The future of digital is human - A Report by EY & HPIC by Bhavya Bedha

The future of digital is human Getting India ready March 2018

Conten 2

| The future of digital is human

nts

Digital driving socioeconomic transformation in a young India

Redefining the human experience

Building trust in the connected era

Circumventing pitfalls of digital

Aiming toward a shared agenda of sustainable digital growth

The future of digital is human |

Foreword Throughout time, humans have sought to amplify their potential through technology. We have always created tools that allow us to do more – be it the first flint hand axe, the Archimedes’ lever, the printing press or the internal combustion engine. But nothing compares to the amplification of human potential that digital technologies are bringing about in the early 21st century. Today, we have created a complex ecosystem of man, machine and software that has transformed our daily lives –how we work, what we consume and how we travel. Digital technologies are even affecting relationships among people, sometimes changing how we feel about ourselves or see our place in the world. We face a future of limitless possibilities. As digital consumers we have an unprecedented choice of products and services. We can manage every aspect of our lives – from our money to our health – more efficiently than ever before. Automation creates the potential for workers with the right skills and mindset to take on more meaningful, innovative work. We can stay better connected to our colleagues, families and friends. We can be entrepreneurs or consumers in our homes or on the go. And we face a future of upheaval. Automation could displace between 400 million and 800 million workers globally by 2030, if we do not retrain them or change our education systems to prioritize lifelong learning. Technology could also exacerbate gender inequality − through biases unconsciously coded into algorithms, or through the underrepresentation of women in science and technology careers. There is also the human cost of an always-on digital world − from cyberbullying to fraud to data piracy.

By understanding these risks we can overcome them. We believe that if we embrace India’s digital future with transparency and purpose, a huge digital dividend awaits us. In this report, we examine the accelerated journey India has been on over the past decade to emerge as a mobile-first, digitally-driven economy, and we take a look at the human experience of digital – the good and the bad. In it we argue that a successful digital future relies on governments, businesses and citizens engaging in an open and honest dialogue about how to realize the upside of technological progress while minimizing the risks. It recognizes that India is at a pivotal time in its digital evolution. Home to 1.4 billion people and more than a third of the world’s young people, India’s demographic dividend is about to merge with a digital one — as a huge, young, increasingly digital-savvy population has unprecedented access to affordable bandwidth and smart devices. The amplification effect of technology on human potential will be huge. The future of digital is human! EY and the High Power IT Committee (HPIC) constituted by the Government of Kerala, are excited to present this report at the #FUTURE Digital Summit. We take this opportunity to express our gratitude to the HPIC — which constitutes prominent industry and government representatives — for its involvement and support to help us frame our point of view.

Rajiv Memani Managing Partner — India Chairman — Global Emerging Markets Committee, EY

Srinivasa Rao Global Vice Chair, Global Delivery Services, EY 4

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About the report EY, in collaboration with the High Power IT Committee (HPIC) â&#x20AC;&#x201C; Government of Kerala, has developed this report on the future of digital in India, delving into the human aspects of the changes that digital adoption is bringing to the society. The report studies the digital journey that the country has witnessed so far, and gauges how technologies are redefining the human experience from the perspectives of mental and physical wellbeing, relationships and safety. The report also analyzes the key pitfalls of digital, and puts forward how can government, businesses and societies circumvent these challenges to create a sustainable and digitally empowered living.

Methodology The future of digital is human: getting India ready has been developed based on first-hand perspective provided by the members of the HPIC Steering Committee, who provided their inputs in the form of concept notes in context of the theme These were combined with extensive secondary research, analysis and insights provided by EY. The report also discusses examples and case studies from India and across the world to supplement the insights. It highlights the many ways in which the government, businesses and societies can work toward a shared agenda for the countryâ&#x20AC;&#x2122;s digital 2.0 journey.

Acknowledgments EY report development team: Daniel A Jimenez Digital Fluency Leader

Rajni Sadana Life Sciences Analyst

Gaurav Aggarwal Media & Entertainment Analyst

Swapnil Srivastava Global Telecommunications Knowledge Leader

Jonathan J Marcin Assistant Director, Brand, Marketing and Communications

Swati Goenka Technology Analyst

Monica Dimitracopoulos Global Knowledge Transformation Leader and Global Digital Leader

Vineet Jain Knowledge Leader, Global Delivery Services

Rajesh Nair Director, Markets & Business Development

Yukti Mittal Telecommunications Analyst

The future of digital is human |

Executive Technology has defined human progress over the years – we are now heading toward a point where digital will be an inseparable part of human lives. Digital is opening countless avenues to revolutionize our society, culture and lifestyles. With a young, technology-powered population, it is time to consciously lay the foundation for a society that is digitally aware and responsible. India, the youngest large economy in the world by demographics, is undergoing a transformation with the rapid uptake of digital technologies. The country has come a long way from the roots of digital in the 1980s which began with computerization and moved to digitalization in early 2010s. It has emerged as a mobile-first, digitally-driven economy, leapfrogging from desktop to mobile, from 2G mobile networks to 4G, and from cash payments to mobile payments. This digital transformation has brought a multitude of changes in our daily lives – be it the way we interact with each other, consume content, shop, among others. But the real impact will be felt in the years to come. It will be second nature for our youth to interact with digital technologies. Increasingly, it will be difficult – even impossible – to fully disconnect from digital technologies. More and more devices will have connected features embedded, society will reward connectedness and businesses will disincentivize unplugging.

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summary As digital becomes a way of life, it will have a profound impact on the way people express their feelings, share ideas, manage their health, maintain emotional ties free from geographical limits, create new trust-based relationships and lead a safe and independent life. It holds the potential to completely redefine the human experience, vastly simplifying, enhancing and enriching lives. Yet, as with any technology, there are some pitfalls attached with digital such as distraction, fake content, mental and physical ailments, online fraud and cyberbullying. Digital technologies are surely not the culprit â&#x2C6;&#x2019; it is how we use or abuse them. Mindfulness and digital intelligence will become essential life skills in a digital world. It is upon the societies and citizens to ensure that the benefits of digital technologies outweigh the costs. A robust digital society will have trust at its core. Increasingly, businesses and governments are recording, processing and analyzing huge volumes of consumersâ&#x20AC;&#x2122; digital interactions. This is also exposing individuals to vulnerabilities such as cyberattacks or frauds. As more products and services are digitally delivered, robust data privacy and security measures will be needed to uphold consumer trust in the digital ecosystem. Governments and organizations will need to work toward a purpose-led digital growth. Furthermore, citizens, organizations and government should actively engage to create a path to sustainable and empowered living. The way societies adapt to the radical change brought by digital will determine the magnitude of benefits we can realize. The foundation we lay today will determine our digital destiny. The future of digital is human |

Digital driving socioeconomic transformation in a young India Catering to a generation of digital natives 8

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India’s journey toward a digital future

1.1 India’s digital journey starts

Buoyed by a favorable mix of demographics, globalization, technological advancements and regulatory reforms, India is on its path to a second phase of socioeconomic development. Underpinning its growth is a digital diaspora — with data fueling the future of services and catering to a generation of digital natives.

1970s to early 1980s: closed economy with limited influence of digital technology During this period, India had a relatively closed economy, with a limited number of private players across sectors. The concept of Licence Raj (a complex system of permits and regulations to start and run businesses) endured, and the markets were largely dominated by monopolies. Consumers had restricted media options to choose from, comprising limited channels on radio and television. Communications via fixed landline networks and print media ruled.

Digital in India has evolved over the years, moving from computerization in 1980s to digitalization in early 2010s. Over these decades, India has evolved to be at the forefront of technological adoption. We also witnessed radical reforms, which drove innovation and technology adoption, shifting from Licence Raj to liberalization and open economy.

