Transcriber: Chryssa R. Takahashi
Reviewer: Sodam Yang (Greek): Good afternoon.
Ιt's amazing to be here, in Athens, the home of Asclepius,
the Greek God of Healing, and in Greece, where
so much of modern medicine has been derived from Hippocrates
and others, Galen and beyond. And the formation and the foundation
of modern medicine has been formed here and it's really informed
the rest of the world and it can form the future
of health care as well. But before we look into the future
we often take a bit of back to the future look and I had the chance to return to my roots,
to Massachusetts General Hospital, where I did my medical training,
for its 200th anniversary. That's very old in the United States,
very very young here. And had a reunion
of the doctors I trained with, and I found myself
after one of the receptions at one of the most famous spots
of health care history. This is called the Etherdome,
the spot where in 1846, this lucky patient was the very first patient
to get general anesthesia with the surgery. And if you go to the Etherdome today it's frozen in time from 1846,
nothing has changed. And it's a very historic spot, I wandered
about 4 minutes down the hall to the ward where I spent my first
month as a brand new doctor. And I found also in over 15 years,
that was frozen in time. Some of the same alarms
were beeping, some of the same nurses,
some of the same patients. The only difference was that
the young doctor was pushing around a cart with an old computer
and printing out the electronic record and putting in the chart
and I thought, even at a great institution,
like Massachussets General Hospital, medicine is still practiced like has been done
for hundreds or sometimes thousand of years, still stucked in silos,
in departments, in old definitions of how health care
has been organized, with waiting rooms. And we are in the new age now,
new age of technology, we can define medicine beyond
just body parts and specialties, in new and powerful ways,
with connected health, with digital health,
with the empowered patient. And we need to change our definition,
instead of how we practice medicine today with most of our dollars on sick care,
we can change our definition to spending more of our focus
on healthcare and using technology to enable
ourselves to be more empowered. We can also change
where health care happens, traditionally in the hospital,
in the clinic, but increasingly the pressures
on the cost are taking health care
out of the hospital to our homes and even onto our own bodies. Now in the 10 years or so,
since I came back to Stanford for fellowships in hematology
and oncology, a lot of technology has exploded. It's a very exciting age and it gives us
the opportunity to do brave new things. Many technologies are moving
at an exponential rate, doubling in their power and performance. The smartphones in your pockets
have more than a billion times the price and speed and performance
of the best supercomputers in the 1970's. And this Moore's law of IT and technology is happening not just in computers,
it's happening in many fields. And it's when those technologies
come together and they converge and the opportunity to rethink
many elements of our society, including that of health and medicine. We thought we've reimagined
many things in the last decade, how we read books,
how we take photos. Many companies have been
disrupted like Kodak, and other companies like BlackBerry
have almost disappeared, because technology can be disruptive
and it can be disruptive in health care. One element that is getting disrupted
is the use of personal genomics. The price of sequencing
your own human genome has dropped from a billion dollars, it's
dropped to twice the rate of Moore's law to about one or two
thousand dollars today. You can have your genome on a disk. The challenge is when a patience comes
to me with their genome on a hard drive, we still don't know yet what to do with that.
There's a lot of opportunities to learn and converge that information
and it's beyond just genomics. It is our proteome, it's the data from
our blood, our environmental data, imaging the bugs in our gut,
our microbiome, all those information come together, and as Hippocrates said, early
proponent of personalized medicine, if you can get every individual the right
amount of nourishment and excercise, not too little, not too much,
we have found the safest way to health and the safest way to medicine
is to truly individualize that. We are able to individualize care now
with high speed computing, so we can do incredible imagery, so a surgeon can appreciate
the anatomy of a specific patient. We are able to see inside the brain now, not only to appreciate
the anatomy at high resolution, but increasingly the connectome,
and mapping the brain, and understanding
psychiatric diseases and treating those in better ways. We are using high speed computing
to disrupt and change old procedures, like an angiogram, to look at the heart can now be done
with a 30-second CT scan. We can scan the heart, send it to the cloud,
analyze the blood vessel, and determine, does that patient
need a stent or a bypass surgery, where it used to take an operating room,
and a catheter, and lots of radiation, and now it can be done computationally. And we can determine, does that patient
need a stent or other therapy? So we are disrupting cardiology.
