Digital Doctors: The Future of Medicine | Derek O'Keefe | TEDxGalway

[Music] [Music] my name is Derrick you've heard a bit about me from the intro and I'm a physician ear so what that term means is is that I've trained as an engineer so I've done an electronic computer electronic computer biomedical engineering and I've also trained as a physician or a doctor so I've done my medical training and my clinical training in general medicine and an endocrinology and in diabetes and as an engineer half my brain is in black and white so it's analytical problem-solving very logical and as a clinician well anyone who knows medicine knows it's a spectrum of color nothing's ever black and white in medicine and the interesting thing is is that doctors have a lot of clinical problems and engineers have lots of solutions so if you put the two of them together you have great opportunity for innovation and I've been lucky in the last 20 years or so to be involved with some of some very innovative projects so back in 2007 and NASA had a problem with monitoring how astronauts sleep in space because if you're in orbit and you're going around the earth 16 times a day that's 16 sunrises and sunsets that's really bad jet lag so they had to figure out how they're sleeping rather than just saying are you sleeping okay subjectively so we came up with an idea where we put a bio vest on the astronauts and we looked at their ECG and what's called our heart rate variability and from that we could deduce their sleep stage and see the quality of sleep they were getting so when you do an intervention then you can see if it's effective or not we've done projects where we've worked with patients who have had strokes and I've had paralysis afterwards we've built exoskeletons with electrical stimulation to allow them to walk more efficiently and more recently we've done work with people with type 1 diabetes developing technologies to deliver instant automatically so the idea of a clinical problem and an engineer being at the table and being involved with the solution is a very very innovative mix and tonight I'm going to hopefully talk to you about that where that mix of engineering and medicine is going in the future with the talk about digital doctors the future of medicine so this story starts actually here in Galway about four years ago I was a doctor on a ward round in the hospital and when you're on a ward round you go out to see all your patients in the morning so you see the patient and you ask them how their how their how the treatment is working you check their vital signs you look at the Bloods you look at the radiology and then during the ward round I get a phone call and I answered the phone because it could be radiology ringing me with an updated report and the patient or it could be the labs ringing me about an updated blood result so I took the phone call and somebody said hi is this dr. O'Keefe and I said yes is this you dad and they said oh this is actually NASA we have a Nemo mission next summer and we're wondering if you'd like to be part of it because part of the mission brief is telemedicine and you did things with telemedicine with as few years ago and I was like okay I'm in the middle of something at the moment can I ring you back later and they were like yeah sure no problem so I hung up the phone and I turned back to the team and they were like who was on the phone I was like it was NASA they were like yeah sure was yeah but it actually was NASA and and for those who don't know who NASA is if you haven't watched any movies or being involved with society in the last 50 years NASA is the u.s. federal agency that's kind of tasked with manned spaceflight and they have a big year this year this year is the 50th anniversary of putting a man on the moon this July so you're gonna hear a lot about NASA and their achievements this year and they've done some phenomenal stuff over the last 50 years of manned spaceflight you're aware of see of the of the shuttle program and the robotic missions and so on but what NASA really have done for us as society is develop new technologies and new protocols for us as as humans and push the boundaries of science and one thing they do really well at NASA and the one of the reasons of their success is what's called the three P's so that's practice practice practice very good so what they asked me to do with NASA is they asked me to get involved with one of their practice sessions so they have these facilities around planet Earth whereby they take a habitat which we're going to hopefully put on the lunar surface of the Martian surface and they take this habitat and they put it in what's called an extreme environment and those extreme environments are in the High Arctic where there's snow and you know for high winds they're on the lava fields of Hawaii they're in the deserts of the Mojave and the one that I was invited to be involved with was underwater off the coast of Florida it's called the Aquarius habitat it's about 60 feet down which is double the height of a two-story house it's about 10 kilometers off the coast of Florida and this pretty much both sized sunken laboratory is where four astronauts live for a month every year in what's called Nemo the NASA extreme environment mission operation and the idea of these four astronauts living there are aquanauts as they're called underwater for the month is that during that month they can do science and engineering experiments and they can develop the protocols here on earth before we put that base on the moon and Mars and you might say well why do they want to put in such an inhospitable environment but that's the key that makes the simulation high fidelity because if something is wrong you can't just pop outside and leave the habitat if you forget something you can't just pop outside historian get it you really have to plan the mission and you have to be in the moment in the mission so it allows us to test protocols and techniques and technology in a high fidelity scenario so why did they want me that was the question I guess so I rang them back and I said yeah I'm actually available next summer what's the what's the mission and they said we have this idea you know we've been doing telemedicine and remote monitoring for a while at NASA but the NEEMO mission this year we have an interesting idea we want to make mission decisions based on physiological data and I was like all right that sounds interesting so usually there's a flight surgeon which is the physician that looks after the health of the astronauts or aquanauts but this was the flight surgeon actually inputting into Mission decisions so the idea would