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DIGITAL PRODUCTIVITY AND SERVICES www.csiro.au Enabling Australia’s Digital Future: cyber security trends and implications
ACKNOWLEDGEMENTS CSIRO would like to acknowledge Defence Science and Technology Organisation (DSTO) for the original concept and broad approach of describing the future cyber landscape in terms of cyber dependency, threat and vulnerability within a context of “increasing dependence on an increasingly vulnerable cyber domain”. We also acknowledge DSTO for contributing their cyber security expertise and methodology, as well as for their input into developing the technology-use framework used to analyse sectoral technology dependence. AUTHORS CSIRO engaged with both Commonwealth and State Departments and Sandra Arico (CSIRO Futures) Industry stakeholders particularly relevant to the Government and Vivek Srinivasan (CSIRO Futures) Commercial Services sector, Health Services and Energy Sector whilst preparing this report and we would like to thank each of them for their valuable input. Some of those Departments and Organisations included: • NSW Department of Finance and Services COPYRIGHT AND DISCLAIMER • Australia Post © 2014 CSIRO. To the extent • National E-Health Transition Authority (NEHTA) permitted by law, all rights are reserved and no part of • Jemena this publication covered by Lastly, CSIRO would also like to acknowledge the support of the Digital copyright may be reproduced Productivity and Services Flagship members Ian Oppermann, Jay Guo, Sarah or copied in any form or by Dods, Geof Heydon and Helen Sargent, as well as assistance and insights provided any means except with the by CSIRO’s Computational Informatics staff John Colton, John Zic, Surya Nepal, written permission of CSIRO. Dimitrios Georgakopoulos, David Hansen, and Mark Paterson (Energy Flagship). B Enabling Australia’s Digital Future: cyber security trends and implications
Contents Executive Summary 3 Increased technology Cyber security threats: An increasingly dependence: our a familiar yet evolving vulnerable environment 28 Introduction 4 digital future 9 landscape 23 A changing paradigm 29 Objectives and scope 4 Customer technology-use Understanding cyber Implications of a breach 29 Approach 4 trends 12 threats 24 Scenario analysis 30 The Australian context 5 Provider technology-use Threat actors 24 trends 15 Evolving threat Enabling Australia’s A changing landscape 6 digital future: key Customer-Provider landscape 26 Healthcare 7 technology-use trends 19 considerations 35 Implications going Energy (Electricity) 7 Implications for ICT forward 27 People 36 Government 8 support infrastructure 21 Process 37 A complex digital future 22 Technology 38 Conclusion 38 References 39 1
Executive Summary Australia’s digital future is set to transform the nation. Our transition towards a more digital economy will drive economic progress, improve social wellbeing, and open up new opportunities for innovation and increased competitiveness on the global stage. Continued technological advancement Advancements in technology may be Taking this direction requires a change and rapid adoption are central to our contributing to these evolving security in perspective, recognising that cyber progress, as new developments spur challenges, but they are also a key security is not solely a technology more innovative business models, part of the solution. Developments in challenge. It is also a cultural challenge, products and services, which are data analytics and machine learning and one that extends beyond traditional crucial in responding to key national are allowing us to better understand information security practices. Alongside and sectoral challenges - such as rising network anomalies and harness big data. investment in new cyber security tools healthcare costs, increasing household Progress in cryptography techniques are and technologies that can keep pace electricity prices and Government helping to better secure information. with evolving threat challenges, our pressures to do more with less. As And sophisticated risk management nation’s future strategies require a technology and digital solutions modelling tools are allowing leaders to commitment to improving cyber security continue to play a key role in driving make more informed cyber decisions. skills, awareness and education, as the economy and society forward, they well as an imperative to evolve cyber Whilst progress has been made become increasingly embedded into security perceptions to understand towards improving and advancing business operations, across key service the central role this capability has cyber security solutions, we are at offerings and into our personal lives. in enabling our digital future. risk of becoming complacent. Amidst Australia’s future is digital, hyper- an environment of continuous, rapid Successfully navigating the road ahead connected and critically dependent change, with increasing levels of will require a whole-of-nation effort, on technology, making strong cyber complexity and uncertainty, we cannot harnessing the full range of resources security capability crucial to navigating afford to rely solely on past and present available across our economy. Alongside the associated risks and opportunities solutions. Ensuring Australia’s digital existing national and defence-related ahead. Our increased dependence on success into the future will require strategies, the research community technology, combined with the evolving bold cyber security leadership and in partnership with industry and complexity and sophistication of cyber further investment now. It will require Government have a vital role to play, security threats, together increase our ongoing science and technology through applying innovation and level of vulnerability – at a national, research that can identify emerging cutting-edge technology to the people, organisational and individual level. cyber security challenges and develop process and technology solutions practical solutions. And it will require a needed going forward. Through cultural shift, extending cyber security the integration of knowledge, ideas responsibility out to every organisation, and resources, we can ensure strong every government, and every individual. cyber security capability is at the core of a digitally-enabled Australia. Dr Ian Oppermann Director, Digital Productivity and Services Flagship, CSIRO 3
