Next steps in health & medicine -- where can technology take us? | Daniel Kraft | TEDxBerlin

so it's a really interesting time for the president in the future of health care and I think part of the theme of this talk will be that the next steps are that all of us can play a role in the future of of health and medicine but if we think about healthcare today it's really actually more like sick care we're more like reacting to when we have a disease we're not Lee our systems are set up to treat the sick not to really keep us healthy and our care is mostly sort of reactive we end up in a system where we wait for the heart attack or the stroke or the cancer be discovered and the data that we get in the healthcare system is very intermittent we wait for the occasional blood pressure check or lab value test or vital sign check or EKG and that makes health care very expensive and discontinuous in fact the most cutting-edge technology for communicating most healthcare data today is still the fax machine most prescriptions are still written on paper and most of our records are turning electronic we're still sort of stuck in siloed health care systems and electronic medical records and paper charts so the feedback loops of health are often sort of very broken and intermittent and that's where things get expensive and that's what takes us time we spend an hour waiting for the doctor for a ten minute visit and I as a physician you know I get rewarded for seeing more patients not for doing a better job with my patients and when my patients come to see me they don't often remember everything about their data or their condition so health care is intermittent and reactive it needs to become continuous and proactive and our healthcare systems are still kind of set back in the 1800's in the old silos and definitions and boxes that they've been placed in for a long long time and in this new age of connected health genomics digital mobile we can start to rethink healthcare outside of the spectrum where we spend most of our healthcare dollar eighty percent or more on the sick care side of the equation we can use our technology and our own initiative to move ourselves to the left side of the equation because if we don't do that we're going to bankrupt our countries here in Germany your think number four on the list of the GDP in the u.s. number one on healthcare spending per capita so if we start to shift our thinking shift our incentives from sort of reimbursement based medicine to evidence-based medicine and start changing how we reward ourselves as individuals and as doctors we can make a big change one change will be that you know no longer is the the doctor the God who tells you what to do as the patient you're going to be the new sort of CEO of your own health a new drug is really the engaged and powered patient who lives and owns their information and stays on top of it and part of that is being enabled by this whole new fast-paced world of technology all around us in 2005 that was the the last Pope being inaugurated there's a next pope in 2013 you can see the difference in the same scene and that's largely been enabled by our smart mobile technologies that are riding Moore's law you know the computational power keeps doubling every two years or so and gets faster and cheaper that's why our smartphones are really becoming medical devices they have about a billion times the price and speed and performance of the best supercomputers in the 70s your tablets are the equivalent of a Cray supercomputer and you need to start thinking in whatever field you're in healthcare otherwise exponentially because as these technologies double they get very disruptive and it's no one technology it's where they come together which is where they converge it's that's the point where reinvention can happen in healthcare and in many other fields so we're seeing this combination of technologies and each of you can start to use that in your own healthcare platforms and as we reinvent the next steps in healthcare because as we've seen with technologies like the iMac it now fits on an iPhone and probably next week the announcement from Google will fit on your eye watch and companies like Apple didn't really invent these technologies they sort of reimagined how they could be used just like we're reimagining how we pay for things how we read for books how we read books those have been now moved to Kindles how we book our travel how we get our movies all streaming to us that's been very disruptive for certain other company country companies even here in the US and in Germany companies like uber which is a San Francisco based company where I come from is valued at eighteen billion dollars after four years they didn't invent the mobile phone they'd invent GPS online maps online payments they just layered it up together and of course that's disrupting the taxi industry to the point where I think it's been outlawed here's or two days ago so sometimes progress needs the help of the regulatory bodies and forward-thinking to move forward so what would the uber uber if occation of health care look like makes it's more streamlined easier to use actually I tweeted that out a few months ago and two companies came back saying we're building that you press a button and a doctor comes to your house so this sort of disruption is starting to occur and it's partly through new thinking from folks who are not traditionally physicians or medical devices or in pharma and in fact if you're not thinking disruptively our friends and pharma are experienced in some cases things like Farmageddon now I'm a physician I also happen to share the medicine track at a new institution based in the heart of Silicon Valley called singularity and university where we look at the cross-pollination and pace of fast moving technologies from medicine biotech robotics artificial intelligence 3d printing and beyond and in our 10-week summer programs in our one-week executive programs we look to ask how can you use technology to impact the world in powerful ways