India growth story

Digital embedded in all facets. Digital as a way of life

With around 34.8% share of youth in the total population, India is one of the largest young nations globally

Mid-1980s to 1990: advent of computerization This period marked the beginning of computerization in the country, with policies encouraging software development and changing the face of the Indian IT industry. India started its journey to become the golden goose of the IT-ITeS revolution, becoming an attractive hub of technology services providers, both in terms of engineering workforce and low-cost business IT solutions. Contribution toward gross domestic product (GDP) started shifting to services sectors and relatively away from agriculture and manufacturing domains. 1990s: market liberalization and focus on mobile telephony The country’s landmark moment came when the economy was liberalized, opening up to foreign competition and innovation. The decade witnessed the opening up of the television market, with the advent of local and foreign broadcasters, from just one government-owned broadcaster. Sectors such as telecommunications were opened, allowing for the entry of private players, which boosted market competition and provided more choices to consumers. The information technology sector — still in its nascent stage — grew ninefold in six years until 2000. 2000 to 2009: technology infrastructure gaining foothold With rising globalization and advances in technology worldwide, the 2000s brought an explosion of new digital means of communications. Indian telecoms operators, internet service providers and cable companies made significant investments to set up their networks and infrastructure, laying the groundwork for the mammoth demand the country was about to experience. This period also saw an influx of content production companies and the proliferation of cable and broadcasting channels in the country. India was now reaping a variety of regional content available through a mix of print and electronic channels.

Note: 34.8% is data for 2011. This share is expected to reach 34.5% by 2020. Source: “Youth in India,” Central Statistics Office, Ministry of Statistics and Programme Implementation, Government of India, 2017

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India’s digital story

Voice revolution 1970–79 • Limited GDP growth rate • Concept of Licence Raj, multiple barriers to entry for new players • Near monopoly in communications and media sectors • Domination of communication via fixed landline networks and print media

1980–89 • Beginning of the era of computerization • Policies promoted software services development, spurring the Indian IT industry • Contribution of services sector to the GDP continued to increase; while contribution from agriculture decreased

Sources: Telecom Regulatory Authority of India; IDC; ITU; news articles; EY analysis

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1990–99 • Telecoms markets were liberalized, enabling entry of private players

2000–09 • India key part of the BRICS nations club

• Rise of mobile telephony and voice revolution

• Increased investments via foreign direct investments and domestic routes

• Limited media content choices decreased

• Concept of interconnected networks and cloud computing • Increased usage of personal computers

Data revolution 2010–14 • Key regulatory push via the National Telecom Policy (NTP) 2012, Make in India Program and draft policy on Internet of Things (IoT) released in 2014 • Proliferation of digital media content via over-the-top (OTT) applications • Investments for high-speed internet • Growing start-up ecosystem

2015–19 • Launch of flagship programs such as Digital India, Smart Cities Mission, expected release of NTP 2018 acting as catalysts to a digital agenda • Providing broadband access to all 250,000 gram panchayats (GPs) and setting up five lakh Wi-Fi hotspots, enabling access to rural citizens. In the first phase of BharatNet program, 100,000 GPS connected with high speed optic fiber network

2020s and beyond Digital revolution placing India as the leading adopter of digital technology globally

• Release of roadmap for machine-to-machine (M2M) and draft revised policy on IoT; M2M connections reached 87 million in 2016 • With 12.1 billion apps downloaded on tablets and mobile phones in 2017, India surpassed countries such as the US. App downloads tripled between 2015 and 2017 • Mobile data on a rise; three hours per day is the average time spent by Indians on smartphones • Third largest start-up hub globally, home to over 5,200 start-ups today • Around 800 million bank accounts are linked to mobile by early 2018, enabling existing accounts mobile-transaction ready

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2010 till present: data revolution, with affordability, accessibility and awareness driving usage of digital platforms By early 2010, it was clear that affordability, accessibility and awareness were the imperatives driving usage of digital platforms across the country. In the ensuing years, these factors, combined with content, devices and connectivity, ushered in an era of digital revolution and allowing the country to leapfrog from desktop to mobile and from 2G to 4G. In fact, today, a smartphone is the first digital platform for most of the young generation. Digital media is now engulfing the entire nation with an array of localized and customized content. Telephone subscribers in India, 1981–2016 (million) 1,200

1,000 Total subscriptions (million)

Introduction of private competition

Prevalence of state-owned service providers

Growth in mobile subscriptions

800

600

400

Fixed telephone subscriptions

2016

2015

2014

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

1990

1989

1988

1987

1986

1985

1984

1983

1982

1981

200

Mobile cellular subscriptions

Sources: Telecom Regulatory Authority of India; ITU

The past few years have brought an encouraging push to India’s start-up ecosystem. Technological innovations in cloud computing and data centers have stimulated the growth of small, technology-based entrepreneurial ventures in the country, which focus on limiting their capital expenditures in favor of alternative pay-as-you-go solutions for infrastructure requirements. Today, India is the third largest start-up hub globally, and is home to more than 5,200 start-ups with a combined valuation of over US$40 billion.¹

¹ “Catalyzing the Ecosystem for A Trillion Dollar Digital Economy,” NASSCOM, February 2018.

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Growing consumption of digital services in India Second largest mobile market

High minutes of usage

1.2b

Outgoing mins (trillion)

subscribers growing 6.8x from 2006

2.3t

1.6t

0.3t Brazil

Rising smartphone adoption

Rise of digital Indian

USA

India

Growing internet penetration

35%

890m

by 2022, representing >60% of all mobile subscriptions, up from 30% in 2017

internet penetration

up from 2.8% in 2006. Total internet users expected to reach 500m by June 2018

Adoption of disruptive technologies

70%

of Indian firms are Nearly expected to deploy artificial intelligence by 2020, as per a survey

70%

Smartphone time on social platforms

Time spent on mobile apps per day

200 minutes

Increasing connected devices

429m

M2M up 3.8x from 2017

connections by 2021,

Growing digital payments

US$1t

market by FY23, growing >5 times over the next five years, led by the growth in mobile payments

Sources: ITU; “Internet Trends 2017,” KPCB, May 2017; “Ericsson Mobility Report — with India appendix,” Ericsson, June 2017; “Catalyzing the Ecosystem for A Trillion Dollar Digital Economy,” NASSCOM, February 2018; news articles; EY analysis

2017

2020E

3x–4x

Time spent

10x

10x-14x Growth in consumption

Share of video

Data usage (GB per user per month) ² News articles The future of digital is human |

Source: EY analysis

Digital evolution enabling socioeconomic development In a relatively short span of four to five decades, India has witnessed striking progress, growing the GDP from a 2–3% in 1970s to over 7% in 2017.² Such stellar growth numbers are the result of the impetus given to support the country’s domestic demand and exports. Today, India is the world’s fastest-growing large economy, and is expected to remain in the top rankings for years to come. India average GDP growth rate* 5.6%

5.8%

1980–89

1990–99

7.2%

6.8%

2000–09

2010–16

2.6%

1970–79

*Note: indexed to 1969 as the base year Source: World Bank

India’s GDP grew at an a annual rate of 7.2% in the quarter ending December 2017, overtaking China, and reclaiming its title of the world’s fastest growing large economy Sources: “India reclaims ‘world’s fastest growing economy’ tag from China,” Livemint, 28 February 2018

Many states in India are focused on tapping the potential of digital technology. They are taking steps to promote digital awareness, connectivity and delivery of services. Kerala is at the forefront of adoption of digital technologies.

