1、Shaping the Future of the Internet of Bodies: New challenges of technology governance B R I E F I N G P A P E R J U LY 2 0 2 0 In collaboration with McGill University Contents 3 4 6 7 8 10 13 14 18 21 23 25 2020 World Economic Forum. All rights reserved. No part of this publication may be reproduced

2、 or transmitted in any form or by any means, including photocopying and recording, or by any information storage and retrieval system. Foreword Executive summary 1 Part One: The internet of bodies is here 1.1 Range and categories of technologies 1.2 Data-enabled social benefits 1.3 Risks associated

3、with the internet of bodies 2 Part Two: Governance of internet of bodies data 2.1 Data regulatory landscape in the US and EU 2.2 New governance challenges in the age of big data 2.3 Envisioning possibilities and options Contributors Endnotes Cover: Unsplash/Umberto Shaping the Future of the Internet

4、 of Bodies2 Foreword In the wake of the COVID-19 pandemic, wearable technologies such as health and location trackers have been thrust into the public spotlight spurring not only excitement about their potential benefits but also debate over their potential risks. Could these devices help public hea

5、lth authorities better predict, manage and avert future outbreaks? How might employers use data from wearable devices to safely reopen businesses? What are the implications for privacy and equity? How might this data be abused or used for other intended purposes such as public surveillance? These qu

6、estions are at the heart of new efforts by the World Economic Forum, in collaboration with public health authorities, leading technology companies and other stakeholders, to develop and pilot new approaches for the ethical treatment and sharing of health data collected by consumer wearable devices.1

7、 This paper aims to take these efforts one step further, looking beyond the scope of wearable devices at the broader ecosystem of connected technologies that is coming together to create “the internet of bodies” (IoB). As with any area of emerging technology, the IoB is evolving rapidly and its futu

8、re is unknown. It is for exactly this reason that careful attention and thought not simply on the part of business but from government, civil society and the public at large is required. We stand at the beginning of an important public dialogue that will have major implications for public health, sa

9、fety and the global economy and may also ultimately challenge how we think about our bodies and what it means to be human. This paper does not claim to provide a comprehensive view of all of the many facets of the IoB. However, it provides a glimpse of the myriad of complex issues that can arise whe

10、n the cyber and physical worlds come together. We invite you to join us in this important work to shape the development, use and impact of these technologies for the benefit of all society. As new technologies integrate with the human body, the opportunities and risks abound. Xiao Liu McGill Univers

11、ity Faculty Fellow at the World Economic Forum Centre for the Fourth Industrial Revolution; Wilson China Fellow Jeff Merritt Head of Internet of Things, Robotics and Smart Cities, Member of Executive Committee, World Economic Forum Shaping the Future of the Internet of Bodies: New challenges of tech

12、nology governance July 2020 Shaping the Future of the Internet of Bodies3 Executive summary To realize the full potential of the internet of bodies, we need robust, up-to-date governance frameworks. Shaping the Future of the Internet of Bodies4 The internet of things (IoT) is increasingly entangling

13、 with human bodies. This emergence and fast expansion of the “internet of bodies” (IoB)2 the network of human bodies and data through connected sensors while offering enormous social and health benefits, also raises new challenges of technology governance. With an unprecedented number of sensors att

14、ached to, implanted within or ingested into human bodies to monitor, analyse and even modify human bodies and behaviour, immediate actions are needed to address the ethical and legal considerations that come with the IoB. The urgency of such actions is further brought to the forefront by the global

15、COVID-19 pandemic, with extensive IoB technologies and data being enlisted for the surveillance and tracking of coronavirus. This white paper comprises two parts. Part one provides a landscape review of IoB technologies, as well as their benefits and risks. An examination of the ecosystem shows that

16、 IoB technologies are deployed not only in medical scenarios but also across different sectors, from fitness and health management to employment settings and entertainment. The accelerating convergence of consumer devices and health/medical devices also shows that the line between medical and non- m