Soon we won't have echo cardiograms. We'll do a ten minute cardiac MRI and analyze the function
and structure of the heart on a tablet, a smartpad or your phone,
anywhere on the planet. So, with faster technology
and smaller technology, we're clearly changing the way
we practice health care. The smartphones in your pocket
have become health care tools. And it's only been three years
since the iPad came out. That's become a disruptive force
in changing the way we practice medicine. Tablets, in fact the cheapest tablets
today are only 35 dollars. Imagine the impact
of giving away a 35$ tablet in education and healthcare
and beyond. And we can use these mobile technologies
to also give us dashboards into our data. If you are a diabetic patient, you can record
your blood trigger directly onto your phone. Get a dashboard of your numbers,
understand what that means and do a better job yourself and as your
clinical team of treating your diabetes. And simple apps, again, can give us
those feedback loops. And soon, instead of always
giving a drug or a vaccine, we'll prescribe an app. There'll be an app for pregnancy,
an app for surgery. They can really help tune
and personalize your therapy. We are in the age of gamification. Making patients more engaged
on top of their own therapy, using gaming technologies like Microsoft
Kinect to make things like physical therapy easier, and more fun. We are in the age now of digital mess and
all this faster computing is digitizing our data. And with digital information now, we can
again leverage our mobile platforms to take pictures of our skin lesions,
analyze those, diagnose eye disease. The case of my smartphone here can measure
my EKG and send it anywhere on the planet. We are in the age that
is called the quantified self. And as Hippocrates said,
"Walking is man's best medicine." Now, wearing new devices -- I am wearing
three of them, one, two, three -- I can track my walking,
I can track my steps. And there is whole new generation
of low-cost consumer technology including connected
blood pressure cuffs. You know, blood pressure, one in three
Europeans has high blood pressure. Now we can control that and
measure it and have feedback loops. Simple technologies, like connected
blood pressure cuffs and quantified health can
make a huge difference. There are now tattoos that can
measure your vital signs. And dashboards of our own body. I am actually wearing a small patch,
a two dollar disposable patch, you can switch to my vital signs. You'll actually be able to see it
transmit through my phone, my vitals. And if I show you how
I run through the stage, you can switch over and you'll see
my live EKG through my phone. Here we go, here's my EKG. OK, only 132 beats per minute, my stress
level's only 100 percent. No problem. (Laughter)
(Applause) And if I run around,
and if I fall down it can call Emergency,
or call my mom. So this sort of technology
is getting powerful and is disposable and will help us control
and treat diseases in smarter ways. So new tools are coming
to physicians and patients. Digital tools to make better physical exams,
for a nurse or for a patient at home. We are using the power
of low cost laboratories. A single drop of blood now, can give us
incredible levels of measurement that were never possible before, with very-very low cost. We can even print out
some of our laboratory tests. So the idea of a digital check up,
anywhere on the planet, whether it's a rural island
off the coast of Greece, or rural India, combined with telemedicine, being able
to interract with a physician, or anybody else through your smart tablets is really changing the way
we practice health care. And enabling us to have better
health care for the older generation. They don't have to come to the hospital
all the time, and to the lab. Now, it's not one technology,
it's the layering of these technologies, the internet of things. Even our new pacemakers have
IP addresses that can be connected. The can also be hacked by the way,
so there's a dark side. So, we need to understand how
to put these together in smart ways, and not be overwhelmed. You know, our brains haven't had
an upgrade in millions of years but our technology
keeps getting upgraded. And so it's very easy,
as patients, as doctors, as healthcare systems,
to be overwhelmed by data. So how do we make sense of this? As Hippocrates also said,
"Life is short, the art is long." We could be reading every paper
in my field, I could never keep up. So the new field of artificial intelligence
is going to dramatically change how we practice medicine. And I like to call not AI but IA,
Intelligence Augmentation because it's going to help augment us. Hippocrates also said,
"Science is the father of knowledge." Now we have so much
science and knowledge. How do we integrate that together? Some doctors are threatened by this. Even Socrates thought that reading
and writing was not a good idea. But if we embrace some of these technologies we can dramatically improve healthcare. Because there is so much inefficiency,
we waste 30 percent of our healthcare dollars and we're not often smart about what we do. There's lot of medical errors. So, by using the integration of sensors,
big data, artificial intelligence, your car. You know more about
the health of your new car than you do. There's hundreds of sensors in new cars. You care about when your own
check engine light goes on. And systems like
OnStar for your car, could eventually become
the OnStars for your body. and integrate all this information
in smart and powerful ways. Might be some Star Trek fans here? The tricorders are no longer
science fiction. There's now, what used to be
a hundred thousand dollar ultrasound, it can fit in my pocket, right? And there's even an Xprize. You met Peter Diamantis here last year,
the founder of the Xprize. There's now a new Xprize I helped design,
to make a medical tricorder. To be at home for patients and consumers,
to use, to do a better job than physicians. And many companies are developing these. And one company that I helped
get started called Scanadu, has developed a technology. Hold it to your forehead,
it pulls up all your vital signs. Talks to your phone. Communicates
with your health care team. This is a view of where this might
be in the next couple of years as we put all this technology together.