Introduction Australia’s transition to a digital economy is opening up new and exciting Objectives and scope • A changing landscape. Focusing on three key representative sectors – opportunities for innovation and global The objectives of this report are to: healthcare, energy and government competitiveness. It is driving change – this section provides an overview across key sectors such as healthcare, • increase general awareness of broad economic and social energy and government and facilitating and understanding of digital trends, which are driving change greater levels of social and economic trends and implications for and leading to increased digitisation prosperity. However, these new cyber security in Australia; and technology use nationally; opportunities are also driving a greater • provide a broad overview of • Increased technology dependence: dependence on technology – which the current and future cyber our digital future. Looking at emerging is constantly evolving, increasing in security needs and challenges technology trends, this section analyses complexity and continuously exposed on a national level; how technology usage and dependence to a sophisticated landscape of cyber is changing across each of the sectors. • present key considerations and threats. This challenge is compounded strategic questions to serve as input A technology-use framework is when you consider the blurring lines for forward planning and investment adopted, which considers various between people, organisations, considerations into the future. usage trends across sectoral providers processes, services and technologies (organisations) and customers A time frame of approximately that require seamless interaction and (consumers), and broader technology ten years (to 2025) has been trust across the cyber ecosystem. trends related to underlying ICT considered in analysing trends and As a result, our national progress is presenting future scenarios. support infrastructure; directly tied to our ability to minimise • Cyber security threats: a familiar Key considerations and strategic risk exposure without limiting yet evolving landscape. Considering questions for cyber security have been progress – making cyber security a the cyber security threats landscape, posed in the broad areas of people, capability of crucial importance. this section explores various types process and technology. Specific of threats, different threat actors and recommendations have not been their motivations, as well as how included in this report, as they will be the landscape overall is evolving in the subject of further collaborative effort complexity and sophistication; in partnership with industry, government and the research community. The • An increasingly vulnerable questions posed are intended as environment. Combining increased input into these further discussions technology dependence and and strategic planning activities. connectivity, alongside a more sophisticated and complex threat landscape, this section examines Approach the implications on our level of cyber security vulnerability.* Like any complex system, cyber space Considered from a broad, national is made up of many interrelated perspective, potential exploitation parts, which can be examined to of vulnerabilities is explored help us better understand the overall using three future scenarios system – and in this case, to help across each of the key sectors; us gain a clearer understanding of our cyber security needs and challenges going forward. Figure 1.0 highlights this approach, reflected in the report structure as follows: *This methodology of technology dependency overlaid with threats to understand vulnerabilities has been adapted from collaborations with DSTO, as well as from other cyber security methodologies.(1),(2),(3) Traditionally, vulnerability assessments are conducted at a very technical level within organisations. For this paper we have adopted the methodology to look broadly at vulnerabilities across national sectors. 4 Enabling Australia’s Digital Future: cyber security trends and implications
• Enabling Australia’s digital future: key considerations. Bringing The Australian context • The Australian Bureau of Statistics Personal Fraud Survey together the dependency, threat and A common question raised in response indicated that over the 12 month vulnerability analyses, this section to cyber security is whether threats period from 2010-11(8): looks at the broad implications for and breaches are happening here in – An estimated 1.2 million Australia’s current and future cyber Australia. Much of the cyber security Australians aged 15 years and security, outlining key strategic data and cases reported point to other over were victim to at least one questions for consideration in countries around the world, which can incident of personal fraud enabling Australia’s digital future. lead to a misconception that this is not – Australians lost $1.4 billion as an issue to be taken seriously on our a result of personal fraud FIGURE 1.0 – APPROACH SUMMARY own soil. It is not possible to present – An estimated 44,700 Australians a complete picture of cyber security were victims of identity theft threats and breaches due to many Broad social and economic trends cases going unreported or being of a – Approximately 6.4 million classified nature and therefore unable Australians were exposed to a scam DRIVING to be publicly shared. However, publicly available information provides enough Increased use of and data to illustrate the reality of the ASIO building plans stolen dependence on technology challenge we are facing here in Australia: It has been reported the INCREASING EXPOSURE TO • Whilst many instances of cybercrime Australian Security Intelligence go unreported, non-government Organisation (ASIO) building More complex and estimates put the cost of cybercrime security and communication sophisticated cyber threats in Australia as high as $2 billion systems blueprints were stolen in annually.(4) Defence estimates that a major cyber attack in 2013.(9) LEADING TO in 2012, 5.4 million Australians were victims of cyber crime.(5) Increased levels of cyber • According to antivirus vendor security vulnerability Trend Micro, Australian computers Assuming deceased identities experienced 17,692,567 malware An unlawful foreign national HEIGHTENING infections in 2008. Australia falsely assumed the identity of reported the fifth highest level four deceased individuals, with Impacts of cyber breaches of infections worldwide.(6) almost $76,000 of false benefit (explored through future scenarios) • CERT Australia, the national computer claims made.(10) emergency response team and the PROVIDING THE IMPERATIVE FOR single point of contact for cyber security issues affecting major This is just a snapshot of data Collaborative, targeted action Australian businesses, reported highlighting the reality that cyber and investment in cyber security close to 7,300 incidents in 2012. security challenges are not confined solutions – across people, The following year, incidents to a just handful of nations – every process and technology increased, with approximately country is affected and every country 8,500 reported by mid-August.(7) has a role to play in enabling better national and global cyber security. 5