and many of those platforms have actually been in the medical realm I've run a conference specifically at singularity University for four years called exponential medicine where we take folks from every different field we mix them up we mash them up and we ask where can we reinvent how can we take the next steps in reinventing health and medicine and I encourage you to come join us in November so let's look now at some elements of technology and how that can in fact are our own health our Diagnostics our therapeutics and how we can all contribute to healthcare innovation so first of all we all know we're supposed to you know exercise and eat right we don't need to have our personalized genomes to let us know that but today the price and speed of sequencing and genome is dropping at twice the rate of Moore's law to the point where it's only about a thousand dollars today and that gives us a lot of opportunity to understand and do smart prevention for the diseases we might be prone to genetically and it's not just genetics that's getting cheaper those proteomic data environmental data our microbiome that's in our and our GI tract there are nano noses that can take a listen to our breath and maybe detect cancer but again that's riding an exponential wave all of us though can do our part to practice healthcare not sick care we can realize that moving appropriately 30 minutes of exercise is the best drug that you can take part of getting enough sleep all those things are really really important and if we practice them in simple ways and leverage technology which we now have ubiquitously we can make the most impact on our own health out of our community and our nation now there's an explosion now of these sort of exponential technologies we're wearing on our wrists I'm wearing like six of them right how many here have some sort of Fitbit a wearable device a few of you right it can make a difference when you can sort of see and understand your data something as simple as your steps or your sleep can be very impactful and these technologies have exploded on the scene you can go into an Apple store now and find twenty or thirty on the shelf there's 40,000 or more health related apps in the Android and Apple store and they're not all terrific but if you use some of them just pick one it can really help you stay on top of things that are really important like your sleep right if you don't take care of your sleep health that can really impact your health downstream and these technologies have started sort of simple on this idea of quantified self but they're moving to this era of quantified health it can be a toothbrush that tracks your kids when they brush their teeth or the scale that tweets your weight to your friends can be new technologies that can tell how much you're drinking and what you're drinking whether that's legal or not or if you're legal or not to drive all those things are emerging very quickly becoming a path I'd some can even measure how many calories you're eating or drinking and don't look to the sensors of today the sensors of tomorrow we're going to start disappearing and layering different elements even Google's building a new smartphone that has multiple integrated components one might be a glucometer if you're a diabetic one might help track your cardiac issues if you're a heart patient these new sensors will start to become embedded in our clothes in our cars the Internet of Things in our homes they're even coming to our youngsters this is the idea of a smart diaper from Wired magazine but actually it's now reality there's tweet P from Huggies you can figure it out what that does I'll let you figure out what this one does number two you know sometimes too much data so we can get all sorts of information even from our youngest citizens including a there's my two month old contributing to the medical establishment so when we have this data and it starts to disappear and be integrated into what tattoos that can be given to us when we leave the hospital or the wearables essentially become inside the Buhl's tools that will start to swallow this is an integrated eye pill that can replace an endoscopy to look at your GI tract so we're now going to be surrounded by lots and lots of big data but the trick is to make that actionable information personal information we can use so we're going to be layering analytics predict oolitic s-- the idea of what your car has today a check engine light that lets you know based on 100 or 200 sensors that your BMW needs to go into the shop will have those kind of mentalities coming in to our healthcare systems to understand you and give you your own early warning light or if you hit the tree when you crash your car can call the emergency services and services like Google now will start to remind you oh it's time to go do your run or to go have a healthy breakfast as opposed to your normal realm and we'll get other reminders like looking in the future mirror you'll see future you a view of tomorrow ok you have tomorrow you kind of work out really working out you have tomorrow ok you're doing p90x you have tomorrow right what if you keeping having streudel for breakfast well that's what happens right now you don't need to wait for the magic mirror you can download apps today here's me now here's me a thousand strudels later right so I I think I think about it before I have that extra Trudel I love screw right or for those of you in Europe who smoke right what's going to happen to your skin if you're smoking what if you could show someone what their skins gonna look like if they spend too much time on Facebook alright so this idea of understanding our health before you smoke after your smoke can be really powerful levers to change your behavior and we're seeing new technologies like oculus rift which was just bought by Facebook for three billion dollars it's gonna be a powerful way to see our environment and train our brains so we want to optimize our brains in new ways right there's new ways to understand and read our brains that's the