be is that the aquanauts under water would wear something like a bio vest that would measure their heart rate their ECG their respire to rate their movement and so on and then with that activity then we could actually make decisions so for example I was able to talk to one of the the crew dr. Marc or Eva and I'd say to me you know you're planning today on the mission schedule to go outside the habitat today to do extra vehicular activity and there's a choice of four people that you can pick but I've been looking at the physiological data for the last 24 hours and I think you should pick Aquanaut number two because Aquanaut number one they haven't slept so well the last three nights an Aquanaut number three they're developing a temperature so they're probably gonna get a flu so we made a mission decision based on physiological objective data and that's a very interesting concept and it's kind of a tease of where we're going to go in medicine so as I said when you're outside their habitat you have to be at your physical and mental best and that's why it's really important that you use data to make the decisions and not just ask somebody how they feel and this technology was 2015 this kind of concept and it's starting to creep in now to what we call elite sports so elite you know soccer in the Premiership or football basketball all the top sports of the world what you're starting to see now is a lot of the players in the training ground wearing this kind of technology both to assess how they're performing and then also on the day when they're playing sports the next level of course which is going to become more common if it's not there already is that a lot of these elite athletes will be expected to wear this equipment all the time not just where they're in training not just one they're playing the game so now on a Friday night when a coach makes a decision about a big international the next day he says okay not only is this player playing well during the week in training I can see that they've been in bed every night at ten o'clock they've got the radar asleep they haven't gone to too many night clubs so that's what's going to be expected of the elite sports person because what's going to happen is on the Friday night when you're picking your team you want to pick the best at the best eleven does that make sense yeah so let's just take that idea and go forward it again another five years and then you're coming into the world of us to consumers so you're all familiar with wearable technology most of us here probably have some intelligent band on our wrist that measures our step counter tells us our calories we have smartwatches we have phones in our pockets that are computers a thousand times more powerful than that Apollo mission in 1969 but the big game changer in the next few years is going to be smart fabrics this has already been developed in some research labs but it just hasn't hit widespread consumer market yet and what that basically means is your t-shirt will have fibers in it that will be measuring your physiological signals so you'll be sitting there and you'll get a text message from your t-shirt and it'll say hey John you're getting your temperature I see you've got tickets booked tomorrow night for the cinema I'd probably pass in it so this is this is interesting this is where the technology is going the idea of wearable tech ultimately making decisions with our lives and then the important thing and all of that discussion is the engine behind those decisions because all this variable technology is just data that doesn't do anything what you need is information and from the information then you get knowledge and that's the second part of the talk so the first part is remote monitoring which I hope you've followed me on the journey the next part is the artificial intelligence so we've all heard this term artificial intelligence we're familiar with that I hope in our lives whereby you're watching a music video on the internet and maybe it makes a suggestion of what video you should watch next and then you watch it you kind of go oh that was pretty cool I didn't know that artist so it's kept you in the same steam attic area but it's going to get stronger and it's going to make our lives more interesting so for example in the United States at the moment and indeed in Ireland more recently if you imagine young drivers they get penalized a lot with insurance policies because typically young drivers you know they tend to have more accidents because they may not understand the risks involved with their behaviors but now you can get an electronic device that you can plug into your actual car so any car built since the mid 90s has a diagnostic port for mechanics this device plugs into it and it monitors your behavior as a driver so if you turn rice and you indicate rice that's a good thing if you drive between the hours of 8:00 and 8:00 and it's daylight that's good if you obey the speed limits that's good so if you have good behaviors you get 10% off your premium brilliant so rewards people who have good driving behaviors and therefore have a lower chance of accidents now imagine the flip of that so all that wearable technology I've just told you about that we'll all be wearing in five years time or so imagine if all that technology is harnessed and now it's a life insurance company or a health insurance companies looking at it and it says you know what Jack you're doing a fantastic job you're going to bed every night at 10:00 you're getting up every morning at 8:00 you're getting a great sleep you're not going to the pub you're going to salad bars you are living your best life 10% off your health insurance policy now Mary you're going to bed every night at 10 o'clock but you're watching Game of Thrones for three hours you're falling asleep at one o'clock you're waking up at 6:00 and then you're wondering why you're tired the next day and you don't have time to prepare the food so you're going to a fast-food joint and then you're so tired you can't go to the gym you're going to get a 10% loading on your premium so do we really want that as a society because these are the kind of questions were going to have to ask it's creeping in already with the car insurance but as society do we want to give that kind of access I guess to artificial intelligence now we are creatures of habit we know this it's part of probably an evolutionary biology mechanism whereby we do things in patterns and that's where artificial intelligence is really powerful is when pattern recognition it sees behaviors and it predicts the future based on patterns so a payton was taken out last year by one