Case study

Kerala declared India’s first digital state3 • Mobile tele-density of >115% vs. 91% for India in 2017 • First Indian state to declare access to internet as a basic human right; internet penetration of 52% vs. 33% for India; over 80% of internet users are on broadband • Aim to make Kerala a 100% e-literate society • More than 3,000 paperless government offices; 30,000 e-certificates delivered daily • More than 2,650 Akshaya centers, creating awareness about e-governance and digital connectivity in rural and urban areas

³ Telecom Regulatory Authority of India

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1.2 India’s digital revolution Till now, digital transformation has brought a multitude of changes in our daily lives, from the way we interact with each other, to the way we consume content, to the way we shop, among others. India is on a path to its digital journey and, this time, the leap is expected to be more gigantic than ever before. Data will be the fuel of the future and digital will be the way of life. With devices becoming more connected, data is giving rise to a new economy with services consumed and delivered digitally. The Indian government’s focus on digital, with initiatives such as Digital India, Smart Cities and Future Skills, is expected to lead the country toward its digital future. The coming generations will undoubtedly enjoy unprecedented access to technological resources.

Factors driving India’s digital transformation

Investments by businesses to strengthen digital infrastructure: IT spending in India expected to cross US$71b in 2021, growing at a compound annual growth rate (CAGR) of 8.9% during 2016–21

Government support via initiatives such as Digital India, Smart Cities, Future Skills

Tech-savvy young population, with mobile being the first digital medium for many

1 2

Making digital an inherent aspect of everyday life

5 Scaling up the use of technologies such as IoT, cloud computing, artificial intelligence (AI) and blockchain

Flourishing start-up ecosystem, with a focus on tech-enabled services: currently, India is the third largest start-up hub globally, home to around 5,200 start-ups with a total valuation of over US$40b

Availability of ubiquitous wireless connectivity, high-speed broadband and low-cost smartphone

4 Increasing availability and adoption of digital services: media, payments, health care, education and governance

Sources: “Catalyzing the Ecosystem for A Trillion Dollar Digital Economy,” NASSCOM, February 2018; “India Semiannual IT Spending Guide: Industry and Company Size,” IDC, July 2017; news articles; EY analysis

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Redefining the human experience Shaping our mind, body, relationships and safety 16

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Redefining the human experience: Powered by digital In India, the young generation are readily adopting digital technologies. Like many other countries, India is moving toward a society where digital is an integral part of life, where people regularly interact with it for their daily activities and needs. Digital technology is vastly simplifying, enhancing and enriching lives. As it permeates deeper, it will have a profound impact on the way people express their feelings, share ideas, manage their health, and lead a safe and independent life.

Mental wellbeing • More time to self • Collaborate and connect online • Improved lifestyle choices • Curiosity and creativity

Physical wellbeing

Relationships • Person to person

Digital

• Person to business

• Health care anywhere, anytime • Personalized care • Patients as partners in their health care

• Person to government

Safety • Independent living • Disaster management and emergency response • Security

2.1. Impact of digital on mental health and cognition Digital technologies have provided countless avenues to live a fulfilling life — being closer to friends and relatives, cherishing great moments, collaborating without boundaries, deriving inspiration from icons and nudging people toward positive behaviors. That being said, digital technologies are inanimate — it is upon individuals to harness technology to derive the best results for humanity. Reducing mental burden — engaging in more fulfilling activities Digital has enabled individuals to conduct mundane but essential tasks, such as paying bills, ordering groceries, food and clothes, managing calendars, reserving travel, recording expenses and more, all at the click of a button. This has made available free time for fulfilling tasks and living a richer life. In particular, individuals are able to devote time to pursue hobbies, discover passions and interests, meet like-minded people from different walks of life in ways we could never have imagined.

The future of digital is human |

Fostering collaboration — harnessing the power of diversity Future generations will not only be well educated, but also well connected. Digital technologies have allowed us to collaborate online without limits such as age, gender, race, religion, experience or income. We are better able to connect with influencers online, derive inspiration, generate ideas and build on those ideas to create successful enterprises. From ideas to wealth — creating young, self-made billionaires4

60%

Of ultra high net worth individuals in India are less than 40 years of age in 2017

Self-made billionaires in India in 2017 versus 8 in 2005.

2005

2017

The internet offers a virtually unlimited collaborative power to pursue our passions — we can now connect ideas, identify patterns, and enrich our understanding of any subject. Before running for a marathon, we can engage and collaborate with local interest groups, interact with experts and ‘learn the ropes’ much faster than in an exclusively offline environment. Similarly, our lives are simplified as digital collaboration has harnessed the knowledge and wisdom of large online groups. We can look for information on everyday problems, from plugging a leak here to removing hard stains. We can instantly learn about precautions during pregnancy, better understand a child’s illness symptoms and develop a nutrition plan. Digital technology has made our lives infinitely convenient as compared to a generation ago. Improving behaviors and learning — incentivizing through gamification Digital audio-visual techniques are scientifically proven to stimulate more senses, lead to better retention rates and improve grasp of key concepts. Personalized, self-paced or adaptive learning, online assessments and instant feedback, coupled with live interactions with experts, bring a conducive learning environment for children and professionals alike. Similarly, gamification — bringing game elements in a non-game context — spurred by digital technology, is driving various consumer services, such as personal health, personal finance, energy conservation, food, dating, as well as professional services, such as health care research, work productivity and pilot training. Many health and lifestyle apps focus on human behavioral aspects to create rewards and incentives which motivate individuals to make positive lifestyle choices. These include promoting a healthy lifestyle, improving financial responsibility and making environment-friendly decisions. India’s leading digital learning company has incorporated gaming and interactive elements to improve the grasp of concepts among students.

Case study

Combining education, technology and gamification for better learning outcomes5 • India’s leading learning app, downloaded 14 million times, combines content, media and technology in an intuitive way to improve the learning experience of students in the K-12 category. Using the data from the app, it creates a unique learning profile of the user, customizing student journeys. • It also uses gamification principles in assessment tests to motivate students to learn more. It allows other students to participate in one-to-one game contests based on the learning modules. Sparking curiosity and creativity Forums to spark creativity and generate new ideas have become accessible through digital technologies. These forums encourage us to ask interesting questions and begin a quest of finding the right answers. Asking better questions is the key to cutting through ambiguity and seeing issues clearly. We can even look for the right answers from experts at online ‘Q&A’ forums. To generate ideas and better questions, digital technologies offer several brainstorming tools on any topic.

4 “India’s Economy: Creating ‘One Billionaire Per Month’ Since 2010,” Forbes, 18 April 2017 5 “Indian teaching startups make work for idle thumbs,” The Economist, 17 February 2018 18

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The power of connecting ideas, consuming different perspectives similar to a dragonfly — which can see up to 30,000 facets of the surrounding environment and merge perspectives — helps increase creativity and look at the big picture more clearly. Similar to the advent of chess software, which helped humans adapt and become more creative, raising the popularity of the game itself, the rise of digital technologies will allow humans to achieve greater levels of excellence through creativity.

2.2. I mpact on physical wellbeing: digital innovation today will transform health care tomorrow Digital is also contributing to improved physical wellbeing. Emergence of digital health care and smart devices are assisting in disease prevention and management. With health trackers, people are proactively opting to manage their health and lifestyle. It will not be long before digital therapeutic technology becomes immersive and revolutionizes personal health management. New health care realities demand new responses6 India’s health care system is facing the dual burden of rising prevalence of lifestyle-related diseases and aging population. These, combined with the huge population and continued high prevalence of communicable diseases, have put great pressure on health care infrastructure in India. Hence, it is becoming imperative to use the existing resources in the most efficient and cost-effective manner, while still providing high quality. Digital technologies incorporating the elements of quality, affordability and accessibility, have come to the rescue.

