FutureMed: Healthcare and Medicine Migrate From Linear Growth to Exponential Growth

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Futuremedlogo I just finished attending a mind blowing event called FutureMed, the medical arm if you like, of Singularity University, which was founded by Peter Diamandis and Ray Kurzweil. Director, curator and chair of the program is Daniel Kraft, who together with a dedicated team, brought in some of the smartest creators and thinkers in medicine and healthcare for the 5 day long program.

Ask yourself: what is the impact that exponential technologies will have on medicine and healthcare? What was your initial response? Whether you’re a scientist, physician, venture capitalist or biomed executive, the answers are profound because of the fast rate technology is developing, improving and having a direct impact on the “well-being” of our lives.

What’s unique about the event is not just the content, which is deep and thought provoking and brings in insights from the top in their fields, but the structure of the event itself. Imagine a combination of panels, lectures and field trips with demos, workshops and breakout sessions all under one roof with only 70 or so attendees.

In other words, the intimacy of the event creates an environment where not only do you have an opportunity to have your answers questioned (and challenged) directly, but you have quality time with the speakers and technology creators, so you can more effectively understand what lies ahead — and then act upon it. It also means that attendees are vetted, so not only is the speaker line-up phenomenal, but the attendees themselves have a host of honors, accolades and accomplishments, all of which result in an environment where the brightest minds can come together to learn, create and grow. A community is formed in which like-minds in medicine and healthcare can accomplish more together than they can alone in their respective fields. (Below is Peter Diamandis and Daniel Kraft in the first session of Day One).

Peter-Diamandis and Daniel-Kraft (2)

While clearly not everyone in healthcare thinks our system is broken and not everyone is looking for alternative means (and more effective means) for care and the way we diagnose and treat patients, those who do, have the hurdles of structure, regulations, linear thinking and legal implications to climb dare they try anything new outside defined parameters.

Challenging the status quo is never easy but if through a combination of persistence, trial and error and really smart, caring and passionate thinkers who want to make a difference, things can change, particularly as you begin to see validation after validation for your thinking (and actions) along the way. In other words, linear thinking “be gone.”

As CNET described the environment for participants, “For attendees, who range from executives in the medical field to practicing doctors to entrepreneurs looking for the next area to invest in, and who come from countries all over the world, FutureMed gives access to talks on topics as diverse as personalized medicine; the future of pharma; patient engagement; regenerative medicine; neuromedicine; synthetic biology; the future of medical education; global health and the hospital of the future; and more.”

Ray Kurzweil and XPrize founder Peter Diamandis kicked things off with the notion that advances in healthcare and medicine have migrated from linear growth to exponential growth. As recapped so well in the MedGadget summary which you’ll find me referencing a number of times because their coverage of the event was so extensive: “One fascinating insight from Ray’s talk was that these exponentially growing advances are often the combination of many different paradigms that grow and develop in a sigmoidal fashion. The exponential growth of computational power per dollar, for instance, is driven by say, vaccum tubes, which start slow, progress extremely rapidly, and then level off, only to be replaced by transistors, which did the same thing until integrated circuits came into the picture. Collectively, even though each of these technological paradigms hit a wall at some point, they were replaced by another advance that allowed the final outcome of computational power to continue to scale exponentially. In proof of this, Ray showed us what seemed to be an exponentially increasing number of charts that demonstrated exponential technological growth.”

Three-time astronaut Dan Barry and Gabor Forgacs addressed the future of 3D printing technologies and how they’ll have a significant impact on both consumer and medical products.  Gabor-Forgacs (5)

Another message we heard from many of the speakers, is how low the costs are going, from sensors that we wear and can self diagnose to the world of 3D printing, which using both plastics and metals, doesn’t cost more to use.

In addition to 3D printing, Dan Barry talked about one of his favorite topics: robots.

There’s no question; robots are getting smarter and smarter. Through sensors, robots are learning how to put objects in the right location and in the right spots within that location, i.e., product placement into a particular location on a particular shelf. “We want to move up the ladder even further,” says Barry. “We want robots to not just organize but to sense, throw and manipulate.”

Robot’s dexterity is improving and their movement is getting more and more fluid. A robot’s hands can correspond to a human’s movements.