of the large online shopping companies called predictive purchasing and the idea is you can say $10 $20 or $50 and you can select once a week once a month or once a year so we'll just say you say $50 once a month and they're so confident with their artificial intelligence algorithms that they know what you want before you've even thought of it that they'll give you free shipping if you don't want it and I know what everyone's saying here in their brain they're saying there's no way a computer knows what I want I am a multi-faceted special sentient human being we are all creatures of passions and as I said it's probably something to do with with our evolution whereby if we used to walk a certain way back to the cave every night and we didn't get killed or attacked we probably kept walking to the cave the same way every day most of us here probably drive the same way to work every day we go to the same supermarket we buy the same twenty things so this new predictive purchasing software that's gonna come online pretty soon you've selected $50 you've selected once a month you look at the calendar and you see it's the first of the month and you're gonna go home and you're gonna see this package on the table and you're gonna think to yourself oh yeah this is brilliant now I'm going to show that artificial intelligence how special I am and you're gonna walk over to the table you're gonna pick up the box open it and say there's no way a computer oh my goodness this is amazing this is exactly what I wanted how did it know so it knew because it got you a guidebook for France on the holidays and it's all in your calendar that you're going to France this summer and it also saw in your calendar that last year you were in Spain and you bought a guidebook in the same thematic style and you gave it a five-star rating so it predicted that you'd want a guidebook for this year's holiday Wow maybe computers do know us better than we know ourselves so this is the kind of artificial intelligence that's going to be making big decisions not only about our purchases but also about our health so imagine all that wearable technology I spoke to you about and the computer is analyzing it and it's saying you know what Jack you have a 50% of getting diabetes based on your current health patterns and then you go when you change your behavior and maybe you can drop it to 30% because the artificial intelligence is able to look at the patterns and given your level of activity and your dietary input and so on it's able to make an accurate prediction of your chance of developing different chronic diseases and that can change behaviors but data gives us the chance to make better decisions and ultimately what we want to do is change the way we deliver health care that's going to be the future of medicine or by the patient is at the center of the health care equation not the institution or the healthcare network so is there a way to take that remote monitoring mix it with the artificial intelligence and deliver health care and way especially for chronic diseases because as we know we're all getting older and medicine is doing a really great job of keeping everyone alive so there's far more people alive now and living longer and healthier into their older age and so we have this plethora of chronic diseases that now need management which is a good thing we just need to change the way we're managing it so hospitals as you know that might have been built 50 years ago which had 30 seats in the waiting room which was enough for that population that's completely redundant now where you have people standing because you need double the amount of seats so there must be better way of doing it and there is traditionally centralized things like shopping go to a department store that's been changed to online banking going to a bank that's been changed to online health has been a bit slower to catch up with the idea of ICT information communication technology because we're afraid about our data being shared and being been leaked but as we know if we can trust the internet for our banking and so on that there's some really good encryption methods there so is there a way to take the remote monitoring the artificial intelligence and to actually deliver better health care and there is this is telemedicine and it's already being used around the world and being used for a long time but not really in the area of chronic diseases so why is a patient coming from Clifton or from the Aran Islands or even from across Galway and spending an hour and a half coming to the clinic 20 minutes parking where he to hours in a waiting room to see me for 10 minutes that's a waste of everyone's resources and you don't need to be an engineer to figure out that's a pretty wasteful process for the environment for the person's time it's much better if for example the artificial intelligence can figure out which patients need to be seen maybe they're having a lot of low blood Sugar's if they're diabetic and it schedules them to have a virtual clinic with me so at 2 p.m. in the afternoon they get a link to log on to the clinic I said in your pockets you have phones that have audio-visual equipment like FaceTime and Skype that are encrypted so I can see you on the computer and then I can see all your data because all these meters these glucose meters now when you take a value it goes to the cloud so I can see your sugar data I can see your activity data and I can see your your your medication administration and then we can have a very rich conversation and I can say as you would if you were beside me I see every Tuesday afternoon you're going low but also I noticed on Tuesday afternoon your activity goes up what's going on and then you might say I've joined a way of walking Club every Tuesday and I say oh that makes sense you better pull back on your your mealtime insulin so we can have rich conversations remotely and it prevents people having to come in to a physical hospital now you'll still have to come in at least once a year for a chronic disease to get you know the general medical exam but a lot of the care can be delivered remotely and if these visits throughout here which will keep people on track with their targets for chronic diseases so in summary two things I hope you learned tonight from my talk one if your phone rings always answer it it could be NASA and to the power of technology to improve the way that we deliver health care that's the future of Medicine thank you

Channel: TEDx Talks

Views: 125,708

Keywords: TEDxTalks, English, Health, Digital, Medicine, Space

Id: mnKemC8HKjo

Length: 18min 10sec (1090 seconds)

Published: Thu Apr 04 2019