Need to rebalance the supply-demand scales in health care Health care infrastructure India below minimum WHO recommendations for health care workforce and infrastructure ~0.6 physicians per 1,000 population 30% below WHO recommendation

~1.3 nurses per 1,000 population

Health care needs Noncommunicable diseases constitute

7 out of top 10

causes of deaths in India

India accounts for

50% below WHO recommendation

>25% of global burden of tuberculosis ~1.3 beds per 1,000 population 70% below WHO recommendation

~20% of global maternal mortality ~25% of global infant mortality

~8 in 10 people have no insurance

Aged population (above 60 years.) currently ~8% of population

~7 in 10 people live in rural areas with access to ~30% of health care infrastructure

expected to be

~19% of population by 2050

ources: Medical council of India (MCI), “Healthcare”, IBEF, January 2017; “The health workforce in India”, WHO, 2016; “Global Tuberculosis Report, 2017”, WHO; S “Tuberculosis in India,” USAID, November 2017; “Non-communicable diseases cause 61% of deaths in India: WHO report”, TOI, September 2017; GBD 2016; “5 women in India die every hour during childbirth: WHO”, Indian Express, June 2016; “India Among The Top Five Countries Responsible For 50% Newborn Deaths Globally, Despite A 66% Drop In Child Mortality”, Indiatimes, October 2017; “India Needs to Start Addressing Issues Concerning Its Growing Elderly Population, Says UN”, The WIRE, June 2017 The future of digital is human |

Digital health is the new response: reshaping health care delivery Digital solutions are the new connectors between health care providers and patients

Hospitals

Mobile health

Digital solutions Physician

Analytics

Social Media

Nurses

Cloud

Patient journey Health and disease-related information

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Physician consultation

Health services e-pharmacy, e-diagnostics, e-insurance

Prevention and long-term management

Indian government has already taken the first steps on its revolutionary digital health care journey The Governmentâ&#x20AC;&#x2122;s push toward digital is playing a critical role in boosting the digital health care ecosystem in India.

Initiatives and incentives

Government playing an active role

Startup India: a flagship initiative of the Government of India launched in 2016 that has so far recognized 6,300+ startups

Reduce medication and medical errors through Integrated Health Information Program (IHIP) and health information exchange

Policy and regulations New standards and guidelines for implementation National Health Policy approved in March 2017. The policy has extensive recommendations on usage of digital health tools of interoperable electronic health records issued in 2016 and preventive health care Setting up of regulatory bodies National eHealth Authority (NeHA) to ensure development and promotion of eHealth ecosystem in India Launching national level health IT programs (eHealth initiatives) Apps and online portals for patient education, disease monitoring and management, integrated disease surveillance, etc.

SMART Health India program: m-health technologies to provide health care workers with personalized clinical decision support to guide the Systematic Medical Appraisal Referral and Treatment (SMART)

Information and communication technology (ICT) infrastructure Computerization of district and sub-district hospitals, and community health centers to implement the hospital management information system for creation of electronic health record and online prescription

BharatNet (earlier known as National Optical Fibre Network or NOFN): to provide broadband connectivity to all the 2,50,000 Gram panchayats of India. Of this around 1,00,000 Gram panchayats had already been connected by mid of 2017

The future of digital is human |

Digital will continue to revolutionize health care delivery systems in the following ways: Health care will be anywhere, anytime We are on a journey from health repair to physical wellbeing. As an increasing number of people from smaller cities and villages are getting access to internet connectivity, digital health solutions are connecting them with physicians and reducing the supply-demand gap. The patients are now able to connect with the physician’s 24/7 for acute and chronic diseases without the barriers of distance and cost. In the future, virtual clinics will offer long-term monitoring of patients in their homes via patient-reported outcome tools. Homes will have replaced hospitals and physicians’ offices as the main health care delivery hub. Here is a glimpse of how digital is revolutionizing tuberculosis (TB) care in India:7

Case study on the use of digital tools for the management of Tuberculosis (TB) in India

NOVEL technology (emerging within technology)

First website on TB in Hindi

99DOTS Real-time remote monitoring of drug adherence

Mobile app AI-based algorithms can help detect TB by coughing into the phone

E-compliance, E-detection, E-alert Apps for diagnosis and tracking of TB cases

SMS reminders to patients and missed dose triggers to care providers

12% drop in the number of TB deaths in 2016 vs. 2015 … … 3% drop in the number of new TB cases in 2016 vs. 2015

>87,600 patients registered

TB detect app Interactive screening algorithm based on WHO guidelines

TRADITIONAL technology (which has been going on for some time)

‘#India vs. TB’ Multimedia campaign: TV, digital, radio, newspaper

Nikshay National weband app-based reporting system for mandatory TB notification.

...India will have to improve the above percentages (3% to 10% reduction in new cases) to meet to goal of eliminating TB by 2025

In 2015, the number of notified TB cases was 34% higher than in 2013 Patient awareness/ education 7

Diagnosis

Disease reporting and tracking

Adherence

ources: WHO; “Tuberculosis in India,” USAID, November 2017; “Why Does India Lead The World In Deaths From TB?”, NPR, November 2017; “Tracking TB becomes simpler with S mobile phone”, Down To Earth, May 2017; 99DOTS

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Mass personalization in care delivery Health solutions are now becoming available throughout the continuum of patient journey — from collecting information, to interacting with physicians, to ordering medicines and lab tests, to treating and managing disease. With new devices and apps specifically tailored to health care needs in India, it is now possible to monitor patient health at all times, send reminders for medication, receive alerts in case of emergency and encourage healthy habits through digital coaches (such as nutrition and exercise). The apps and electronic medical records (EMRs) are providing physicians with detailed information about their patients. Data analytics and predictive AI-based algorithms will enable real-time changes in patients’ health status to be identified and addressed. Patient care will be personalized — the drugs, solutions and services they receive, their experiences, their interactions with health care professionals and stakeholders, and even where they receive their care. Physicians are also benefitting from the availability of new apps and social platforms where they can share experiences and learn from each other globally. The Government of Kerala is leveraging digital technology to prevent the spread of diseases and improve health outcomes.

Case study

Kerala government’s focus on eHealth8 • Kerala government's eHealth project envisages the development of electronic health records (EHR) of the population and end-to-end automation of all government health care institutions, along with the integration of an electronic demographic database. • Through this project, the Government aims to lower infant mortality rate, maternal mortality, reduce avoidable deaths dues to noncommunicable diseases. • The project is already on a pilot run in 12 health care institutions in Thiruvananthapuram district and will be scaled up across 7 out of 14 districts of the State. Patients will be active partners in managing their own health care: With access to digital health solutions, patients are now evolving from being passive recipients of care to active participants in their own health care. Digital tools (such as mobile apps, wearables and social communities) are equipping them with their own health data, encouraging them to develop the right behaviors and equipping them with the required tools to own their care (e.g., reminders for followup with physicians, fill and manage medication, etc.). To sum up, integrated health care delivery models will become the new reality, provided India continues to march ahead on this transformational journey with an increasing rigor. In this connected ecosystem, 4Ps will become the new normal: painless, prompt, personal and purposeful.

2.3. Relationships: bonding online and offline According to research, an individual’s relationships are the strongest predictor of their physical health, longevity and quality of life.9 Tools such as social media, video communication and online chat platforms have shrunk our world, bringing relatives and friends closer than ever. At the same time, there are prevalent notions around reduced intimacy and personal touch due to pervasiveness of digital devices. Despite some of the adverse consequences, social media and digital technologies have greatly supplemented or even enhanced our offline relationships in various ways. Person-to-person relationships — maintaining long-distance ties Digital has provided a platform for people anywhere in the world to maintain emotional ties and relationships. We are recording an unprecedented amount of our lives in videos and photos, and in activity statistics on smartphones, wearables, and personal computers. This has given us new means to cherish key moments with our close relatives and friends over the years.

