Design for Care has apparently been discovered by the larger design community this year, after a year in print! With the launch in June 2013, I had thought that between Rosenfeld Media and my own decently-connected network we might find numerous reviews in the first few months – but more reviews have emerged so far this year. Of course I’m appreciative, they’re all insightful pieces, and its so heartening to me to find that readers are getting the message. The late reviews trend also indicates that the book may have several cycles of discovery. Some of the more in-depth reviews include:
These are primarily reviews within design publications – there are only a few in the healthcare field, and I hope to see more uptake in the clinical and educational domains. My hope is that the late appreciation of the work suggests that the book was slightly ahead of its time, and is connecting with thoughtful readers as its discovered, rather than through reviews being pushed by author or publisher.
The goal of a startup is no longer just user engagement or viability. A “preference for disruption” is celebrated, without reservation, whether a small or big business. (Only recently were reservations even fussed over – Jill Lepore’s critique of Disruption culture was published the week after this conference talk, June 23.) She states (without critical analysis of causation):
“Ever since “The Innovator’s Dilemma,” everyone is either disrupting or being disrupted. There are disruption consultants, disruption conferences, and disruption seminars. This fall, the University of Southern California is opening a new program: “The degree is in disruption,” the university announced. “Disrupt or be disrupted,” the venture capitalist Josh Linkner warns in a new book.”
As an ethnographer of innovation practices, I have always appreciated Christensen and his contribution to theories of change. I also observe the trend signified by Lepore, the increasing meta-narrative of “disruption is good.” Disruptive innovation is not always beneficial to a society or even markets. In Design for Care I fret over the preference for disruption in current business thinking and its unjustified hubris in the healthcare field. With the mantra of disruption, we can gain attention by claiming the long process of disruptive innovation is occurring, for whatever it is we supposedly want to change. Much of this talk is (technically) bullshit, technology-centric wishful thinking promulgated as a rhetoric of winning, that ignores the realities of institutional practice and the complex forces and demands in healthcare that function differently.
Lepore starts to critique the social effects of disruption rhetoric, but she doesn’t go far enough in critique of cultural effects. However, she’s wrong to blame Clay Christensen for the wave of current disruption talk, as disruption has become a theme of startup and business culture only loosely based on Christensen at this point. She unfairly critiques The Innovator’s Dilemma, the 1997 work based on Christensen’s earlier research on the disk drive industry. But Christensen describes a very real systemic effect within business cycles, that new markets grow around inexpensive but viable alternative products and services, and that these markets can grow under the new cost structure and shift market share to the new provider. I observed the struggles and barriers to effective innovation practices in my own research of within-organizational innovation, discovering causes resulting from shifts in a company’s values (which of course are influenced by success and a growing customer base, also consistent with Christensen’s Resources-Process-Values theory). When successful products prevent strategic innovation. Design Management Journal, 2002, 13 (2).
Disruption has become in itself desirable, presumably preferred because of the theory of displacing entrenched regimes. It is the ultimate asymmetric power play, as the algorithmic efficiency of the startup is believed the inevitable winner in a technocentric future. We have culturally created a preference for technological innovation as a “disruptive” force, even in social domains such as education and healthcare. We now expect technology to save us, to provide ready-made “solutions” for supposedly entrenched problems, problems which are often framed as stupidly as “healthcare is broken. Obviously we must fix it.”
Evgeny Morozov eviscerates the Silicon Valley business of solutionism in his recent work, aiming to shift discourses from technological fixes of everything to shore up our collective ability to think and speak well about concerns. In an interview with Columbia Journalism Review his book To Save Everything Click Here is framed as an attempt
“to integrate the debates about technology into the broader debates about politics, economics, history, and culture—areas of study with much richer traditions and far greater intellectual resources for tackling the many challenges that technology presents. Such a shift in discourse, he feels, would limit the influence of those advocating narrow technological solutions to what are essentially non-technological problems—like spreading democracy—and would rob a word like “disruption” of the positive connotation it has acquired as a force for progress, allowing it to be seen instead as a painful example of neoliberal economics.”