A changing landscape Understanding Australia’s cyber security needs and challenges is a complex task, considering technology use and digital connectivity cut across all sectors, organisations and individuals, in multiple ways and to varying degrees. In considering this complex system, we have focused on a subset of sectors to help us understand the broader national picture and the common trends and patterns evolving across all dimensions. The three sectors are healthcare (focussing on health services), energy (focussing on electricity) and government (focussing on government services), all of which are considered critical to Australia’s sustained economic prosperity and social wellbeing, and whose services impact the wider population. The following section presents an overview of the broad economic and social trends across these sectors, which are driving change and leading to increased digitisation and use of technology. These trends serve as a backdrop to the detailed technology dependency analysis that follows. 6 Enabling Australia’s Digital Future: cyber security trends and implications
Healthcare Energy (Electricity) SECTOR SUMMARY • More people are using health services, SECTOR SUMMARY driving healthcare costs up The healthcare sector is in the midst The electricity grid is modernising exponentially. More Australians (young of a turbulent transformation. towards a smart grid, improving and old) are increasingly visiting As the population ages and visibility, reliability, monitoring doctors, having a higher number of lifestyle-related illness continues and control of the electricity tests and operations and taking more to rise, increasing pressure will be network. In addition to enabling prescription medication.(17) These placed on the healthcare system, a greater use of emerging conditions are resulting in higher with costs expected to grow to technologies (such as renewables), healthcare costs per person and unsustainable proportions. This modernisation will help to reduce increased health expenditure across the creates an increasingly challenging operating costs, particularly system, with government health environment in which healthcare those related to servicing peak spending in Australia estimated to grow providers will need to operate, demands, which account for a large from 4% of GDP in 2009-10 to 7.1% in with several implications for the portion of Australia’s electricity 2049-50.(14) Unchecked, healthcare health services industry. Demand expenditure. This will in turn help expenditure could consume as much as for health services will continue to control electricity price rises 40% of Australian taxes by 2043.(18) to grow, as will expenditure, and consumer bill ‘price shocks’. driving changes in the nature and • Demands on health services workers delivery of care, as well as creating are changing. By 2050, the demand new models for care outside of for aged care staff will quadruple due to an ageing population.(19) Key trends: existing traditional institutions. An increased number of aged and • Household electricity prices are chronically ill patients will also likely increasing. Household electricity increase the need for longer-term prices increased by 70% between Key trends: care, requiring a greater breadth 2007 and 2012,(22) resulting in a ‘price • Australia’s population is ageing. of skills to allow workers to be shock’ to Australian consumers. Whilst Between 2012 and 2060 the number more effective with these patients.(20) there are a number of reasons for of people aged over 75 years The result will be greater competition this increase, a large portion was as a will grow by approximately four for healthcare workers. result of network costs (such as major million people, an increase roughly • Delivery of care is changing, from electricity network upgrades),(23) which equivalent to the current population institutions to independence. are forecast to increase. The current of Sydney.(11) This is in part due to There will be an increased drive five year cycle for transmission and advancements in science, technology away from institutional care and distribution networks, for example, will and healthcare, which are enabling towards alternative community and see an increase in investment of 16% people to live longer. In 1901, the independent care options, with and 60% (real terms) respectively.(24) average life expectancy in Australia advances in technology enabling • Servicing peak demand is expected to was just 47 years;(12) by 2025, it this transition.(21) Additionally, remain a key cost driver. To ensure will increase to over 80 years.(13) in comparison to previous reliability of services and electricity • Lifestyle-related illness and generations, Australia’s elders generation, network capacity is chronic disease are on the rise. will be better educated and more designed to accommodate the highest Non-communicable diseases such tech-savvy, with improved financial amount of electricity consumption as cardiovascular disease, cancer, resources, more purchasing power, (peak demand) at any point in time. respiratory disease and diabetes, will and higher expectations.(13) This peak demand is often driven by account for almost 69% of total deaths extremes in weather, such as a heat in 2030 (up from 59% in 2002).(14) wave or cold snap. By its nature, peak The World Health Organisation is demand occurs infrequently, yet still calling this an ‘invisible epidemic’.(15) requires a large proportion of The Australian Institute of Health and investment. For example, in New South Welfare note that from 2003-2033, Wales, peak demand events occurring treatment costs for diabetes alone for less than 40 hours per year (or will increase by as much as 436% to less than 1% of the time) account for $8.6 billion.(16) around 25% of retail electricity bills.(22) Whilst future rates of peak demand are uncertain, limiting its growth is 7
projected to save 2 c/kWh each year on the costs of electricity distribution Government • Governments face increasing pressure to do more with less. between 2020 and 2050.(23) As demand for government services • The use of renewable power increases and budgets tighten, SECTOR SUMMARY pressure will continue to be placed generation is growing. There is growing societal pressure to reduce Government departments and on governments to ‘do more with the electricity sector’s greenhouse gas agencies are digitising processes, less’. Virtually all governments are emissions, which in Australia is the systems and services in the face of reducing staff levels, often without single largest source of emissions.(23) greater consumer expectations, any real reduction in service levels.(29) This is resulting in a significant push tightening budgets and increasingly Governments that can adapt and move for renewable energy sources such as complex operating environments. to shared models of services, labour wind, solar, hydro and geothermal. This transition to a more and resources through increasingly By 2049-50, it is expected that connected, digital government or networked and digitised approaches, approximately 51% of Australia’s ‘e-government’, is occurring at both will have the ability to remain lean but electricity generation will be from state and federal levels and includes still deliver on their mission.(29) In line renewable sources (up from 13% in an increase in online services, with this, the Department of Finance 2012-13) with a large percentage coming coordinated whole-of-government estimates that their co-ordinated, from wind (21%) and solar (16%).