Take a look. (Music) (Video): Technology has given us an
unprecedented window into the human body. But on a day-to-day basis we are still
in the dark about our own health. We are changing that. What if instead of fearing the worst when
you notice something out of the ordinary, you could identify the condition yourself. Getting the right diagnosis
would save you worry. And an unnecessary doctor's visit. Instead of hearing about
a viral outbreak on the news, imagine you got an alert, that was tailored to your family's needs. It would also give you advice
about what to do next. What if you had a way to identify
what was wrong right away. A way to get
all of the information you need, to understand the situation. (Music) And in serious cases, you would
know when and where to seek help. (Music) We're building a way for people
to check their bodies, as often as they check their e-mail. It's all possible.
And it's only the beginning. Now that's not science fiction. These technologies have been built. They'll be on sale next year. In fact, this company crowd-sourced
the funding of their next clinical trial. So we can now have
an era of connected health care. Where we can share our information
and make sense of it. The social network
is very important to our health. And it's not our genetics that are
most important for our health. In fact it's our social networks,
it's our behavior. And as Hippocrates also said,
"It's far more important to know the person the disease has,
than the disease that the person has." So understanding the social construct
can enable me to influence you to behave better
and have better habits. If you can look in the mirror in the morning
and see healthy you, right? Or what happens if you have
too many baklava, right? You can change how you may
be wiring your behavior. I can now download an app and see my self
today and one thousand baklava later. It changes my thinking, right? Or if I'm trying to influence
a patient to stop smoking. What they might look like
in twenty years, if they keep smoking. Or if they spend too much time
on Facebook for example, right? (Laughter) We can use technologies,
including telepresence, new ways of using robotics
to interact as clinicians. New ways of having low cost telepresence
robots to visit our friends and family. and interact both
in medicine and beyond. We are using robotics
to enable the disabled. There's a lot of innovation
going on with robotics. In fact I was a judge last week
at the Google Science Fair, and Harry, a young student,
17-year-old, here from Greece has developed a robotic exoskeleton
to help his grandmother. (Applause) And robotics is enabling
the severely disabled, those who have
completely paralyzed to connect their brains
to a robotic limp. So we have an incredible ability now, to change the way the disabled
interact with the environment. We're seeing robotics that are
now wearable, wearable exoskeletons. So someone who is paralyzed,
for example, can put on a wearable exoskeleton
and climb a mountain. And it's going beyond that. We really
want to cure spinal cord injury. And the next generation of regenerative
medicine can enable that. Shinya Yamanaka there,
won the Nobel prize last year for developing induced pluripotent cells
that you can turn your own skin cells into any cell in your body. So the opportunity to have extreme remedies
and build a fountain of youth and converge technologies,
like 3D printing. I am actually wearing a 3D printed belt. You'll hear from the next speaker
more about 3D printing. But 3D printing can be applied
to health care from neurosurgery to next generation
prosthetics to orthopedics to even being able to scan my own self
and have a little version of mini-me, right? It's cute, but what if I have cancer
and I have lost part of my face. We can make a prosthetic,
or combine that with bionics. So incredible potential, to eventually
3D print the organs of the future, from simple ones that we do today,
to complex ones in the future like our hearts. Now, I've been diving into this world
as the head of a medicine track at a new institution called Singularity
University, based in the heart of Silicon Valley. And our mission is to cross
fertilize technologies and to say how can we take
exponential technologies, put them together to solve
global problems, like even global health. And a student from Greece, Andreas,
formed a company, called MatterNet, at Singularity University, to use drones
to deliver drugs and vaccines. A better way of delivering medicines
in parts of the world with poor transportation. Other students build
gloves for telemedicine. I've formed a program at
Singularity University called FutureMed. We bring together doctors and researchers
and scientists from all sorts of fields to rethink and reinvent medicine
in new and powerful ways. And I hope some of you can join us
at FutureMed this November. Just go to FutureMed2020.com where
we rethink the future of health care. So, many new people
come into health care. You don't need to be a doctor or a roboticist
to go into health care today. Any field can impact health care. In fact, even Google is
now approaching longevity and a new company to think
about longevity and health care. And we're bringing new folks
with beginner's mind. Even designers.