“Kerala's digital transformation will empower and impact healthcare delivery in a big way: Rajeev Sadanandan,” Economic Times, 6 March 2018; “e-health project launch,” The Hindu, 6 March 2018 9 “Good genes are nice, but joy is better,” The Harvard Gazette, 11 April 2017 8

The future of digital is human |

Individuals who face one or more of life’s several problems can find solace in the company of online friends. This can help them bounce back more easily from personal tragedy — and subsequently help inspire others. When you believe that you have people in your life who care about you, and you interact with them regularly, you are better off. For instance, you may be less likely to catch a cold, have a stroke or heart disease, slip into early cognitive decline and develop depression. You may even be more likely to overcome socioeconomic disadvantages, recover quickly from illness and live longer. Person-to-business relationships — new-found trust-based economy From cab sharing to designer clothing or furniture rental to shared office and personal accommodation spaces, the sharing economy is embedding deeply in our lives. Rentals of goods such as luxury bags, appliances and agriculture equipment are also gaining popularity. In India, the usage of ridesharing apps grew by 60% in 2017. The rise of the sharing economy and peer-to-peer websites have created trust-based relationships with strangers from different backgrounds and locations as well as businesses, reinforcing positive behavior. In a digital economy, businesses and individuals have entered into a symbiotic relationship whereby users derive benefits in exchange of their data and attention. The gig economy also has emerged in employment, where companies are moving to hybrid working models that allow for greater flexibility when it comes to career paths, career advancement, job titles and job roles Gig economy’s growing presence in India10

1 in 4

global freelancers are from India

50%

of software-related global freelancers are from India

10m sq ft.

2020e 2017

1.5m sq ft.

of co-working spaces expected to be built in India

Person-to-government relationships — rise of citizen engagement Social media tools and digital technology are shifting power into the hands of citizens. The rise of citizen journalism, online blogs and photo sharing apps are supplementing the voices on formal media outlets. There is rising citizen activism and engagement in the wake of more open communication among diverse groups. Citizens have the power to influence government policies by starting public debates, bringing civic issues into focus, issuing online petitions or protesting against government apathy. • An online petition backed by 60,000 signatures led the Karnataka government to withdraw the proposed amendment to de-notify 50 species of trees, potentially reducing green cover at Bengaluru.11 • The Government engaged public participation through mobile app to drive cleanliness across the country. It launched an app whereby citizens can post pictures of areas in the city which are unclean and receive a response from local civic bodies within 24 hours. • The Government of Kerala launched two mobile apps to make the state corruption-free with active participation of people. The people can use the app to record video and audio to report instances of corruption.12

Digital technology is also being adopted by the Government for smooth delivery of services. Under the ‘Digital India’ initiative, the Indian Government launched the ‘UMANG’ app in November 2017. It offers 185 government services such as gas booking, crop insurance and National Pension System, with a target to reach over 1,200 services by end of 2019.

“Gig work: India now contributes 1 in 4 freelancers,” Business Today, 9 January 2018; “How 2017 fared for co-working spaces and the trends expected in 2018,” Economic Times, 8 January 2018 11 “Resilience of Bengaluru's civic activism wins again,” Economic Times, 23 February 2018 12 “Kerala govt launches mobile apps to fight corruption,” Times of India, 10 December 2016 10

| The future of digital is human

2.4. Safety: marching forward with confidence Digital technologies are augmenting even the most basic human need — safety. In this hyperconnected era, the internet of things is slowly making truly connected, digital cities a reality. Real-time monitoring devices, responsive disaster management services and assistive technologies for seniors and differently-abled are just a few examples in the way digital has allowed us to live with more confidence than ever.

Connectivity and security

• Various apps and wearables are being designed that are empowering women. These apps can not only alert police and family in emergency situations, but also have features to identify safe and unsafe areas • Mobile and web platforms have been designed where women can share any incidents. This information can be used for future urban planning, for example highlighting areas which currently have little or no street lighting

• Digital tools are enabling disabled people and seniors to live independently and confidently

Disaster management and emergency response

Connectivity Independent andliving security

Independent living

• Apps are being designed for people with visual or hearing disabilities that help them in managing their routine tasks without assistance • Tools and devices are being tailor made for seniors so that they can use them effectively and conveniently for daily tasks.

Disaster management/ emergency response

• Though it is not possible to completely avoid natural disasters, information technology tools are slowly making it possible to shift from a ‘relief and recovery’ model to ‘risk and vulnerability assessment’. • IoT sensors can relay information about surroundings in real time and raise timely alerts • Disaster communication system can integrate phone, internet, television and radio outputs for managing response and mitigation

Innovative tools and technologies are empowering everyone — especially women, children, aged and disabled — to live a more fulfilling, secure and independent life. The new technologies are also saving lives by providing the right information at the right time to manage natural disasters and to pre-empt them well in advancew.

The future of digital is human |

Building trust in the connected era Making judicious use of customer data 26

| The future of digital is human

3.1. Trust as the building block of digital lifestyle Trust in business in India is rated at 74% — second-highest worldwide and significantly above the global average of 52%.13 As our society becomes more connected, it is critical to maintain this level of trust. The steps businesses and the Government take to facilitate trust among consumers will lay the foundation for a smooth transition to the digital economy. In the digital age, data is the source of competitive advantage. Businesses collect, store, analyze and monetize unprecedented and ever-increasing amounts of data about their customers. In India, the data flowing through consumers’ mobile phones alone will rise 7.4 times from 2016 to 2021, at a CAGR of 49%.14 Individuals can benefit when they trade their attention and personal data to obtain valuable services or perks, such as loyalty points, cash back or exclusive offers from businesses. Businesses use analytics to gain insights about their consumers and tailor their offerings to provide a compelling value proposition. Some businesses already know more about consumers’ online behavior than consumers themselves, predicting their next purchase or website visit. At the same time, consumers’ readiness to engage with businesses will substantially depend on how trustworthy their digital services or products are perceived.

Bridging the trust gap

Security

Control

Digital trust

Trust is the foundation of digital society and it is also the most fragile aspect of human lives — easy to lose but difficult to gain. Still, it remains one of the most valuable part of businesses. Once individuals entrust their loyalty to a business, they are exposed to vulnerabilities. With a mélange of technologies, devices and standards, it is becoming Transparency Integrity increasingly challenging to protect customer data and privacy. In the absence of trust, consumers use advertisement (ad) blockers and virtual private networks (VPNs) to avoid collection of personal data and hyper-targeted ads. The penetration of mobile ad blockers and VPNs in India is at 28% and 38%, respectively — one of the highest in the world.15 In some countries, digitally-aware consumers may avoid or stop using an online service because it did not provide enough control over their personal data.16

Trust Barometer report — 2018, Edelman “VNI Mobile Forecast Highlights, 2016–2021,” Cisco website, accessed 20 February 2018 15 “Ad blocking user penetration, India,” eMarketer accessed 22 February 2018; “Top 10 countries ranked by VPN users, Q2, 2017”, eMarketer, accessed 22 February 2018 16 “Shaping the future implication of digital media for society,” World Economic Forum, January 2017 17 “Data breaches could cost Indian firms Rs 11 crore this year: IBM,” Economic Times, 20 June 2017 13 14

The future of digital is human |

3.2. Security: creating a resilient data organization Data breaches in cyberspace continue to grow in frequency and intensity, laying bare the weaknesses in organizations’ systems. The cost associated with data breaches and subsequent recovery efforts is significant, with an average cost of US$1.7 million in India. Fixing cyber operations is typically in the US$3–5 million range.17 Cyber-attacks continue to play havoc, disrupting operations and leaking sensitive information around the world. India is one of the most-affected countries globally.

Cyber breaches have significant disruptive potential18 • WannaCry ransomware attacked over 300,000 computers across 150 countries; India was the third most-affected country. • A malicious attack on leading food delivery app in India exposed 17 million records and was one of the biggest data breaches in 2017. • A leading US-based credit rating agency was hit by cyber attack revealing credit card and personal details of 143 million consumers. • Operations at India’s largest port terminals were halted due to an attack by global ransomware, Petya Indian businesses are still not ready to fully protect customer data and privacy19

Top 5

33,167

60%

75%

Cyber risks and data fraud or theft identified among the top five global risks by the World Economic Forum

Indian companies in an EY survey were unfamiliar with the General Data Protection Regulation (GDPR)

News articles “Data breaches could cost Indian firms Rs 11 crore this year: IBM,” Economic Times, 20 June 2017 20 “Cyber security — the best weapon remains good information security hygiene,” Computer Weekly, May 2017 18 19

| The future of digital is human

data records leaked per breach in 2016 in India

Of Indian companies, say that their cybersecurity function does not fully meet the organization’s needs, as per an EY survey.