Dan gave a useful example of the impact on a human body when they do a space walk. He says, “it takes 4 hours just to get the nitrogen out of our system, but you can do a space walk with a robot through virtual reality and get the job done a lot faster.”

He also brought up the social and ethical implications of people who may choose robots as their companions rather than human beings. In the future, robots will become true companions for people who are lonely, have lost their loved ones or generally just want companionship. Hmmm. Not sure about companionship (for me that is), but I definitely get the value of robots in eldercare and have already seen amazing advancements coming out of Willow Garage, where their PR2s are being trained to put dishes away, set the table and clean among other things.

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On the Data Driven Healthcare panel, Stanford University’s Dan Riskin talked about the convergence of devices. Says Riskin, “We’re able to take these platforms, such as an iPhone or a computer system, pull together valuable information and make it really useful. We’re seeing an innovation shift to mature platforms.”

As for devices and technology, medical intervention will become an app. In fact, it’s already starting to happen. Apps will be prescribed just like medication, i.e, welldoc shows a decrease in diabetics problems (a 4 fold benefit from an app than using medications alone).

We also heard about a perspective on the fundamental flaws of the RCT, which included things like the long term nature of it (often a decade to change care), the high expense (not affordable without support), the fact that it can be biased (selected based on drug and device firms) and lastly, that they’re poorly generalizable. It’s just not working and ineffective.

Other apps are able to extract words/language that a patient uses and put them into a matrix to show how these words relate to each other, i.e., fever, nausea, chest tightness. The power of analytics is helping the doctor make a diagnosis by structuring a record so that he/she has more data and beyond that, some actual “meaning” within that data.

An example that was given was a test they did with a small group of patients who got re-admitted into the hospital. They did an analysis and discovered what contributed to people being re-admitted to the hospital and more importantly, why. The results helped with quality improvement and flow of data.

A force behind eLegs is Iceland-born Eythor Bender from Berkeley Bionics. They augment humans with wearable, artifi­cially intelligent bionic devices called exoskeletons. Below is a young man demonstrating it to the FutureMed audience, showing how flexible and dynamic his world has become using their technology. Since visuals (and patient feedback) is most powerful, check out their YouTube channel for stories and use cases and their eLegs FAQ for the hows and whys. All I can say is: inspiring. There are no words for the rest.

BerkeleyBionics Eythor-Bender (4)

Below Tamara Mena talks about her dream of being able to accept her college diploma standing rather than in wheelchair.

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Healthtap founder Ron Gutman pushed the need to unite consumers and physicians in personal health – both the data and the conversation. In other words, get physicians into the game and allow them to particate in the conversation so they can access this data in real time and better help their patients. The two step approach involves creating an infrastructure, then getting the physicians to engage with the data so its always up to-date and therefore relevant. It’s essentially a database that combines data, conversations, and personalization around the patient so the physician can be more effective in their care and decisions.

Sutha Kamal talked about feedback loops, which was a constant theme throughout the program. If I (a patient), can access data in real time through a wearable sensor and make sense of that data, then I can help my doctor better understand what is happening with my health over time. Feedback loops provoke action. (also refer to the beginning of my TEDxSV post where Wired’s Chris Anderson talks about the same thing citing examples).

If you have no “meaning” from the data, then essentially you have a “broken” feedback loop. Data without meaning doesn’t move a patient to take the right action OR have the right conversations with their doctors and other experts. “When you get this data, that data should belong to you,” says Kamal. “We want to understand the things that you would adhere to but don’t today. Feedback is personal but meaning needs to be in that personal data so you, the patient, end up doing something with the data.”

Ultimately, if you think your body is a “black box,” aka poor health, you’re going to end up getting depressed because you don’t know where to start. In the future, a lot of this gathered data will end up on our phones because they’re with us all the time.

Roni Google’s Roni Zeiger says, “our cell phones will become our data lens for information about our bodies. You will also be able to access information in real time about the workflow of a hospital and the wait of the line in the emergency room. The patient is at the center of information flow and decision making.”

The patient has ALL of the data because they know how they feel better than anyone else does. The data transmitted from a patient’s body in the not too distant future, will be used to allow physicians to look at your veins and arteries remotely on a device. Ones and zeros will be flowing back (aka the patient’s data), with analysis so the physicians can make real-time diagnostics and decisions.