The medium has become the message again, as disruption is not the fix itself but signifies the capacity for innovation, which has become celebrated as a cultural value, not the content of specifically valued developments. Any startup can be disruptive if we merely pivot it enough; any innovation is inherently and perhaps equally desirable to another. The embedded values that accompany technological disruption are rarely questioned, as the headline value of disruption and its promised effects sweeps away the questions that might be asked with a lesser fate. Our own values and social responses are increasingly mediated by technological culture, by apps, by “context”. As a result, citizens become increasingly unable to imagine effective collective responses to actual shared concerns. Issues deemed too complex for political agreement and deliberation are deferred to the technological solutions of “innovation.”
Critics of Lepore (there were many) come down on her “incompetent” analysis of the Dilemma or her weakly-supported claims of an emerging “faith in disruption.” As she’s a business academic and not a cultural observer, she may have missed the larger system in which disruption fever is happening. We now live in a technogenic culture, a much larger cultural system that has disrupted several generations in society by replacing these “broader debates” with the promises of a frictionless future enabled by an ever-smaller number of ruling figures in Silicon Valley.
How Innovation Regimes Reproduce Culture
Media Ecology Association, Toronto, June 20, 2014
“We shape our tools and thereafter our tools shape us” John Culkin, SJ (Usually attributed to his friend, Marshall McLuhan)
We live in a technogenic culture – a society that generates ever more technology, whether necessary or not. Mainstream culture celebrates the economic value of technological ingenuity, and worships innovation.
Our desires become captured and entranced by the tools of tech. In this post-age of ubiquitous smart-things, everyone now “owns technology,” or gadgets – whether a smartphone, stack of computers, soon personal robots. For the first time in history perhaps, there is little differentiation between generational ownership – children, the elderly, very poor people – all have similar gadgets. There may finally be little or no cachet to having the latest hardware or gadget.
The desirable commodity has become the capacity to produce technology. The capacity for mass self-production with 3D printing and “desktop app publishing” represents an entry point toward the ownership of technology as the medium itself. Owning an app or a capacity says more about your technological self than owning any device. It is not enough just to communicate – in fact, we may be communicating ever more poorly. But the desired distinction will be reproduction.
We may have started with a hosted blog, but now wish to own a cloud site or “have” a startup (as a high-end reference point.) The emerging new media in this regime are not merely the ecology of “apps” but the media of technology production, the ability to spin off dozens of apps. Whether this is fruitful, desirable or socially beneficial does not matter, as in media ecology terms reproduction has become the ground. Apps and startups themselves are figures emerging from the ground.
The global Internet has made technogenic culture universally accessible. Globalization has exported and socialized a culture driven by economic values associated with Silicon Valley venture capitalism. We are all startups now, giving pitches, we’re all watching or giving TED talks. But these are the surface behaviors. All modern economies, and their associated societies and cultures, now value technological innovation as a desirable public good.
Developing nations, universities, and research enterprises are encouraged to behave as entrepreneurs, placing the outcomes of research, and increasingly culture, into the realm of global competition and market valuation. As such, it isn’t enough to just win as an entrepreneur – we are taught to look for the Exit Strategy, to cash out on our ideas. We hope to Disrupt something thereby, the grail of Impact and the aim of every startup.
As a self-reinforcing socialized process, our capability to produce technological efficiencies has become a societal norm and even a public good. Only crank critics bother to suggest that economic efficiency may have unwanted consequences. But there seems to be no limit to our demand for efficiency – we may have maximized the ways in which technology production makes life easier or better for people, as robotic labour becomes a reality. So as innovation elites we now seek the super-productive power to “disrupt worlds.”
If it were possible, I’d roll back this penchant toward disruption as we will see this misconstrued notion carried along into all avenues of commerce and design. A startup bent on disrupting its stolid traditional competitor is to be expected. But now we have institutions, hospitals and cities, banks, trying to disrupt themselves. We will see radical disruption in human services and socially-critical industries, such as energy and education. And we will have no right to expect these services to serve society better. The point of disruption is economic values, not human betterment.
We might just ask, would you trust “radical system change” to inexperienced enthusiasts with little patience to understand the systems they are hoping to change?