(25) strategies (such as consolidated ICT whole-of government approach to infrastructure), as well as improved data centres will avoid $1 billion in • The grid is moving towards two-way costs over the next 10-15 years.(30) collaboration and information management and control. Australia’s sharing across government and • Digitised services can help to cut electricity grid largely operates with with businesses and citizens. costs and increase productivity. systems, processes and technologies that are designed to manage energy Globally, successful e-government flow in a single direction – from large projects have reduced transaction generators to customers. However, Key trends: costs and processing times, and improvements in technology (including increased government revenues.(29) • Consumer preferences are changing. In Australia, the introduction of the renewable technology) supported Consumers are increasingly choosing by changes in policy, are enabling Department of Immigration and to interact via online channels and will electricity to be generated at or close Citizenship’s ‘SkillSelect’ system in expect that governments are agile and to the point of consumption. This 2012 has seen a 200% increase in keep pace with private sector digital allows surplus power to be fed back online skilled migrant applications maturity. In 2012, Australians showed into the distribution network.(22) This and a 20-30% reduction in referrals a strong preference for the use of concept, known as distributed (or to exception processing at Sydney e-government service channels over on-site) generation, creates two-way Airport through the Border Risk other means of interaction, with two energy flows, which must be carefully Identification System.(28) Digitised thirds of people using e-government monitored to ensure reliability. services can also assist governments for their most recent contact.(27) By to contribute to productivity gains • New developments are leading to 2020, four out of five Australians will across the economy, through a smarter grid. Requirements to choose to engage with Government unlocking value in shared data.(31) manage peak demand, decrease through the internet or other types of carbon emissions and facilitate on-site online service.(28) However, in order • Governments are operating in an generation are driving a modernised, to satisfy consumer expectations increasingly complex environment. ‘smarter’ electricity grid, allowing into the future, governments will The issues faced by the public sector greater visibility, reliability, monitoring need to recognise the importance are increasingly multi-dimensional in and control of the network. This of convenience in interactions and nature and require more collaborative modernisation (which includes the the need to meet or exceed private effort between governments, roll-out of smart meters) is not unique sector service standards.(27) departments, agencies and public and to Australia. USA, Canada, Europe, private communities to innovate and Great Britain, Ireland, Japan and develop more sophisticated solutions. (29) A key theme from the 2012 OECD Korea for example, all have regions with smart grid and smart meter E-Leaders meeting(32) acknowledged projects deployed or underway.(26) this, stating that governments need to take steps to defragment as they are historically structured to solve domain- specific problems. ICT and better information flow across boundaries were seen as key enablers of improved collaboration and co-ordination. 8 Enabling Australia’s Digital Future: cyber security trends and implications
Increased technology dependence: our digital future The world is undergoing a digital transformation, driven by rapid technological innovation and uptake. Technology is becoming increasingly embedded into our personal lives, the way we do business and the way we govern our nation. This is transforming Australia into a truly digital and highly competitive economy, with cyber security capability central to our success. 9
To understand our future cyber FIGURE 2.0 – TECHNOLOGY-USE FRAMEWORK security needs, it is important to gain an appreciation of our future technology dependence. Given the pace CUSTOMER PROVIDER of technology change, it is impossible (Citizen or Business) (Healthcare and Energy to predict exactly how technology providers; Government usage will evolve over the next decade. Departments and Agencies) However, signs of our digital future are Processes supported by software that runs on ICT support infrastructure already here. Pockets of our economy TECHNOLOGY USERS Customer only Provider only that are more progressive, as well as How will customers use How will providers use specific technologies that are highly technology in the future? technology in the future? advanced and ahead of the curve, give us insight into how the nation could be Customer-to-customer Provider-to-provider transformed if adoption was widespread. How will customers use How will providers use technology to change the technology to change the In exploring some of these way they interact with way they interact with developments, this section focuses on each other in the future? each other in the future? emerging technology usage trends across the key sectors of healthcare, energy Customer-to-Provider and Provider-to-Customer (electricity) and government, providing How will customers and providers use technology to change a snapshot of our digital future. the way they interact with each other in the future? Adopting a technology-use framework (Figure 2.0), we consider emerging ICT Support Infrastructure TECHNOLOGY ENABLERS technology usage trends across sectoral providers (organisations) and customers • Networks (such as fixed (LAN), wireless (Wi-Fi), mobile (2G, 3G, 4G), cloud etc.) (consumers), and how these and broader technology trends are impacting • End-points (such as PCs, laptops, tablets, Smartphones, underlying ICT support infrastructure. smart meters, supervisory controls, sensors, wearable Customers and providers are considered devices etc.) to be the primary technology users, with • Data storage (such as storage on secure servers, underlying ICT support infrastructure caching on mobile devices etc.) components presented as the enablers • Processing (such as processing in servers (private or to that usage (i.e. the systems, networks, cloud), and at client-end (such as hand held devices)) processes and devices that allow us to use and interface with technology). The technology-use framework presents a simplified picture of what is in reality a complex ecosystem of non-linear, dynamic processes, platforms and interactions. It is not intended as a Across each of the sectors, providers and customers are considered to be: comprehensive model, acknowledging that the lines between all dimensions of users and technology enablers are CUSTOMERS PROVIDERS becoming increasingly blurred and interconnected. The trends explored Healthcare Citizens and recipients Public and private are also not intended to be exhaustive, of health services hospitals, GPs, but provide an evidence-based allied health, etc indication of how the sectors and our Energy Citizens and businesses Electricity generators, nation are digitally evolving. Figure 3.0 (Electricity) that are recipients of distributors and retailers provides a high level summary of these electricity services trends, which are explored in detail in the next section. This provides us Government All citizens and All government with the foundation to explore cyber businesses departments and agencies security implications going forward. 10 Enabling Australia’s Digital Future: cyber security trends and implications
