The pace of technological change is multiplied by the rapidly changing business and healthcare landscape.\nIoT continues to reshape the way business is done. Retail stores are free to carry less inventory because they can direct customers to internet shopping sites for specialized items. The number of people completing their Christmas shopping lists online increases every year. As a result of social media, our language is being invaded by new jargon and mnemonics. Online retailers and resellers are mastering the art of data mining to give online shoppers a superior shopping experience. Online education sites are becoming the new norm for top universities. Private sector businesses with deep pockets are hoping to make inroads to the healthcare business sector.\u00a0 Even clothing and luggage are being redefined to accommodate our connected life styles. Driverless automobiles are a reality, and GPS, at one time a luxury feature on automobiles, is now common on economy models.\nMix all of this with shifting social and political norms, and you have a challenging world in which to provide technology leadership in companies. So, it was challenging to choose which trends I would include in this final installment, but I feel they are good ones to consider because they have current as well as future implications.\nMore often healthcare system leaders will hire professionals from outside the healthcare industry.\nThis trend has taken hold and I predict will gain even more momentum as healthcare leaders try to figure out how to survive and thrive in a connected world where patient expectations are being shaped by innovative products and services they experience in other industry sectors. Consumers are demanding more convenience, more control, more choice, customized service and exceptional quality at lower costs from healthcare organizations.\nHealthcare CEOs and their teams are importing non-healthcare talent into roles such as marketing, innovation, strategic planning and information technology in hopes of learning from them how to satisfy new era healthcare shoppers.\nThe jury is still out as to whether this is the best way to solve the business model problem. Some suggest that what is really needed is the liberation of in-house talent, setting current employees free from norms and constraints that stifle creative and innovative thinking.\nThis may mean changing the incentive and reward structures for in-house leaders, and adjusting policies, procedures and organizational structures so obstacles to implementing new ideas are reduced if not eliminated.\nWhether internal liberation or talent importation is used, there is a start-up tax to be considered. People coming into healthcare from other organizations will have to learn the nuances of the healthcare business model in order to be effective, and that takes time as well as mistakes. Internal professionals already understand healthcare, but it will take them time, and yes mistakes, to break old thought and behavior patterns. It will be interesting to watch this trend to see what is successful. \u00a0\n5th-generation wireless (5G) technology will improve bandwidth and management of wireless networks amid controversy of its public health implications.\n5G is engineered to dramatically increase the speed and responsiveness of wireless networks. 5G data transmission rates over broadband connections could meet or exceed 20 Gbps, rivaling wireline (fiber optic and copper cable) network speeds. 5G bandwidth will greatly increase the volume of data that can be quickly transmitted over wireless systems, but it will also decrease latency to 1 ms or less, therefore supporting applications where real-time feedback is required.\nLatency is a measure of how much time it takes for a network data packet to make a round trip from sender to destination and back. The goal is to get latency as close to zero as possible so real-time performance can be achieved. With 5G comes better network management and capability to support new business services such as self-driving cars that require low latency.\nThere is a controversy brewing about 5G that health professionals and technology leaders would do well to be prepared for. Some scientists warn that 5G technology may have a cost to public health due to a massive increase in mandatory exposure to wireless radiation created by the larger number of antennas required to support it. Because of the capabilities of 5G, some expect IoT connections to rise by billions of connections across the globe, substantially increasing the total, long term RF-EMF exposure for most people. These scientists suggest this exposure may result in an increased risk of cancer, cellular stress, harmful free radicals, genetic damages, structural and functional changes of the reproductive system, learning and memory deficits, and neurological disorders.\nI am not expressing an opinion in support of or against these warnings, but as a responsible technologist remaining aware of all issues that may impact my business as technology decisions are made. Concern over the impact of EMF to the human organism is not new and has been under on-going debate for some time. As a technology leader, you may be called upon to express an opinion, so I suggest it would be good to develop one if you don\u2019t have one already.\n5G will be delivered in phases up through 2019 when we can expect to see 5G devices released. Technology leaders need to start thinking about what 5G adoption will mean to their corporate networks and mobile device strategies. \u00a0\nPatient Generated Data (PGHD) will rise in importance as analytics capabilities and mobile device accuracy improves.\nThe feds PGHD as health-related data created, recorded, or gathered by or from patients (or family members or other caregivers) to help address a health concern. There are numerous wearable, mobile, and at home devices that make this possible and valuable, especially since many of these technologies are surprisingly accurate. With encouragement from the feds, organizations will harness the benefit of PGHD by developing tools to gather and analyze this data in conjunction with the patient\u2019s formal electronic health record. \u00a0The following excerpt from the HealthIT.gov website describes why the feds and others think this emerging opportunity is important to the future of health care:\n\nThe use and sharing of PGHD supplement\u00a0existing clinical data, filling in gaps in information and providing a more comprehensive picture of ongoing patient health. The use and sharing of PGHD in care delivery and research can:\n\nGather important information about how patients are doing between medical visits.\nProvide information for use in shared decision-making about preventive and chronic care management.\nOffer potential cost savings and improvements in quality, care coordination, and patient safety.\n\n\nThe feds have created guidelines for using PGHD that can be found on their website at HealthIT.gov.\nHealth related wearables, and at-home devices will continue to proliferate.\nI already touched on this trend in my discussion of PGHD, so I won\u2019t spend any time describing this trend. What I will do is list some interesting devices and applications that may encourage you to do your own research. This is pretty exciting stuff. The challenge will be to build a business around these capabilities.\n\nSmart glasses for the visually impaired. An \u201cagent\u201d can see what the blind person sees in real-time, and then talk them through whatever situation they\u2019re in.\nA fitness tracker in a stylish ring. It has a step counter, heart rate monitor, sleep tracker, swimming tracker, and other functions--freeing up the crowded real estate on your wrists.\nHealth monitor you wear in your ear. Tracks body temperature, heart rate, VO2, speed, distance and cadence; and while in your ear allows you to listen to music and make phone calls.\n\nThese three only scratch the surface of what innovators are coming up with. Get yourself to a wearables conference and you will be informed and amazed.\nTechnology capabilities will challenge our legal and ethical systems.\nTechnology is emerging every day that will test our ability to determine the ethical and legal impact to citizens. How much privacy should citizens be forced to give up in the name of progress? Is technology-based gender selection a positive or negative thing for humanity? Who owns the information in my electronic health records and who has a right to see it without my permission? How much EMF is okay? We have gone way past the challenge of figuring out when it is right to pull the plug on a terminally ill patient. We have drones that peer through walls, listening devices that can hear from miles away, mountains of personal information available in social media sites, and so on. Technology leaders should prepare themselves to be the trusted advisor on ethical and legal risks surrounding technology used or planned by their firms.\nI hope this series has been of value and has inspired you to perform some prognostications of your own. Whether you employ tea leaves or crystal balls, it is an important capability to cultivate if you are to fulfill your role as a technology leader.