the old Back to the Future way but there's now an explosion of consumer devices that you can wear that can give you insights into your own brainwaves I can wear this headset essentially and take a look at my brainwaves I can learn to focus if I need to focus playing a game for kids who have attention deficit disorder that can be very useful we can use this to train folks to meditate here's my brain signal when I'm actually calm for a few minutes we're seeing folks start to open-source these technologies and hack them to use brain waves and new ways and in fact some groups at MGH and other places where I train are starting to create devices that will put energy into your brain to maybe make you smarter have more focus or treat Parkinson's or other disorders so it's a really new world now just for diagnosis and health but also for diagnosis most of you when you go to the doctor that's when you have access to certain diagnostic kits now as a physician I have a digital doctor's bag I may have a device I can attach to my smartphone to look in a child's ear for pediatric visit or again on our phones we have a whole new version of connected technologies like the smartphone case I can hold the case and it will give me my EKGs directly I could screen the room here and pass this around and find folks might have medical issues and if you don't read EKGs you can press a button on the app and boom your EKG rotors all comes to you and your physician right away so it's a really interesting world where we can start to get continuous data anyone on the planet in fact I'm wearing a little patch maybe we can switch over to the live screen right now I'm wearing a little disposable patch right here and if the AV folks can help out who there's my live data talking from this patch I'm wearing to my phone you can see my EKG sort of my stress is only 99 percent thank you if I run around or if I fall down it knows my posture and it can tell and call my mother or emergency services if I don't get up in time all right I'll switch back and so this is an example of big data coming to us who's going to understand this data who's going to analyze it we'll need to use this in smart ways other ways to look at my heart this is a technology from Stanford where you can do a five-minute cardiac MRI completely reconstruct the heart function and this will replace the ultrasound in a few years or if you're a patient that you're trying to that might have epilepsy or other neurologic disorders we can measure and protect predict when you're going to have epileptic episodes or if you're a patient with advanced disease or complicated disease like multiple sclerosis what if we have a dashboard to look at the integration of signals and give your medicines before you have the MS flare-up so lots of ways to start integrating this data we're going to need to put this together for the consumer for you at home I've been involved with organization called the XPrize for a few years and we've designed a medical tricorder X PRIZE like from Star Trek the medical tricorder and over 200 teams have entered this competition one of them started at the first exponential medicine program and they're already have developed a handheld medical device for the home that you hold your forehead it gives your heart rate temperature oxygen saturation respiratory rate talks to your smartphone which is connected IBM Watson it can help you as a consumer and your medical team make better diagnoses and that will maybe replace or visit to the emergency room or we can use tools now to dip your urine and take a picture of the urinalysis so I dip the urine stick I take a picture with the app and boom it gives you your analysis immediately or if you might have influenza or swine flu you can spit in a tube and have that analysis done at home so new ways of doing connected diagnosis from home are going to enable all of us hopefully be healthier and do smarter triage and lower costs what's really interesting about this company is that they raised most of the money for the clinical trial 10,000 of these will ship next month through online crowd sourcing so new ways to fund medical innovation are certainly coming as well back to the brain how about diagnosing things that are very expensive and hard to treat like Alzheimer's we can now put someone in a scanner and using a special technique determine if they're going to get Alzheimer's or other diseases about 10 years ahead of time maybe then we can be more proactive now there's new blood based tests that may be able to diagnose Alzheimer's 10 years early or even now visual tests an app and a little sensor that looks your eye motion can track i'm movements and determine 10 years or 20 years early who's likely to get diseases like Alzheimer's so lots of new ways to think about diagnosis using these connected tools and new and powerful ways ok hopefully we're healthy hopefully done good diagnosis but we're still going to need therapy whereas they're worse technology taking health care therapeutics well a lot of the future of medical visits will be mediated by telemedicine about six companies have launched in the last six months that are offering sort of online visits directly from your smartphone or tablet for less than 20 euros and I think a good percentage maybe 50% of doctor visits or other healthcare visits will be mediated by these apps you can have absolutely help you make appointments can have in my case idle lump on my neck I used a dermatology app that connected to a real dermatologist helped diagnose a little lump then I made an appointment with a plastic surgeon and in one visit with two apps I had my little mole removed so boom right lower cost and better experience and in some cases this is lowering costs we're seeing evidence now that these apps will prevent heart patients who have difficult complicated disease from coming back and forth to the hospital or using therapeutics using artificial intelligence systems to maybe even do a better job than your psychiatrist some sometimes all right we're blending