FIGURE 3.0 – TECHNOLOGY DEPENDENCY TREND SUMMARY CUSTOMER PROVIDER CUSTOMER-PROVIDER TECHNOLOGY-USE TRENDS TECHNOLOGY-USE TRENDS TECHNOLOGY-USETRENDS SUMMARY: The future customer SUMMARY: The future provider will be data SUMMARY: The future customer- will be increasingly empowered, driven, breaking down existing barriers to share provider relationship will open with greater choice, a louder information, skills, knowledge and infrastructure, up unprecedented levels of voice and a stronger connection within and outside of their organisation. communication, personalisation to local and global communities. and collaborative engagement, improving service delivery and creating new opportunities for growth. Customer only Provider only Customer-to-Provider/ • Shifting from provider- • Rapidly evolving service delivery by Provider-to-Customer centric to patient-centric transitioning to a more digital environment • Relationship between customers • Customers more actively • Enabled by electronic health records, and healthcare providers will involved in own care cloud computing and mobility, and a new continue to evolve and deepen • Enabled by personal health generation of diagnostic technologies • Greater personalisation and records, personal monitoring more frequent interactions Provider-to-Provider HEALTH devices and mobile applications • Increased opportunity for • Shifting from silos to a connected preventative care and outreach Customer-to-Customer health services ecosystem through new remote care • Relationship expanding to • Integrating of data, knowledge and expertise and consultation models encompass patient, family • Enabling improved diagnosis, treatment, and the community patient mobility, access to care and • Increasingly empowered scientific research opportunities and connected patients • Enabled largely by social media and community websites Customer only Provider only Customer-to-Provider/ • Shifting from reactive • Step change in decision-making and load Provider-to-Customer and consumption-based forecasting by combining real-time smart meter • Evolving relationship between to more engaged and data and advanced analytics and modelling customers and providers as smart proactive customers • Greater application of advancements meters improve communication • Generating own energy and in remote monitoring, distributed and real-time monitoring monitoring consumption generation and storage technologies • Greater information • Enabled by real-time data sharing, improved demand Provider-to-Provider management and personalised ENERGY from smart meters and apps connected to appliances, • Provider-to-provider relationship transforming, energy pricing schemes buildings and homes integrating data and information through use • Incorporation of personal electricity of smart meters generation back into the grid Customer-to-Customer • Enabling smarter electricity grid, increased • Interacting in new ways grid efficiencies and greater control and influencing electricity and reliability of electricity developments e.g. new consumer electricity sharing models • Enabled by social media and energy technology advances Customer-to-Customer Provider only Customer-to-Provider/ • Rise of ‘e-democracy’ • Digitising operations to reduce costs and increase Provider-to-Customer leading to more policy flexibility e.g. leveraging cloud services, analytics, etc • Interactions increasingly debate and discussion • Improving processes and employee flexibility moving online GOVERNMENT • Faster, larger scale through teleworking and mobility technologies • Enabling improved communication, conversations happening greater control (self-management), outside of government Provider-to-Provider increased information accessibility, channels – presents • Greater sharing of data and services, more efficient transactions opportunities and challenges infrastructure consolidation and whole- and lower cost to serve • Enabled by social media of-gov. technology roadmaps • Leading to improved experience, and online collaboration • Greater integration, process efficiencies, reduced especially when dealing duplication, improved decision-making and a with multiple departments better view of operations and national needs and/or agencies 11
Customer technology-use trends The future customer will be increasingly empowered, with greater choice, a louder voice and a stronger connection to local and global communities. Healthcare • Growth in the use and sophistication of smart phones and mobile • Online health platforms are using innovative approaches to connect applications (apps) is empowering consumers to one another in a individuals with unprecedented more personalised way, as well CUSTOMER ONLY control of their personal health. In as improving the information on The focus in health services is 2012, one in five US smart phone offer. Online patient community shifting from being provider-centric owners had at least one health app PatientsLikeMe engages with and to patient-centric, with customers and 31% used their phones to look empowers individuals through taking a more active role in their up medical information.(38) By 2016, knowledge and peer support, own care through the use of as many as 142 million downloads connecting those with similar medical personal health records, personal of mobile health and fitness apps is conditions and allowing for tracking monitoring devices and mobile anticipated.(39) and sharing of personal experiences. applications. This shift is expected Launched in 2004, PatientsLikeMe to play a pivotal role in creating now has over 200,000 patients on the CUSTOMER-TO-CUSTOMER platform and tracks 1,800 diseases.(42) a proactive and preventative health culture in Australia. Through the use of social media, • Consumers are increasingly being the healthcare relationship is given more power and a stronger expanding beyond the traditional voice through social media. Early indicators: patient-doctor relationship to Independent site Patient Opinion(43) include a new customer-to-customer allows patients to share feedback • Australian Government’s personally relationship, encompassing the on experiences with health service controlled electronic health record patient, their family and the providers, helping others to make (PCEHR) is enabling individuals to community. These relationships decisions about their own care, as own and control their own personal will result in increasingly well as driving improvements within health record, as well as share it. empowered and connected the healthcare system. Significantly, PCEHR provides significant value individuals, moving care away high volumes of feedback have been to those with chronic illness and from being a solitary experience. experienced from hard-to-reach disabilities, caregivers for the elderly groups such as the elderly, disabled and parents with small children.