Technology Outlook now also addresses societal aspects of technologies. This is based on statements made by an interdisciplinary group comprising a total of 94 experts, in a Delphi survey. The technologies covered and the questions asked were selected in cooperation with the think tank Pour Demain. As is usual in Delphi procedures, the survey was conducted in two rounds. The second questionnaire was prepared on the basis of the first round’s results: It presented the answers from the first round together with the follow-up questions, in an attempt to eliminate any ambiguities and to confirm findings.
Although no socio-demographic factors were surveyed, it can be said that the majority of respondents are male, have a degree, are at an advanced stage in their career and work in a managerial role. The survey is therefore by no means representative. Nevertheless, the responses give an impression of the opportunities and challenges that the SATW experts see with regard to technological developments in the coming years. The survey addressed aspects of the research categories ‘digital world’, ‘energy and environment’, ‘manufacturing processes and materials’, and ‘life sciences’. The survey results on artificial intelligence (see artificial intelligence showcases) in healthcare were interwoven with the responses on point-of-care testing, as data security and privacy are central to both topics. In the research category ‘energy and environment’, questions were asked about priorities and conflicting goals regarding energy supply. In the category ‘manufacturing processes and materials’, the focus was on the topics of recycling and knowledge transfer.
Upheaval in the healthcare system is affecting not only roles and job profiles, but also diagnostics and treatment. In some cases, these changes are driven by new technologies. Comprehensive developments include artificial intelligence (see artificial intelligence showcases), the internet of medical things (see Internet of Things), medical wearables and point-of-care testing. All these technologies offer opportunities that are to be exploited and risks that need to be mitigated as much as possible.
With regard to the use of artificial intelligence (see artificial intelligence showcases) in healthcare, the experts paint a rather optimistic picture. Three quarters of the participants are more likely to trust an AI-assisted medical specialist to correctly diagnose a medical condition that is not entirely simple than a medical professional with 20 years of experience. As machine-learning systems need to be trained using large amounts of data, the hopes associated with artificial intelligence are in stark contrast to the unwillingness to make personal health data openly available for research: Two thirds of the participants value health-data sovereignty more highly than open data for research.
Bedside testing, as point-of-care testing is also called, brings laboratory diagnostics from the central laboratory to the person being treated: to the point of care. Such applications are already in use today, e.g. as blood glucose meters or as rapid tests to detect viruses. The goal is for more tests and measurements to occur at home, without a central laboratory, as a basis for further progress towards personalised medicine.
The participants in the Delphi survey agree that point-of-care testing could make an important contribution to prevention (81 per cent); however, only 46 per cent believe that widespread use of the technology is likely to lead to cost reductions in the healthcare system. The survey’s second round shed some light on this discrepancy: 73 per cent of the participants are convinced that point-of-care testing will lead to a higher number of medical consultations; 66 per cent fear unnecessary preventive treatments; 55 per cent fear that materials required for tests will entail high costs; and a few see the considerable bureaucratic work as a cost driver. Nevertheless, almost three quarters of the respondents are convinced that the advantages of point-of-care testing outweigh the disadvantages. As for who should cover the costs of such testing, the experts see this as the duty of the health insurance companies mainly (99 per cent rather or completely in favour), the service recipients to a lesser extent (82 per cent rather or completely in favour) and the state least of all (50 per cent against or rather against).
Without a doubt, the medicine of the future will require more data. A significant portion of this data will be personal and, as such, particularly sensitive. Anxiety about collecting, and especially storing, such personal data is evident throughout this survey and is potentially a major obstacle to a digitalised and personalised healthcare system. The concerns are particularly apparent when it comes to the question of whom such collected data is to be made available to. The response pattern is clear: The further away the respective parties are from the attending healthcare professionals, the less support there is for sharing the data with them, or making it available to them. Among the respondents, 95 per cent are rather or certainly in favour of making the data available to the attending health professionals; 96 per cent are rather or completely against sharing it with health insurance companies; and a considerable 98 per cent stated that they are decidedly against sharing it with employers.