17、edical IoB devices is blurring. This suggests that new strategies of governance are needed for IoB devices, which are traditionally subject to different regulatory agencies and rules. It is worth noting that this white paper will not delve into gaming and virtual reality (VR) devices nor the data fr

18、om them. While related, these devices raise distinct issues from the more traditional health and fitness devices. Part two examines the governance of IoB data focusing, in particular, on the regulatory landscape in the United States, with a comparative perspective of regulation in the European Union

19、. This part examines current regulatory approaches to IoB data, as well as the challenges raised by the rapidly shifting ecosystem, especially the wide adoption of big data algorithms. Whereas IoB technologies also entail other issues such as the physical effects of devices on users and liability fo

20、r physical harms, this paper focuses only on the governance of data generated from IoB, particularly from health and wellness IoB devices. Two main findings for policy-makers and stakeholders are highlighted. First, broad adoption of the IoB and frequent flows of IoB data across scenarios and sector

21、s requires robust and consistent governance frameworks in both the medical and non-medical sectors. This is particularly the case for IoB data governance as, while clinically derived data is in general strictly regulated, the regulation of consumer-generated data and other non-clinical data is often

22、, given the sensitivity of the data, uneven in terms of coverage and strength across sectors and jurisdictions; this is the case in, for example, the United States. Second, IoB data governance approaches and data protection laws need urgent updates to address the risk of privacy, unfairness and disc

23、rimination brought about by common practices of big data analytics. This risk presented by big data analytics exists with both medical data and non-medical data, as even deidentified medical data can be reidentified or misused in a way that causes harm and discrimination to individuals and groups. W

24、e therefore urge stakeholders from across sectors, industries and geographies to work together to mitigate the risks in order to fully unleash the potential of the IoB. The internet of things (IoT) is increasingly entangling with human bodies. Shaping the Future of the Internet of Bodies5 Part One:

25、The internet of bodies is here Recent advancements in the internet of things are transforming the human body into a new technology platform. 1 Shaping the Future of the Internet of Bodies6 Recent technological advancements have ushered in a new era of the “internet of bodies” (IoB),3 with an unprece

26、dented number of connected devices and sensors being affixed to or even implanted and ingested into the human body. This has turned the human body into a technology platform.4 The IoB generates tremendous amounts of biometric and human behavioural data. This is, in turn, fuelling the transformation

27、of health research and industry, as well as other aspects of social life, such as the adoption of IoB in work settings, or the provision of new options for entertainment all with remarkable data-driven innovations and social benefits. Yet the IoB also raises new challenges for data governance that c

28、oncern not only individual privacy and autonomy but also new risks of discrimination and bias in employment, education, finance, access to health insurance and other important areas for the distribution of social resources. Generally, IoB technologies include medical devices,5 a variety of lifestyle

29、 and fitness tracking devices, other smart consumer devices that stay in proximity to the human body and an expanding range of body- attached or embedded devices that are deployed in enterprise, educational and recreational scenarios. It is worth noting that the IoB technologies examined here are mo

30、stly “personal devices”, in the sense that the devices always develop a relatively stable relationship with the individual body of the user over a regular, extended period of contact. This, therefore, excludes the type of biometric technologies that are installed in public and private spaces, such a

31、s facial recognition systems, fingerprint sensors and retinal scanners, which focus on collecting and processing the data of a large population or group rather than particular individuals. As reflected in Figure 1, IoB technologies can be characterized as non-invasive or less-invasive, in the sense

32、that they are not expected to interfere with the structure or any function of the body; or as invasive, with sensors going under the skin to be implanted into or become part of the body. Range and categories of technologies1.1 I m pl a nt a bl e (i n v a si v e) M ed ic al N o n- m e di c al W e ar

33、a bl e a n d b o d y pr o xi m it y t e c h n ol o gi e s (n o n- in v a si v e) Hearing or eyesight aid/augumenting devices, continuous vitals (e.g. glucose) monitoring system, wearable peritoneal dialysis devices Digital pills, artifi cial pancreas and organs, smart prostheses, brain implant devic