(33) and homeless, which Patient Opinion By 2013/14, PCEHRs are expected to Early indicators: CEO attributes to people wanting reach 1.5 million registrations.(34) “their voice to count for something, • The market for wearable health • One third of Americans have gone especially vulnerable people… this is and fitness devices (such as wrist online to better understand theirs because they normally don’t know watches, chest and arm bands) is or another’s medical condition, with how to get their voice heard.”(44) growing rapidly and estimated to 26% in 2012 having read about or reach 170 million devices in 2017, up watched someone else’s experience from 21 million in 2011.(35) This new with health or medical issues, and generation of wearable devices have 16% having tried to find others who the ability to monitor and wirelessly share similar health concerns.(40) transmit health data on blood • Health content and community pressure, heart sounds and electrical websites are continuing to spring up, activity, body and skin temperature, offering up-to-date, often expert- respiration, oxygen saturation and checked information and advice to blood glucose.(36) Advancements will consumers on medical conditions. continue, evidenced by radical new Medical website WebMD has grown innovations, such as the smart contact in popularity exponentially, with an lens for Glaucoma detection.(37) estimated 80 million unique visitors per month (as of March 2014),(41) providing knowledge, as well as hundreds of discussion communities, where members and experts can share and respond to health questions. 12 Enabling Australia’s Digital Future: cyber security trends and implications
Energy • At-home (on-site) electricity generation is expected to increase as Early indicators: technology costs fall and electricity • Although currently a minor segment bills continue to rise. Between 2008 of the car market, electric vehicles CUSTOMER ONLY and 2012, the total estimated install are attracting the attention of capacity of rooftop solar systems state governments, due to growing The focus is shifting from a reactive, increased from 23MW to 1,450MW; consumer awareness, goals to improve consumption-based model, to one based on a moderate growth scenario, air quality, economic benefits and where customers (citizens and the Australian Energy Market Operator energy infrastructure needs (such businesses) are more engaged (AEMO) estimate that capacity as re-fuelling stations).(52),(53) Unlike and proactively monitoring their will hit approximately 12,000MW traditional combustion engine energy consumption, through by 2031.(50) New business models vehicles, which require refuelling at real-time data from smart meters may increase uptake (such as solar specialised, infrastructure-intensive and applications connected to leasing schemes found in the US(51)). locations (i.e. petrol stations), appliances, as well as through the However, the growth rate of solar electric refuelling can occur almost generation of their own energy rooftop systems (or similar on-site anywhere, opening the door to new (such as the use of renewable generation methods) will be highly customer-to-customer electricity energy sources). dependent on Government policy. sharing models. This is already happening amongst citizens and businesses, such as the US City of San Early indicators: CUSTOMER-TO-CUSTOMER Francisco, which operates electric • Energy monitoring, automation and Advances in technology are vehicle charging stations in city- control for non-residential buildings enabling customers (citizens and owned parking facilities, including are expected to increase. This will businesses) to interact in new ways, the San Francisco International be particularly important for heating, with the potential to influence Airport.(54) In 2013, the major retailer ventilation and air-conditioning developments in the electricity Kroger also announced plans to (HVAC), which are estimated to sector. The growth in use of offer charging stations at a number consume 9% of Australia’s electricity electric vehicles for example, is of locations.(42) With the electric and create over 55% of peak demand opening the door to new consumer vehicle market expected to grow to in CBD buildings.(45) The value of electricity sharing models; whilst 5-7% market share of total car sales smart meter data to monitor and increasing use of social media by 2020(55), electricity sharing in the control electricity consumption will is enabling communities to consumer market could also increase, grow as building energy efficiency form around common issues of which has the potential to cause standards rise to include six, concern with a louder voice. significant shifts in the electricity seven and eight star ratings.(46) sector (for example, through changes in electricity load requirements(56)). • Increasing sensitivity to electricity price rises is leading to a greater adoption of in-home energy management devices and applications, wirelessly connected to data from smart meters. The sophistication of energy management will increase as homes become connected with smart devices (machine-to-machine), such as the smart fridge, television and thermostat.(47) This will allow consumers to monitor, control and optimise consumption across their entire household.(48) In future, this may lead to ‘set and forget’ home monitoring approaches, allowing consumers to completely automate electricity consumption-monitoring based on their personalised needs.(49) 13
• Web-based platforms have the potential to strengthen the voice of Government communities and mobilise change around common issues of concern and importance. An example in the energy CUSTOMER-TO-CUSTOMER sector is the debate about smart Social media and online meter safety. Whilst energy providers collaboration are enabling a new and state government departments form of ‘e-democracy’, leading to have provided assurances that smart unprecedented levels of citizen- metering devices are being installed to-citizen policy debate and safely and meet health and safety discussion. As a result, public standards,(57),(58) online platforms have opinion and discourse is occurring been used to enable anti-smart meter at a faster rate and on a larger campaigns. A number of community scale outside of government websites have sprung up to influence channels, posing both challenges the banning of smart meters(59) and and opportunities for the sector. cases of physical meter damage have also been investigated by police.