Businesses can no longer ignore the effects of cybercrime. They need to include customer trust as part of their organizational strategy and culture, not just an isolated responsibility at the Information Technology (IT) department. Investing in robust digital infrastructure as well as teaching employees to maintain good digital hygiene can also mitigate against data infractions. Simple acts such as using an anti-virus, implementing two-factor authentication, driving awareness about not opening email attachments from a unknown sender, changing passwords, not clicking suspicious links − all can prevent over 80% of all cyberattacks.20

Three lines of defense against cyber risks Given growing customer concerns over the use of data, coupled with increasing government scrutiny, businesses are realizing that threats from the digital world require dedicated resources and efforts. They need to create three lines of defense against cyber breaches, comprising sense, resist and react phases. Sense Sense is the ability of companies to predict and detect cyber threats. Companies need to use cyber threat intelligence and active defense to predict what threats or attacks are heading in their direction and detect them when they do, before the attack is successful. They need to know what will happen and need sophisticated analytics to detect early-warning signals. Resist Resist mechanisms begin with assessing an organization’s risk appetite, followed by establishing the following three lines of defense: • Executing control measures in its day-to-day operations • Deploying monitoring functions such as internal controls, establishing legal, risk management and cybersecurity processes • Establishing a strong internal audit department React If sense fails (early-warning signals did not detect the threat) and there is a breakdown in resist (control measures were not strong enough), companies need to be ready to deal with the disruption, ready with incident response and mechanisms to manage the crisis. They also need to be ready to preserve evidence in a forensically sound way and then investigate the breach in order to satisfy critical stakeholders — customers, regulators, investors, law enforcement agencies and the public. They also need to be prepared to bring the organization back to business as usual as quickly as possible, learn from what happened, and adapt and reshape the organization to improve cyber resilience going forward.

Threats Sense Corporate shield Risk appetite Three lines of defense

Resist

Critical assets Intellectual property

Revenue

Reputation

React React

Adapt and reshape

The future of digital is human |

Some businesses self-disrupt their systems without spoiling the end-customer experience to understand and fix known vulnerabilities. This allows them to prepare for and adapt to changing conditions and withstand and recover rapidly from disruptions.

Case study

From fail-safe to safe-to-fail systems • A leading global online video company uses a software that attacks its own networks almost 1,000 times a week, testing the ability of the company’s IT systems to respond and recover. The impact is not noticed among the service’s consumers but they gain insights into their network’s pain points and create a resilient infrastructure as a result.

3.3. Control — empowering customers Businesses need to empower customers with advanced controls of their data. Customers should have access to easy-to-use digital tools to manage their personal data. Features such as ‘do-not-track’, ‘right to forget’ or ‘opt-out’ of advertisements need to be incorporated in digital products from the design stage. Customer can also be given options to change preferences, which lead to broadening their knowledge or interest, instead of narrowing it based on their browsing history. For example, consumers might want to expand their perspectives as opposed to being fed the same type of content. Some companies have already realized that they are, in fact, a trustee and not the owner of customer’s data. These companies are taking active steps to allow consumers to control their data.

Case study

Giving back control over digital data to consumers • A leading European telecom operator launched an app which gives users more control over their own data in the app. The users are paid in the form of redeemable credits when they answer survey questions, agree to allow location tracking, interact with ads in the app or sync their email accounts with it. • One of the top credit information companies in the US keeps an active directory which records consumers’ preferences where they do not want to be tracked. The consumers can exclude themselves from different types of targeted marketing. Of late, consumers are becoming enlightened about the value of their data. A number of services place member data on their servers, monetize it with businesses and share the proceeds directly with their members.

| The future of digital is human

3.4. Transparency — data disclosures and communication Rather than requiring consumers to accept convoluted ‘end-user licensing agreements' to begin using their services or products, businesses should lay down and publicize clear policies and processes for collecting, processing, storing and destroying data. Data architecture, classification and flows have to conform to privacy strategy, meet compliance requirements and support customer rights. The privacy framework should incorporate the elements of data governance, its use and third-party contracts validation, as part of the overall risk management structure. Customers are getting smarter about aspects such as price discrimination based on individual data. They increasingly demand insights into how a company’s pricing algorithms work. Thus, communication is becoming a big aspect of data transparency. Companies are publicly disclosing their data policies, informing customers about how they will use their data and asking express permissions to share it with third parties. They are also illustrating benefits consumer can derive from sharing their data. Furthermore, they are reporting data breach information before the situation falls out of hands, pro-actively disclosing the likely impact and resolution measures taken by them.

Case study

Improving data disclosures and customer privacy • A leading smartphone maker describes on its website the steps it takes to keep people’s location, communication, browsing, health tracking and transactions private. The company processes private customers' information on their personal device rather than on a cloud server. • UK’s major broadcaster uses a humorous video on its website to explain its data protection policy, including the type of information gathered and its use. It assures customers that their data will not be sold and that they can erase their personal information at any time upon request. This resulted in increased credibility with only a negligible number of consumers opting out of data tracking. • A social media company aims to promote transparency in political advertising on its platform. It involves updated policies that provides details about all ads carried on its platform and place clear visual markers on political advertisements and disclose how political ads are targeted.

“India ranks 23rd among 165 nations in cybersecurity index,” Economic Times, 6 June 2017 The future of digital is human |

3.5. Integrity — data stewardship in digital ecosystem Businesses glean rich customer insights from the data they gather. However, government, research and non-profit organizations are devoid of such detailed data assets. In a digital ecosystem, businesses can build credibility by playing the role of data stewards. They can engage with the society to gather new insights for humanitarian causes and public good, while protecting the privacy of individual customers. Large companies are anonymizing their data and sharing it to improve disaster response, predict the spread of diseases and utilize public infrastructure efficiently. Similarly, companies are proactively helping in mitigating the negative impact of digital technology such as the spread of fake news, curbing piracy and restricting access to websites promoting inappropriate content such as child pornography.

Case study

Data for good • A leading social media platform partnered with various fact-checking organizations and a network of researchers to check the spread of false news, clickbait, and sensationalism and block ad revenues accruing to organizations promoting such content. The company also changed its algorithm to encourage social interactions as opposed to promoted content. • A genetics company obtained consent from a set of its customers to donate their genetic information to scientists in order to advance genomics research and develop new treatments for the Parkinson’s disease. • A cab-hailing service plans to donate its anonymized transportation data to city governments to help reduce congestion and enable better city planning. • Another social media company built tools to provide prospective college students with valuable information about their potential career path, field of study and choice of school, by analyzing the education tracks and careers of its users.

| The future of digital is human

3.6. Role of government: pro-active regulation for a safe digital environment The Government is already focused on online security and safety. India is ranked 23rd out of 165 nations in the Global Cybersecurity Index, which depicts its ‘maturing’ commitment to provide a safe and secure online environment to its citizens.21 The Government of Kerala has initiated measures to improve cybersecurity in the state.