With regard to AI and health data, the participants also see health insurance companies as representing the greatest risk of data misuse: 84 per cent believe that health insurance companies would use such data to their advantage. Likewise, 84 per cent of the participants think that a digitalised healthcare system could lead to more unfairness in the context of medical treatment. Only 24 per cent of the experts consider there to be a realistic danger of a negative impact on careers.
These figures are not encouraging with regard to the willingness to share health data. Therefore, the question arises as to which factors could have a positive influence: 95 per cent of the experts think patients are more willing to make the relevant data available for research, the better they are informed about what will and may happen with the data. The level of trust in health institutions and their staff plays a similarly important role. Thus, 91 per cent of the participants assume that people who have a high level of trust in the healthcare system are more willing to share data. The sense of responsibility for one’s own health, on the other hand, is judged to be rather unimportant when it comes to the willingness to share data: 67 per cent of the participants do not consider that the sense of responsibility for one’s own health has any influence on the sharing of health data.
A 2022 study on digitalisation of the healthcare system, conducted by Deloitte, even speaks of a crisis of trust in healthcare. The population’s concerns must be taken seriously, and not used as an excuse for failing to push ahead with digitalisation of the healthcare system.
Willingness to share health data is a factor that demonstrates the importance of digital trust – the confidence users have in digital products and services. If the opinions expressed here are correct, this will not only have consequences for healthcare institutions, but also for the Swiss Confederation and the cantons: Firstly, the legislator is required to ensure that individuals and organisations can control (and make self-determined use of) data that they themselves have generated or that refers to them. Secondly, it is necessary for the Swiss Confederation and the cantons to develop modern data-use guidelines that meet data-protection requirements, but simultaneously make it possible to benefit from the advantages of a digitalised healthcare system by facilitating simple and comprehensible exchange of data between the various service providers. As willingness to share data depends greatly on the level of confidence in the healthcare system in each case, it is imperative that healthcare institutions invest more in gaining and maintaining the population’s trust. This includes comprehensible regulations on self-determined use of personal data.
According to the Federal Statistical Office, Switzerland’s energy demand grew eightfold in the years between 1910 and 2010. For many years, the supply of low-cost energy seemed to be a given. Climate change, the associated need for decarbonisation and the Ukraine war have shaken this certainty, such that security of supply and the fear of possible shortages are issues that are once again more firmly anchored in the collective consciousness. In order to compare the various objectives that can be associated with energy supply, SATW asked its experts about their personal preferences with regard to the various goals. Here, each goal was paired with each of the others and, for each pair, the experts were asked which of the two to prioritise if there was a conflict between them. On average, the participants ranked the various objectives as follows, in descending order of importance:
The survey participants rated security of supply, technological security and climate neutrality as significantly more important goals than the other three. The fact that low-cost energy has the lowest priority may reflect the social status of this survey’s participants.
A somewhat more in-depth examination of the responses shows that they are highly intercorrelated and can be grouped together using cluster analysis: a mathematical procedure in which similar response profiles are put into groups, whose elements are similar to each other and as dissimilar as possible to other groups. The four response profiles can be described as follows:
The largest segment (N=44) sees security of supply as the central goal of energy supply, followed by technological security and climate neutrality. Energy self-sufficiency and intact landscapes are rated as significantly less important than the three most important goals, but are still well ahead of low-cost energy.
For the second group (N=19), the three most important goals are: climate neutrality, followed by technological security and intact landscapes. Security of supply is also important, albeit significantly less so. Energy self-sufficiency and low-cost energy are of little importance to this group. People who name climate neutrality as an important goal of a future energy supply are willing to pay significantly more for climate-neutral energy than people who rate climate neutrality less highly.
For the third group (N=14), security of supply is also the central goal of energy supply. Low-cost energy is the second-most important goal, along with technologically secure energy generation.
The fourth group (N=9) sees security of supply as the most important goal and energy self-sufficiency as the second-most important, followed by intact landscapes. In this group, the level of importance attached to the other goals (technological security, climate neutrality and low-cost energy) is significantly lower than the overall average among the participants.