(60) Whilst smart meter rollout is still Early indicators: continuing in Australia and around the world, such groups have the • Web-based communication is fast • Online collaboration to enable potential to stall progress, as a strong evolving to create new opportunities large-scale change is extending community voice demands a response. and challenges. The widespread use beyond the citizen, to include As social media and online channels of the internet as a communication businesses with some serious power. grow in use and influence, customers channel has changed the way we A large-scale example of this was the will continue to demand greater disseminate, access and process 2012 co-ordinated online protests transparency, access to information information, presenting significant against two proposed laws in the US and a voice in decision-making, opportunities for greater openness, Congress – the Stop Online Piracy Act requiring electricity sector businesses transparency and accountability.(61) (SOPA) and the Protect IP Act (PIPA). to engage more closely with the Online communication is not new, Protests were based on concerns that community, as well as consider but with an increasing number of measures in these acts would harm cultural change elements in the rollout people connected to the web and the free distribution of information of any new large-scale technologies. collaborative platforms constantly and lead to censorship if abused.(63) evolving, citizens from all corners Several influential websites, such as of the world are being empowered the English Wikipedia, considered to discuss key issues, share ideas and temporarily closing their content in effect real change on unprecedented protest; other sites such as Google, levels (such as GetUp!(57) and Mozilla and Flickr featured protests WikiLeaks(58)). However, the anonymity against the acts; and some shut and reach that the web enables can down completely. It is estimated that pose new risks, particularly if 115,000 websites joined the internet information is inaccurate, falsified or protest,(64) which then extended misleading.(62) This will require the offline and was reported globally. continued adaptation of policy and The impact of these collaborative regulatory frameworks to reflect protests was the shelving of the and respond to online developments. piracy bills and ceasing of further Despite challenges and risks, voting and progress.(65) The New York citizen-led online communication, Times called this a “political coming including via social media platforms, of age from the tech industry”.(66) will continue to play a key role outside of formal government communication channels. 14 Enabling Australia’s Digital Future: cyber security trends and implications
Provider technology-use trends The future provider will be data driven, breaking down existing barriers to share information, skills, knowledge and infrastructure, within and outside of their organisation. Healthcare • Investment in cloud computing will increase over the next decade in Early indicators: order to drive provider efficiencies • At a provider level, Australia’s across IT operations. By 2018, as many PCEHRs have experienced positive PROVIDER ONLY as 19,000 hospitals across Asia Pacific traction, growing from 3,039 will adopt cloud solutions.(69) By 2023, organisations registered to 4,502 Providers are rapidly evolving pay-as-you-go clinical software is also between May and July 2013. While an service delivery through expected to be used via the cloud estimate of 53% of General Practices transitioning to a more digital across a number of providers, allowing (GPs) are currently registered in environment, enhanced by compatibility and interoperability Australia,(34) greater opportunities electronic health records, cloud of systems from finance to clinical are possible if adoption increases computing and mobility, and a departments.(69) across all providers (such as new generation of diagnostic pharmacies, aged care facilities and technologies. • Adoption of new and emerging hospitals), such as in countries like diagnostic technologies will reduce New Zealand, Denmark and Sweden, testing costs, improve patient who are further along in provider Early indicators: experience and deliver greater adoption rates(72). Australia can look outcomes. The high growth point- • Digitisation of providers extends to these international experiences of-care-testing market, expected to beyond adoption of electronic health for lessons; however progress will reach over $9 billion by 2019,(70) is records and paperless environments. be highly dependent on sector and creating a new generation of portable, Most providers have begun investing government policy decisions. non-invasive, bedside diagnostic in the re-architecture of technology • Video conferencing, analytics and devices, which provide accurate systems, applications and processes. cloud-based services are enabling monitoring and results within minutes For example, a number of Australian providers to integrate and leverage and allow faster physician decision hospitals have increased investment services from specialist providers. and action times. Phillips and Google in wireless technologies to enable For example, through telemonitoring are also demonstrating innovative care from ambulances to rooms,(67) as technologies,(73) an experienced progress through their “Google Glass” well as integration of biomedical and professional can supervise, train and technology, which will in future environmental machine-to-machine assist a fellow practitioner on medical allow clinicians to gain hands-free, sensors and mobility investments procedures remotely. In future, this voice-controlled access to critical allowing data to be displayed, stored may extend to telesurgery, where information while operating or mobile and transferred between central surgical procedures are conducted through the hospital – enabling faster nursing stations to a physician’s remotely via a robotic surgical system; analysis, diagnosis and response.(71) tablet or handheld device(68). such as the pioneering laparoscopic cholecystectomy successfully PROVIDER-TO-PROVIDER conducted on a patient in 2001 in Integration of data, knowledge France.(74) Although feasible, there and expertise across providers are still challenges present, such as (underpinned by the rise of network latency and equipment cost. electronic health records) is transforming healthcare from siloed operations to a truly connected ecosystem of health services. This will enable improved diagnosis and treatment, greater patient mobility, increased access to care and greater scientific research opportunities. 15