Case study

Government of Kerala’s emphasis on cybersecurity • The Government has set up Computer Emergency Response Team-Kerala (CERTKerala or CERT-K) in line with CERT India (CERT-IN). • The purpose of CERT-K is to coordinate security efforts and incident response for IT threats at a state level and to enhance the security of the Government's IT infrastructure through proactive action and effective collaboration. • CERT-K also oversees the implementation of crisis management plan of the Government of Kerala. However, online security is a moving target. Governments need to constantly evaluate existing and likely threats to their systems, testing for robustness of response and update security infrastructure to prevent advanced cyberattacks. That being said, a comprehensive data protection law in India is not yet in place. Currently, limited aspects of policies related to data protection are governed by various industry-focused regulators and bodies. However, the legislation process is in the works. The Ministry of Electronics and Information Technology constituted a committee to conduct public debate and discussion on principles to create a framework for enacting data protection regulation. Globally, governments are already implementing punitive regulation on businesses handling personal and sensitive data. The EU GDPR fine is up to 2% or 4% global turnover and will come into force in May 2018. Last year, the Supreme Court of India declared the right to privacy as a fundamental right — with wide implications for digital data protection, placing India on par with developed countries in terms of data protection frameworks. Of late, attacks on critical infrastructure such as power plants and hospitals have increased. Similarly, large-scale government initiatives such as ‘Digital India’ and ‘Skill India’ aim to improve access, connectivity and digital delivery of services. Robust cybersecurity laws, policy frameworks and response mechanisms are needed to enable a safe digital environment for citizens.

The future of digital is human |

Circumventing pitfalls of digital Monitoring the impact on mental and physical health 34

| The future of digital is human

Youth in digitally emerging countries such as India are 130% more exposed to risks emerging from digital than their peers in digitally advanced countries.22 We need to be vigilant and mindful, at least until we reach the stage of digital maturity. While we regularly see press headlines replete with numerous pitfalls of technology, we can argue that it is the over-use of technology which brings forth these negative side effects. Mindless internet surfing and activity on social media is the key deterrent. Additionally, for most of the dark aspects, the direction of causal relationship is not clear. For example, does social media use leads to depression or depression leads to greater time on social media?

4.1. Negative effects of digital technology Below are some of the negative effects of digital technology which need to be monitored: Distraction or multi-tasking and attention deficit — down the ‘rabbit hole’ With so much information and apps vying for our attention, it is natural to have difficulties focusing on urgent and important activities. Digital technology tools are designed to keep us hooked, as depicted by their success metrics which include clicks, views, ‘likes’, shares, engagement and duration of stay. With enormous data on each individual, these tools are getting even better at securing our attention. Human curiosity to know more pulls us into different directions, away from the task at hand. Only later do we realize that valuable time is lost doing meaningless surfing.

2000

A wealth of information creates a poverty of attention and a need to allocate that attention efficiently Herbert Simon, Nobel Prize winning economist

2015

33% 12 Seconds

8 Seconds

Fake content and filter bubbles Fake content, trolls and false propaganda can influence and mislead individuals. Filter bubbles on the web can isolate an individual’s worldview due to content surfaced by algorithms based on past online behavior. This restricts individuals from accessing broader information that disagrees with their viewpoint, creating an echo chamber effect online. Physical and mental illness Long hours of mobile use cause posture-related issues such as arm and neck strains. Mentally, the negative effects arise largely from excessive use of social media, online gaming and gambling, sometimes leading to sleeping and eating disorders. Other mental effects include feelings of stress, anxiety, envy; syndromes such as ‘fear of missing out’ (desire to stay continually connected) or ‘phantom vibration’ (perception that one’s phone is ringing when it is not) etc.,

22 23

“Forget IQ. Digital intelligence will be what matters in the future,” World Economic Forum, 6 February 2018. “Modern lifestyles leading to joint pains among youngsters,” Times of India, 1 March 2018 The future of digital is human |

Adverse impact on children The internet can be an uncontrolled jungle for young, impressionable minds. Youth fall prey to cyberbullying, online sexual abuse and exploitation; or they are prone to digital addiction spending disproportionate amounts of time online, sometimes watching inappropriate content such as pornography and violence. The combination of mobile and social media mostly lead to negative effects among children. Additionally, excessive use of digital technologies are linked to increasing obesity and ailments such as joint pains, which used to be prevalent among the old demographic. Cyberbullying remains a concern in India22

92%

worry about their children’s safety online, particularly how their actions will have repercussions on the family.

54%

Of parents feel that their children are more likely to be bullied online than on a playground

Online financial fraud and identity theft India is ranked second globally in the adoption of FinTech services (at 52%) and is second only to China (at 69%), according to the EY FinTech index 2017. This increasing customer adoption has also brought to attention the urgent need for tightened cybersecurity to protect customers’ financial and personal information and money. Around 48% of Indian online users have experienced retail fraud.25 Similarly, identity theft can lead to compromised critical personal information or financial fraud.

“ 92% Indian parents fear cyber bullying risk for kids: Report,” BGR India, 10 March 2016; “2016 Norton Cyber Security Insights Report: Family Edition,” Economic Times, 23 January 2017 25 “48% Indian online users hit by fraud, finds survey,” Times of India, 23 November 2017 24

| The future of digital is human

4.2. Nurturing a digitally-powered society Given how pervasive digital technology will be in our lives, it is imperative to ensure that its positives outweigh the negatives. It will be second-nature for the youth to interact daily with digital technologies. Digital technologies are not the culprit — it is how we use or abuse them. For example, generally, individuals who are socially active online tend to be socially active in their offline world and vice versa. Digital technologies may accentuate that impact. Children who actively engage online through hobby and interest groups tend to display more civic involvement and engagement offline. This is because children who encounter diverse backgrounds, gain confidence in dealing with strangers and broaden their skill set are generally more optimistic toward life.

Digital safety and security

Moderation

As these technologies permeate individuals’ lives, it will be difficult — even impossible — to fully disconnect from the online world. More and more devices will have connected features embedded, society will reward connectedness, and businesses will disincentivize unplugging. Thus, it will become ever more important to manage the transition.

Stress management

“Parents Are Spending More Time With Their Kids, But It's Not The Minutes That Matter,” Huffington Post, 24 July 2017 The future of digital is human |

Cultivate mindfulness and practice meditation Schools need to include courses on time management and mindfulness — connecting their mind to deeper inner thoughts. Amid lot of noise on social media, the young generation needs to be aware of their inner selves to bring harmony between body and mind. Similarly, yoga can help individuals alleviate the side effects of digital technology. With Indian roots and recent international recognition, the time is opportune to popularize it among youth. Mental, spiritual and physical attributes of yoga serve as a holistic technique of relaxation amid rising noise in the digital world. Responsible parenting Parents have a great role to play in driving responsible behavior among kids in using technology judiciously. In most developed countries, the time parents spend with their kids has doubled since 1965.26 In India, the need to engage children and spend quality time with them is key. Parents should be actively involved in their children’s digital lives, monitoring online activities and their effects in the physical world. They need to be aware of sudden change or drifting of child’s behavior, including the amount of time spent online. They should actively consult professionals if there is apprehension that their child is at risk. They also need to teach children to use digital devices responsibly, and make them aware of privacy and safety risks. Lesson should include not divulging personal information, and the risks in sharing location and photos. Moderation of use Individuals need to learn when to switch digital technologies ‘on’ or ‘off’. There is a constant stream of information online — much like water in a flowing river. Individuals should learn to disconnect when they feel satiated. There are a number of mobile apps available to limit time on social media sites. Other strategies include ring-fencing specific times in the day or week where individuals can distance themselves from screens and use that time for face-to-face interaction, pursuing hobbies and connecting with nature. Similarly, parents can define places in their homes where devices can or cannot be used.

| The future of digital is human

Digital awareness In the hyperconnected world, digital intelligence will emerge as the key life skill. It encompasses the knowledge, skills, values and behaviors that are critical to become responsible members of the digital era, and imbibes the ability to confidently manage challenges and demands of the digital world. The DQ Institute partnered with the World Economic Forum to increase ‘DQ’ (similar to IQ or EQ) among individuals at an early age.