Across all participants, it can be said that there is less acceptance of additional costs for energy sovereignty than for climate neutrality. In some cases, this is due to the fact that people who give higher priority to energy sovereignty also consider low-cost energy to be significantly more important than other goals. It should be noted that the groups formed in this way appear to be more homogeneous than they actually are. The groups formed here constitute an idealised abstraction. Within all groups, there are clear deviations from the group average.
Ecologically transforming the energy supply while simultaneously improving security of supply is a major challenge for all players involved: for politicians at all levels, for the energy industry and also for consumers. In order for a future energy supply to be organised in a secure and sustainable manner, and for it to meet all the various requirements, a broad-based dialogue that takes concerns and fears just as seriously as novel and innovative ideas must be established early.
According to the participants, responsibility for a sustainable and secure energy supply resides primarily with energy companies (88 per cent), as well as with the Swiss Confederation and the cantons (79 per cent), more than with the consumers, i.e. the business community and private individuals. If the business community and private individuals are to take responsibility, then rather via installation of photovoltaics (PV) or borehole heat exchangers (76 per cent and 72 per cent respectively) than by saving energy (62 per cent and 60 per cent respectively). Energy companies (76 per cent), as well as the Swiss Confederation and the cantons (67 per cent), are considered to have the greatest influence on the energy supply; businesses (43 per cent) and private individuals (28 per cent) are more likely to influence it by installing PV and borehole heat exchangers than by taking energy-saving measures (31 per cent and 21 per cent respectively). It is interesting that science’s influence, unlike its responsibility, is considered to be relatively high: Research into new energy sources (56 per cent) and the development of energy-saving equipment (42 per cent) are evidently seen as more effective than efforts to save energy.
Every physical object consists of at least one material and usually even comprises various substances in a complex interplay. The discourse on materials in the general public is limited to a few topics, most notably the problems related to plastics. However, as materials represent a much broader field and there are a great many different substances, it is necessary to direct the discussions in society towards other materials as well. After all, materials are closely linked to ecological, economic and societal issues. “It is essential to reduce the consumption of resources if the planetary limits are not to be exceeded (…). Switzerland must commit to truly closing resource cycles (…). This is the only way to decrease the environmental impact of our throw-away society.” (Xaver Edelmann, Technology Outlook 2021). In order to achieve this goal, the SATW experts envisage a two-pronged approach: Improving the level of knowledge among the general population and closing reusable material cycles.
Society’s general knowledge about materials, their advantages and their disadvantages, should be improved. The study participants consider broad-based transfer of scientific knowledge in schools, with inclusion of geographical, historical and political aspects, to be effective (89 per cent rated the degree to which they agree that it is effective as high or medium). Information campaigns (80 per cent high or medium agreement) and living labs (68 per cent high or medium agreement), in which the various materials, their advantages, disadvantages and possible uses can be experienced, are rated more highly than approaches using gamification (54 per cent high or medium agreement).
For materials to be sustainable, even if they are made from biodegradable resources, the resource cycles must be closed. To this end, homogeneous recycling is essential. As means of establishing the goal of closed reusable material cycles, the experts rate taxation instruments such as deposit systems (65 per cent high and 27 per cent medium agreement) and other incentive systems (56 per cent high and 39 per cent medium agreement) more highly than, for example, information campaigns. The latter are only considered to have a limited effect on closing reusable material cycles (16 per cent high and 57 per cent medium agreement).
Most of the main drivers of the development of new materials in research and industry constitute ecological, economic or societal challenges that require a solution. The question of whether the population is willing to accept additional costs for materials that are more sustainable was answered with a ‘no’ by 48 per cent of respondents. Another 37 per cent stated that they are undecided or do not know. Only 15 per cent believe that price rises caused by materials that are more recyclable or more durable would be accepted. Among those surveyed, 58 per cent see a possibility that improved materials could lead to rebound effects, such that they result in behaviours with lower overall sustainability than, for example, materials that are less sustainable but correctly disposed of.