therapeutic modalities this idea now of ultrasound which you use for Diagnostics can be blended with MRI so a woman for example with a uterine fibroid or tumors in their liver or their brain can have focused an ultrasound to knock out these lesions and that might be the focus of less invasive surgeries as we go forward so lots of ways that are happening in therapeutics my field I'm trained as a oncologist a cancer doctor is getting very exciting because now with lower cost genomics we're going to start sequencing every single tumor using artificial analytics and other services to predict what drugs are specifically right for you there are new classes of drugs like this one that was just approved this week that are leveraging the immune system and are much more targeted and less toxic we're seeing new interventions that are like our pacemakers but they're getting smaller and more powerful they can be placed by less skilled doctors we're seeing pacemakers not just for the heart but for the brain for the GI tract in a whole new set of modalities even some pacemakers or implants that will modulate long-term birth control you can turn it on and off with your app might be convenient so again from wearables externals to inside the balls and part of therapeutics like it or not will be mediated by artificial intelligence and robotics we're already seeing robotic anesthesiologist embedded with artificial intelligence you can think about like the taxi drivers here who's who's not very happy about this right so robotics is coming we're seeing the era of wearable robotics the woman on the left there is paralyzed from the waist down she's wearing a wearable exoskeleton with components of it that are 3d printed to actually match her anatomy and 3d printing by the way is really exploding and really is starting to impact health care if you're a fracture your orthopedic patient you're going to have things that match your anatomy if you need a new hip or new joint those might be printed exactly for you I have been scanned and I've been printed here's a little mini me carry my my pocket now it's fun to have mini me but what if God forbid I had cancer on my face and I could print a component that matches and replaces that so new ways to think about these 3d printing realms as we move forward and including new ways to educate and help the physician whether they're in the operating room using technologies like Google glass what are the best use cases and most common apps that are being developed or these are in the world of healthcare so the surgeon can see the vital signs or be in communication with a senior surgeon or a medical student we're seeing new ways of Education where physicians and nurses and students and you can share your images and and help the whole process of medical discovery so speaking of discovery we all can play a role if we can crowdsource our our health and our information in fact just there was an earthquake in near San Francisco about two weeks ago and they could tell all the folks who are wearing this jaw bone device they can tell who woke up based on how close they were to the earthquake pretty amazing right so that was sort of crowd source information about sleep what if we could start to crowdsource our genetic information if you start to share your genetic information and volunteer it with smart privacy laws in place that will be powerful or now for 100 US dollars you can have your microbiome sequenced and you can share that data soon we'll be prescribing bacteria to replace our GI tract and do other things and finally just like when we fly we can track all the airplanes we can now have dashboards of our data and share our information just like when we drive now with Google Maps or Waze you share a little bit of your privacy this is a map of Rome being built in a day just from the google map data right what if you can then get some information back like the best route to school or to work and you crowdsource and share your information and realize that we're all connected we're all part of a social network it's our social networks that are often most important in our healthcare outcomes we can mine our social network data with privacy in mind we can then determine who to maybe shake hands with or not shake hands with that day and we can all become not just organ and blood donors but potentially data donors so in closing think about all the technologies that are merging they're moving very very quickly the new innovators in health care aren't the traditional physicians anymore their new accelerators and incubators I visited one in here here in Berlin just yesterday we can all have a global impact just not just here in the West but in the developing world by leveraging mobile and health and new ways by taking technologies like this $35 Android tablet which could be used in health and education and powerful realms we could take new technologies like drones from a company from singularity University called matter net that's taking drones to deliver drugs and vaccines and soon we're now seeing big players like the Amazons and the googles get in this room home so even for real there's a company in San Francisco that's going to be delivering drugs from the pharmacy to you in San Francisco not sure what kind of drugs but they'll be delivering the my drone so this is happening so remember health care shifting from one that's been episodic and reactive to an area that's more continuous and proactive technology is often here before we expect it and the best way for us to take the next step and create the future of health and medicine is to go and create it ourselves so I want all of you to be the next step in the future of health yourself and for the world with that I'll say

Channel: TEDx Talks

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Keywords: ted, Biomedical Engineering, ted x, Germany, ted talk, Medicine, English, tedx talk, ted talks, Health, tedx, Technology, TEDxTalks, tedx talks

Id: zrW3-yzWt5Q

Length: 21min 23sec (1283 seconds)

Published: Wed Oct 01 2014