Case study

Building digital intelligence among children • DQ Institute, in collaboration with the World Economic Forum, launched the digital intelligence curriculum which teaches kids 'digital citizenship' — a set of key skills from detecting fake content to protecting their privacy, managing screen time and handling cyberbullying; as well as 'digital empathy' — aimed at making children less likely to bully others. • A pilot program in Singapore in 2017 demonstrated that children who completed the course showed a 30% reduction in risky cyber behaviors. e.g., they were, significantly less likely to share private data. • DQ Institute also launched a pilot cyber risks help reporting system for children. It can detect a child's exposure to cyber risks and allow proactive intervention to help kids who are at risk. Key aspects of digital awareness Digital education • Critical thinking

Digital rights, security and identity • Digital citizenship

Digital integrity and collaboration • Online communication

• Digital content creation

• IP protection and awareness

• Digital empathy

• Find and utilize digital content

• Privacy

• Knowledge of communication tools

• Digital hygiene and safety

• Device security

• Regulation awareness

• Digital footprint

Use of private groups Social media, in its early stage, was treated as a mental escape route from the real world. However, benefits proved transitory and individuals, going forward, will look for more private interactions. In 2017, the number of internet users in urban areas increased by 18%. At the same time, social networking penetration grew only by 4%. However, overall adoption of online communication tools witnessed a 16% increase, suggesting that the new consumers are preferring to communicate privately.27 To prevent cyber-bullying and undue exposure, individuals are realizing the need to set boundaries of online interaction, especially with strangers. This is evident with the advanced use of privacy settings, child safe apps and closed group interactions. Consumers are already gravitating toward using social media apps which auto-delete social media updates or ones which offer better closed group interaction or better protect personal data.

“Kantar IMRB ‘eyes wide open’ predictions 2018 The future of digital is human |

Aiming toward a shared agenda of sustainable digital growth Role of government, businesses and citizens 40

| The future of digital is human

Ensuring an overall positive impact of digital lifestyle India is currently the hotspot of digital innovation. We possess a growing market for technology innovation as well as a conducive ecosystem for budding entrepreneurs. We have a lead due to our young tech-savvy demographics, and with millennials getting active in workforce environment, digital is expected to drive many more changes in our lifestyle. With such exciting times and a period of unrivalled opportunities, it is imperative that our society lays the right foundation to tap the potential of digital disruption and enable inclusive growth. For this, citizens, government and businesses need to work toward a shared agenda of sustainable digital growth.

• Light touch regulatory mechanism — focus on data governance and encryption frameworks to create a safe digital environment • Create digitally aware citizens — enlightening individuals on data misuse, data sharing restrictions, shared data and legal implications • Actively track and curtail the misuse of social media platforms to prevent antisocial activities

• Data security and customer privacy as part of the business culture: data protection features should be embedded in the products and services from the design stage itself, instead of being looked at as an afterthought • Strengthen consumer trust with adequate data security measures and consumer awareness initiatives • Work toward a collaborative environment, focus on providing the latest technologies with better security features via joint industry efforts and partnerships

Citizens

• Invest toward a Digital First agenda

Businesses

Government

Role of government, businesses and citizens to ensure a sustainable digital growth • Develop a mindset where digital technology can be switched ‘on’ or ‘off’ as they choose, instead of being dependent on it • Learn to make better choices about using time productively — especially for young generation that has instant access to a world of information and knowledge • View digital technology as a tool and not an end; imbibe critical life skills such as mindfulness and stress management

Unlocking the full potential of the digital economies requires investments toward sustainable and inclusive digital growth first

The future of digital is human |

Continuing its lead in digital, Kerala has drafted comprehensive policies to enable its citizens derive maximum benefits in the digital world. Many of the above elements such as creating a robust digital infrastructure, improving cybersecurity and increasing digital awareness underlie its approach to an enhanced digital lifestyle.

Kerala's four-pronged strategy for IT development 1

Building human capacity through technology education and skill development

Creating world class technology infrastructure

Attracting domestic and foreign investment through time-bound and modern marketing systems

Creating a citizen-centric digital economy and enabling a vibrant start-up ecosystem

Empowering citizens via digital: key focus areas Digitally empowered citizens • Digital identity, participatory e-governance along with omnichannel portals • Single government portal for interactions and service delivery • Promote e-procurement, mobile banking • Develop smart villages and panchayat programs Digitally empowered lifestyle • Increase digital literacy by strengthening the ICT academies • Establish connected education hubs through tele-presence and audio/video conferencing • Encourage and support local content and community-relevant applications Digitally empowered commerce • Enact a policy for enabling the growth of e-Commerce • Encourage and facilitate business processes via internet (B2B or B2G) • Enable innovation and entrepreneurship; establish Technology Innovation Zone, conduct Grand Innovation Challenge • Create a Kerala App store for apps catering to the need of citizens • Facilitate IT industry through policies on tax structure, single window clearance, incentives/promotion packages and SME assistances • Brand "Kerala IT": send delegations to identified, conduct IT expos and seminars Sources: “I.T. Policy 2017,” Government of Kerala

| The future of digital is human

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Our offices

Bengaluru 6th, 12th & 13th floor “UB City”, Canberra Block No.24 Vittal Mallya Road Bengaluru — 560 001 Tel: +91 80 4027 5000 +91 80 6727 5000 +91 80 2224 0696 Fax: +91 80 2210 6000 Ground Floor, ‘A’ wing Divyasree Chambers # 11, O’Shaughnessy Road Langford Gardens Bengaluru — 560 025 Tel: +91 80 6727 5000 Fax: +91 80 2222 9914 Chandigarh 1st Floor, SCO: 166–167 Sector 9-C, Madhya Marg Chandigarh — 160 009 Tel: +91 172 331 7800 Fax: +91 172 331 7888 Chennai Tidel Park, 6th & 7th Floor A Block, No.4, Rajiv Gandhi Salai Taramani, Chennai — 600 113 Tel: +91 44 6654 8100 Fax: +91 44 2254 0120 Delhi NCR Golf View Corporate Tower B Sector 42, Sector Road Gurgaon — 122 002 Tel: +91 124 464 4000 Fax: +91 124 464 4050 3rd & 6th Floor, Worldmark-1 IGI Airport Hospitality District Aerocity, New Delhi — 110 037 Tel: +91 11 6671 8000 Fax +91 11 6671 9999

Hyderabad Oval Office, 18, iLabs Centre Hitech City, Madhapur Hyderabad — 500 081 Tel: +91 40 6736 2000 Fax: +91 40 6736 2200 Jamshedpur 1st Floor, Shantiniketan Building Holding No. 1, SB Shop Area Bistupur, Jamshedpur — 831 001 Tel: +91 657 663 1000 BSNL: +91 657 223 0441 Kochi 9th Floor, ABAD Nucleus NH-49, Maradu PO Kochi — 682 304 Tel: +91 484 304 4000 Fax: +91 484 270 5393 Kolkata 22 Camac Street 3rd Floor, Block ‘C’ Kolkata — 700 016 Tel: +91 33 6615 3400 Fax: +91 33 2281 7750 Mumbai 14th Floor, The Ruby 29 Senapati Bapat Marg Dadar (W), Mumbai — 400 028 Tel: +91 22 6192 0000 Fax: +91 22 6192 1000 5th Floor, Block B-2 Nirlon Knowledge Park Off. Western Express Highway Goregaon (E) Mumbai — 400 063 Tel: +91 22 6192 0000 Fax: +91 22 6192 3000 Pune C-401, 4th floor Panchshil Tech Park Yerwada (Near Don Bosco School) Pune — 411 006 Tel: +91 20 6603 6000 Fax: +91 20 6601 5900

4th & 5th Floor, Plot No 2B Tower 2, Sector 126 NOIDA — 201 304 Gautam Budh Nagar, U.P. Tel: +91 120 671 7000 Fax: +91 120 671 7171

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