through bio-connectivity, and extension of the hospital into a community-care oriented structure. A consumer driven, retail oriented health care environment for non-critical care treatment that provides significant opportunities for cost reduction. Real time analytics and location-intelligence capabilities which provide for community-wide monitoring of emerging health care challenges. “Just-in-time” knowledge concepts which will help to deal with a profession in which the volume of knowledge doubles every six years. That and much, much more.

The fact is, we are going to witness more change in the world of health care in the next ten years than we have seen in the last 200. There’s plenty of opportunity for innovation!

Here’s the press release for the upcoming keynote:

International Foundation Announces Annual Conference Keynote Speakers
12 April 2011, Targeted News Service

BROOKFIELD, Wis., April 12 — The International Foundation of Employee Benefit Plans issued the following news release:

The International Foundation announces the following keynote presenters for their upcoming 57th U.S. Annual Employee Benefits Conference to be held October 30 – November 2, 2011 in New Orleans, Louisiana:

Lou Holtz–Considered among the greatest motivational speakers in America, Mr. Holtz will share how to overcome seemingly impossible challenges by setting personal goals and striving to achieve them. As one of the most successful college football coaches of all time, he has tested and proven that philosophy.

Jim Carroll–One of the world’s leading futurists, Mr. Carroll will share his thoughts on transformative trends that will define the road ahead in the critical area of health care. He will forecast what paradigms will change as health care is transformed through the next decade, far beyond the impact of health care reform.

Bertice Berry, Ph.D.–Ms. Berry will bring a dynamic close to the conference with her message, “When you walk with purpose, you collide with destiny.” As a best-selling author and college professor, she is a gifted speaker with a comic edge and a comic with a serious message. Attendees will leave with a sense of renewal and commitment to life, family and work.

More than 5,000 trustees, administrators and professional advisors serving multiemployer and public sector benefit plans attend the Annual Employee Benefits Conference each year. Attendees to the event discuss the latest cost-saving ideas, get updates on legislative developments, find creative approaches to new challenges and collaborate with their peers who face similar issues.

The conference features more than 125 sessions ranging in complexity from basic to advance, that cover health and welfare, pension, investments, fiduciary responsibility, communication, administration, technology, public plans, and training and education funds.

Learn more about the Annual Employee Benefits Conference at

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