34、es Implanted chips to speed up access to home, offi ce and other devices Activity trackers, smartwatches, smart garments, brainwear neurotechnology, augumented reality wearables, other body proximity consumer products Examples of internet of bodies technologiesFIGURE 1 Shaping the Future of the Inte

35、rnet of Bodies7 Invasive technologies include, for example, digital pills a recent drug-device combination developed to deliver encapsulated medicine and monitor medication adherence which rely on ingestible mini-sensors to be activated in the patients stomach, and which then transmit data to sensor

36、s, the patients smartphone and other data portals. Other examples of smart medical implantables include: an internet-connected artificial pancreas as an automated insulin delivery system for diabetes patients; and robotic limbs for movement rehabilitation in people with physical mobility limitations

37、. In recent years, increasing numbers of people have chosen to implant chips under their skin, not for medical purposes but as a personal choice to speed up their daily routines and for convenience accessing their homes, offices or other devices just by swiping their hands, for example.6 As part of

38、biohacking culture, people have also sought to enhance their bodies with implanted technology, from magnets and RFID chip implants to miniature hard drives and wireless routers.7 Among less invasive technologies, some devices remain on the surface of the human body these are usually called wearables

39、. Wearable technologies are a fast expanding area, with a $15.74 billion market in 2015, estimated to grow to $51.60 billion by 2022.8 Electronic skin patches alone, which are widely adopted in medical wearables for cardiovascular monitoring, diabetes management, temperature, sweat and motion sensin

40、g and other types of biomarker monitoring, achieved more than $7.5 billion in revenue in 2018.9 Non-medical wearables are a dynamic field, with products and adoptions ranging from personal fitness trackers and smartwatches to enterprise applications. These include connected glasses and helmets in em

41、ployment settings for location tracking, safety monitoring and job performance improvement; neurotechnological devices for work/learning productivity; and augmented and VR devices for entertainment and education. In addition to implantable and wearable technologies, smart sensors are increasingly ap

42、pearing in ordinary consumer products such as combs, razors, toothbrushes, skin products, mattresses and others. Although they do not stay affixed to the human body at all times, these products remain in proximity to the body and collect users biological and behavioural data on a regular basis. Curr

43、ently, medical and non-medical IoB devices are often subject to oversight by different governance bodies and separate sets of legal regulations and rules. In the United States, for example, the pre-market approval and post-market oversight of medical devices fall under the domain of the Food and Dru

44、g Administration (FDA), while non- medical devices in the consumer domain are mainly overseen by the Federal Trade Commission. Yet, in terms of their use scenarios, the division between medical devices and non-medical consumer devices is becoming blurred. Consumer wearable manufacturers such as Appl

45、e and Fitbit look to expand their products into certified health- monitoring devices and tap into health insurers and enterprises as their customers, while traditional medical device companies are also building devices for use outside medical facilities. IoB devices are being increasingly adopted ac

46、ross the division of medical/non-medical categories. Smart exoskeletons, for example, are used in industrial settings to augment human performance, but also for mobility assistance, rehabilitation and other health purposes. A national survey conducted in the United States by Valencell in 2018 reveal

47、ed the accelerating convergence of consumer wearables and personal health/medical devices.10 This invites a reconsideration of the line between medical and non-medical in the governance of IoB technologies. The variety and vast amount of data collected through IoB technologies is propelling transfor

48、mations in health research and industry, especially with the development of the direct-to-consumer digital health market. IoB technologies have also been adopted to enhance work safety in high-risk scenarios. Four of the more notable social benefits are detailed below. Data-enabled social benefits1.

49、2 1. Enabling remote patient tracking and reducing cross infection The continuous monitoring of body vital signs through sensors allows healthcare providers to better track the condition of patients within and beyond medical facilities, from data regarding blood pressure, oxygen levels, glucose levels and heart rate to the persons sleep, steps and other health-related factors. Continuous monitoring is increasingly recognized as a helpful tool to address the healthcare needs of the worlds ageing population and patients with a chronic disease.1