• In combination with real-time analytics, health providers will have Energy • Providers are facing an explosion of data generated by smart meters, the ability to make new scientific which are measuring electricity usage discoveries. Hood and Flores predict in 30 minute intervals (compared to the discovery and advancement of PROVIDER ONLY the historic monthly meter readings). health research will shift from being Energy providers have used Across Victoria, this equates to over communicated primarily through technology for decades to improve 17,000 meter reads per year for articles and journals to being operations, such as using control each of the 2.5 million smart meters “integrated through digital networks systems to drive greater efficiencies installed across the state.(79) As the and heterogeneous databases that in energy management. However, smart grid expands to include smart capture data from every clinical new technology advancements, devices in homes, businesses and encounter”.(75) This may improve combined with access to real-time operations, the amount of data the efficiency and success of drug data via smart meters and data collected will grow exponentially, development and research processes, analytics, are enabling a step change making new developments in big which have been estimated to cost in operational efficiencies, decision data analytics of crucial importance over $1 billion and take between 10-15 making and load forecasting. to the efficiency and effectiveness years on average to eventuate.(37) of the grid going forward. A pioneering example of this is the • Smart meter data combined with 2013 White House sponsored initiative Early indicators: analytics will increasingly enable on open science, “Champions of invaluable insight into provider Change”. Open scientific data and • In addition to improving back-office operations and customer usage and publications from thirteen leading functions via applying new IT service behaviour. Frost and Sullivan present people and organisations is being models (such as cloud computing), the journey of data-driven utilities used to “accelerate progress and providers are increasingly adopting in Europe evolving from simple improve our world”,(76) including an and applying emerging technologies reporting tools in 2013-15 towards initiative publishing 400 trillion data to significantly improve operational advanced analytics and forecasting points on disease in partnership with efficiencies. This ranges from by 2020-25.(80) This journey will a children’s hospital. improvements in maintenance and enable opportunities in areas such remote monitoring, to the use of as cost and process optimisation, distributed generation and micro load forecasting, customer insight, grids (small, self-contained electricity new pricing models and data-driven networks), which ease the burden of decision making. As an example, the transmission and distribution to remote US utility company Oklahoma Gas and Australian communities.(77) With Electric (OG&E), which services nearly the expectation that energy storage 800,000 customers, is leveraging costs will decline by 50% by 2030,(23) analytics and high performance providers will also be able to ensure database technology to forecast higher levels of network reliability, energy demand and understand an whilst at the same time reducing individual customer’s consumption costs through deferred or decreased data in hours instead of days – infrastructure investment.(78) processing over 30,000 records per customer per year (up from 12 records per customer per year).(81) OG&E has also experimented with using its data to offer variable peak pricing programs and time-of-use programs that help customers understand energy saving opportunities. 16 Enabling Australia’s Digital Future: cyber security trends and implications
PROVIDER-TO-PROVIDER • The integration of renewable energy sources will drive increased data Government Integration of data and information sharing among providers, enabling through the use of smart meters is improved monitoring, forecasting and reliability. Operations can be PROVIDER ONLY set to transform the provider-to- provider relationship and enable significantly impacted by variability In addition to improving processes a smarter electricity grid. This will in wind and solar energy output, and allowing greater mobility of help to increase efficiencies across which is highly dependent on employees, individual government the grid and allow for greater local weather conditions.(83) With departments and agencies are control and reliability of electricity Australian wind generation expected digitising operations – eliminating (particularly in the management to rise from over 2,500MW in 2013 to paper processes, leveraging of electricity generated by approximately 11,500MW in 2020,(84) cloud services and developing renewable energy sources). providers (particularly distributors analytics capabilities – to reduce and generators) will need to share costs and increase flexibility. a significant amount of data and information to closely monitor and Early indicators: control any fluctuations in generation. Early indicators: • Australia is heading towards a This will include using forecasting more integrated, efficient, smarter algorithms to combine current • The use of cloud computing in electricity grid, made up of smart and historic load, with weather Government is on the rise. The US meters, automated energy control and geographic data to create Federal Government cloud computing and management systems, and new forecasts.(85) If not managed market alone is expected to reach $10 process and policy change. This will adequately, power issues could result, billion in annual value by 2018.(87) This help to transform siloed generation, such as voltage spikes, which can is reflective of the implementation distribution and retail activities impact reliability and safety.(56) of the US Government’s “Cloud First” into a truly integrated system that is policy, adopted in 2011, with improved • The combination of smart meter digital, two-way, self-monitoring and efficiency, agility and innovation infrastructure and renewable energy self-healing, adaptive and, among as the major drivers.(88) European sources across the grid will result other things, facilitates distributed Governments are also moving to in unprecedented levels of data generation and greater customer cloud solutions to boost business and communication across the grid choice.(82) In the long term, this achieve cost savings and efficiency and a significant reliance on data smart grid may expand to become improvements.(89) Australia has set communication networks. Using Australia-wide, encompassing its own goals for transitioning to the Victorian smart meter example all current state energy grids.(22) the cloud, releasing the Australian from earlier, the state would be However, integration will require Government Cloud Computing conducting over 42.5 billion meter greater smart meter penetration, Policy in 2013, stating: The Australian reads per year (17,000 reads per year which today is highly dependent on Government will be a leader in the x 2.5 million smart meters).(79) In state-based policy and direction. use of cloud services to achieve the US, the Massachusetts Institute greater efficiency, generate greater of Technology (MIT), predicted that value from ICT investment, deliver “over the next 20 years, the growth better services and support a more in percentage terms of data flowing flexible workforce.(90) through grid communications networks will far exceed the growth of electricity flowing through the grid”.(86) They went on to highlight that future advances such as the use of renewables and the requirement for real-time control would depend on both the data collection and communications network. 17
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