It’s happening now with sleep devices and soon it will be happening from a lot of different sources. He also gave examples of smart health realted search queries like “poison control,” which immediately returns the number for the US poison control center, and “suicide,” which displays the number for the US suicide prevention hotline.

Additionally, people are putting their data online, on Twitter, Patients Like Me and in other places and asking people to mine that data in a way that will be useful for their care givers and doctors. The distinction between data and conversations are becoming blurred, and eventually they’ll go away.

Lawrence Sherman added wit and humor to a talk on medical education – video clips of his talk can be found here and he tweets over at @meducate.

Carol mccall and esther dyson (3) Esther Dyson and health economist Carol McCall discussed behavior change and no surprise, feedback loops were raised again.

Gamification is a natural example, where incentives are given for a a particular behavior. Esther asked: “Where are the HR execs in this conversation?”

There’s an increasing trend in employer benefits where companies can start to engage with employees in innovative ways that has a positive impact on their health.

On reimbursement, McCall suggested that rather than see this as a barrier, think about creative ways to compensate. She noted that “there are ways for these things to pay for themselves.”

Google’s Astro Teller gave a fascinating talk about body monitoring. He asserts that body monitoring isn’t really about healthcare. “It misses the point,” he says. “That way of thinking derails us from understanding what body monitoring can actually become in the future. Fitness people tend to be quantitative nuts. If you drive at the group that makes the most sense, you miss all the other amazing opportunities.”

He talked about major obvious opportunities in this space, such as the “patch” which is very small and very cheap. Other trends around body monitoring in the future?

Astro-Teller (8)
Upselling new pieces of value to the same wearer by showing value and cost effectiveness. Passive monitoring will also be big, he says, because at the end of the day, people don’t like to “do” a lot for their health but they do want to be healthy. Passive monitoring allows us to have sensors on our bodies, but we don’t have to think about them. He’s spot on about that one.

Monitors can tell us how much time people spend on their computers, their heart beats, the “way” they use something, such as a mouse. By monitoring a “behavior” such as mouse movement, you can get an idea of visual motor quality which is often a result of sleep deprivation or early warnings of Parkinsons and Alzheimers disease.

With sensors, people often ask “what does it measure?” Teller says, “this is not the point. We want the guess/surrogate to be better than it makes the statement about and we want accuracy to be good enough that we can make a better analysis overall about your body.”

He also reminded us that while we’ve spent a lot of time sequencing the human genome, we haven’t spent much time sequencing the human lifestyle. Wearable body monitoring isn’t about being quantified, reinforcing his point by saying that “Mary Jo Jane” (aka the average person) doesn’t want to be quantified.

“Wearable body monitoring is about having the right parts of the world know who you are and in what you want and need in a million little ways, in real time, and all the time.”

At the end of the day, you want people/things/data to respond to what you need without you having to think about it. AND, there will literally be a million apps for that. (his prediction is 1 million+ apps by 2015).

Check out the CBS Interactive Smart Planet clip for a “short” on Dan Barry’s talk. And for incredibly in-depth coverage of the entire event, check out the summaries by MedGadget by the day.

Day One Summary: Ray Kurzweil, Gabor Forgacs, Eythor Bender and more.

Day Two Summary: Eric Schadt, Esther Dyson, Kaiser’s Innovation Center.

Day Three Summary: Robert Hariri, Mike West, Autodesk and more.

Day Four Summary: Andrew Hessel, Philip Low, Intuitive Surgical and more.

Day Five Summary: Erik Rasmussen, Andy Kogelnik, Brad Peterson and Goodbyes.

And let’s not forget David Bolinsky and team’s incredible animation.

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For a mind numbing experience, check out their site for a video that will take you through the human body in the most exciting way you could ever have imagined. (it’s a bit like being on a Back to Future ride). Below, a glimpse of the magic they have created for companies, healthcare institutions and hospitals.

Animation
Below is a shot from the FutureMed graduation at NASA AMES in Silicon Valley on the last night, a group shot taken during the week and one taken at an after party. And, here are some images I shot from the kick off party, which includes an overview of the program and the first day.

FutureMed Graduation and afterparty (12)

FutureMed group shot (6)
FutureMed Graduation and afterparty (94)

Disclosure: I provided some consulting to FutureMed.