Design thinking is important. Like, I'm flying back
tomorrow to California. I need new technologies, you know... Oh, by the way, you can do
smart things with your furniture to help older folks get up and have
a smart design in our environments. And even our walking canes. We need smart design thinking. If I'm flying, I don't want
to put wings on my car. I need a 747, and a 747 doesn't fly by itself,
it needs a whole system, right? So we can take lessons actually
from aviation and other fields to apply to health care. I've been a pilot for 20 years,
since college, and I've had the opportunity to fly
in fighter jets as a flight surgeon, in the International guard. And there's lessons to take from aviation,
from the fighter pilot world, from the military,
that apply to health care. Like checklists. We use checklists
to make flying safer. We use checklists to make
the operating room safer. So checklists have been applied and
dramatically improved outcomes in that regard, and we amplify checklists
and personalize those. The idea of simulations,
simulations have made flying safer. Now we can simulate procedures and do training for surgeons
and nurses and medical students. And we, instead of see one,
do one, teach one, we see one, and simulate it
and get it right. And we get to practice it,
not on our grandmothers, we practice it in the simulation lab. We're using the world of a new cockpit, that we have now digitized. We can see our world in new ways and make the data
information actionable. Even Lockheed Martin is helping create
the new intensive care units at Johns Hopkins. We, in the fighter pilot world,
use heads up display. We need other information
in bad weather, that might remind us
when to hit a mountain. It'll give us a cue, a sound. We can sometimes use it, different
information if we are in a dogfight. We use feedback loops in our cars now. We might soon have a GPS
for our own health care, that says, "Daniel, go to the right to the gym,
not to the left to the McDonalds." Right? It helps guide us, right? We want just the right amount of information,
not too much information also. We're seeing the world in new ways. The blind now have visual
prosthetics to help them see. And we are also as sighted people
seeing the world differently. We have new technologies being developed,
like an assisted living contact lens, so we can see the world maybe
through our contacts. It might have some
interesting implications. You might be wearing your assisted
living contact lenses and be out on a date
and you need a little bit of help, so you bring up the Wingman app. (Laughter) So, some interesting implications.
(Laughter) Do we need to wait for those?
No, today we are in the era of eyewear. Google Glass is here. Google Glass
is going to be transformative I think, in many fields, including health care. As a doctor I can see
my patients vital signs. As a patient I can understand
my medicines and be more on track with things. We might see our food in different ways. And another Greek saying "Everything
in excess is opposed to nature." What if you're having a little bit
of excess, you might have a clue. You know, from your visual cue. As you might have another clue. (Beeps) (Voice): Pull up, pull up. From the fighter pilot world. (Beeps)
(Voice): Pull up, pull up. Finally, we have the idea
that there's radar. What if we could see
other patients like ours, or other patients like mine,
and share that information. When you drive now and use
Google Maps, you use a little privacy, but you can crowd-source that
information together and share it. Now you can build a map of Rome,
build a map of Rome in a day and see what's the right route to work, what's the fastest way to get there, how do you avoid the traffic jams. What if we could do that in health care, and share our information
in new and powerful ways. So in conclusion, medicine, traditionally
has been very much blind, very empiric. Now we have new technologies,
new sensors, new data being shared. We can get information about
our individual neighborhoods and from our individual social networks,
and maybe even decide, you know, who to shake hands with
each day, based on that information. So, we can use other ways of thinking and
dashboards, and contextual systems medicine to change the way we do things,
and design thinking. All these elements can come together
to re-invent health care. And changes from a world that's been
traditionally very episodic and reactive, you have a chest pain and a lump,
the problem, and you get seen two days later,
or after the event. To changing health care to being
continuous and pro-active and leading us to a much healthier
society at lower cost. And I would encourage all of you
to get engaged in your own health. You don't just need to be
blood donors or organ donors, you can also be data donors and
change the face of health and medicine. So, I think with lessons from the past,
from Hippocrates and others, we can have a brave
new world of health care. In many ways, like my Google Glass,
the future is already here, it's just not evenly distributed yet. And it's up to you, not just to imagine
that future but to go out there and create it. So, with that, I'll say thank you.
(In Greek): Thank you. (Applause)
