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Esther Dyson and Daniel Kraft: Health care in 2013

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Thank you I have the pleasure of talking about the healthcare in 2013 2013 is going to be a a a big year for healthcare there's an enormous amount of exciting research both in mobile health and on personalized medicine and at the same time the affordable care act is continuing its torturous implementation whilst 2014 is the big year medic aid will be expanded when people will be required to get insurance and this continuing questioning of how you expand access to healthcare how you improve healthcare, how you lower costs is going to heat up in the next year that's even possible, given tenure of the debate in the past few years But, to discuss these issues we have Esther Dyson, the chairman of Adventure Holdings and an angel investor She also has trained as an astronaut and it turns out to go into space is much much easier than health reform So, please welcome Esther Good morning So, I'm going to talk and very briefly make predictions for three markets concerning health they are the markets for healthcare which you're familiar with the market for bad health which you're also familiar with, but maybe not into that name and then finally the market for health itself So, the healthcare market is what you think of drugs, Pharma insurance companies, doctors, hospitals In the US, we've now got "Health Reform" and things are changing, but that they're going to change slowly Incentives are slowly turning towards keeping people healthy rather than treating them when they're sick The drug companies are gonna continue to whine because they can't charge enough for their drugs and that's why they can't make new drugs The insurance companies are going to whine because they have to treat people that are sick as opposed to just the healthy ones they pick but they're going to figure out, to some extent, how to align their incentives with that the government is going to not pay if you have to re-admit somebody So, companies like Health Flood, in which I'm an investor, are helping institutions to change their processes to improve that kind of thing and... that will continue I think overall it's pretty good, but... don't expect any dramatic changes The market for bad health companies are beginning to understand that they need to promote healthy food So, they're going to put new additives into the same old bad food So, now you have, like, fruitbars with yogurt or, you have candy with fiber Watch out. More that. It's really really hard, because there's a huge market for bad food it includes not just the bad food itself, but advertising, everyone around you is eating stuff that is full of sugar and salt and it tastes really great that will continue as well the third market for good health we're seeing some exciting and dramatic changes based on two fundamental things that had been moving along for a while they're are coming together, and and you're gonna see announcements even over the next few days as well as in 2013 It's, first of all, the rise of user-generated data whether it's things like my Nike Fuel or my FitBit that let me count how many steps I've done all kinds of Ipad and Iphone apps that let you monitor your sleep your blood pressure the big Holy Grail, which may or may not get closer to be realized in 2013 is a non-invasive monitor for internal biomarkers like blood sugar and various other chemical components in your blood there's a big excitement now about the bacteria in your gut people are going to start collecting that stuff on themselves sharing and posting it, etc and so, the second half that's making this all happen is online networks. You heard about social media this is social health data it will be used in two ways, one People will encourage other people through gamification to engage in healthy behavior, avoid the products of the second market I metioned or at least eat them in moderation and then also we're gonna be generating a whole lot of data sets we can use for Phase IV clinical trials that will be open after drugs are released or maybe things that aren't cost-effective because nobody is excited about selling them The number of glasses of water you drink or sleeping more we're going to generate data that will allow us to quantify the effects of our behavior on our health Thank you, I think your last point is a very good segway for our next speaker: Daniel Kraft, who is the Executive Director of Future Med and thinks a lot about very fast developing technologies in medicine and healthcare, generally Please welcome Daniel So, it's a fast moving world and I think the World in 2013 needs to shift, my first slide, please from where it has been currently, so I recently was back at massachusetts general hospital, where I did my residency in the 90's and if you go to any hospital there or clinic it's often sort of as it's look for last hundred years sort of defined in old buckets, you know not that much has changed I think the opportunity in 2013 is to start unsealing healthcare getting out of the sort of buckets that we find ourselves in in terms of anatomy and allergies and start crowdsourcing and thinking differently and part of the big shift with Obama care, being honest is to take the incentives - for today, as physicians, we practice not evidence-based medicine ,but reimbursement-based medicine - shifting that curve to the left and technology is enabling us to watch our health in shift that curve to some degree and there's also pressure now to take healthcare at the hospital, at the ICU increasingly into our home and into our own bodies I will show you some examples on that A lot of that has been enabled through really really fast moving technologies we're sort of in an exponential age now and, what's interesting, you know you know Moore's law, but there is other disruptive fast moving technology not just computing and they're coming together helping a variety of folks reinvent healthcare in a variety of ways so, in genomics, we now dropped the price of sequencing human genome twice the rate or more, I think Esther was the third person in the planet to be sequenced this year, there's a few thousand in 2013 there will be tens of thousands of folks sequenced and we're gonna start to learn what to do with that data, as you put that together Huge opportunities and challenges. It's not just sequencing. It's your proteome... The fact that you can now drop something in the mail and get your gut biome sequenced and analyzed all that will come together and provide this new big data era Computation is getting faster... so, one prediction will be that we're gonna change all procedures such as the old angiogram and start essentially doing those quick CT scans, done in the cloud So, take for example, heart flow measured in a 30s CT scan setting up computers in the cloud you can analyze the core of a blood vessel and then personalize the therapy for that individual Do they need a stent or not? If so, what kind of stent? So, the convergence of cloud, big data and better imaging is gonna come together in powerful new ways, including how, for example, you might replace ultrasound with quick MRI's you can access on the flight from your mobile or laptop Obviously, the phone has been a dramatic change and it's evolution and has been quite impactful in healthcare in 2013 arises the iPAD era, but now just in the last few months, there is a 35 dollars Android tablet produced in India and this has huge implications for both health care and education we will start to give this away to our patients, and essentially, we're going to start to see new dashboards on our mobile phones or cheap pads I think that a practitioner would be prescribing apps in the next year, as physicians, and this has been mixed with gamification to keep people engaged we're seeing the digitization of data, not just through our regular phones, but increasingly, the liability to use them as smart platforms, so just last week, was this new iPhone case approved that enable you to do a real time ECG on my phone and send it to my cardiologist or it could be used for triage nurse, so that's an example you see here that's one example of something moving to the phone. It's not just, diagnostics, it's my Basis watch, which will come in next year that can measure my heart rate and my motion we have sensors everywhere and those are becoming a sort of point of care diagnostics and the idea of a check up wherever we might be telemedicine, the fact that you can visit your physician now on your smartphone is gonna evolve quickly in 2013 up to the point where we have devices in our body and who owns that data has becoming a challenge, as well finally, artificial intelligence is gonna become more common in healthcare because, we can't keep up, we need intelligence augmentation to understand, as clinicians, what's happening with our patients and to integrate all this new data to the point where we almost will have the "on start" for a body full of sensors everywhere we're starting to wear simple versions of those, and those are getting more complex just last year, there was a Tricorder X Prize announced and we have versions of tricorders today, a ten million dollar prize 200 teams entered that competition and the early prototype that won was just released I don't know if I can do a quick demo, but the fact that I can put this little tricorder device on my forehead and get streaming data to my smartphone, which you can sort of see here live temperature, heart rate, respiratory rate, pulse oxymetry speaking to my phone and eventually to my clinician will be very powerful and this will be selling, I think, by the end of 2013, that's the data you just saw last couple of examples will be connected health social media, social connectivity leveraging our behavior so, how we will look like if we stay health, I downloaded an app today if you go wrong direction, this is me if I gain 50 pounds, so I'm leveraged, right? augmented reality in 2013 is gonna start entering healthcare robotics are striving trying to move from severe disabled enabling paralyzed to walk to brain-computer interface to sort of help the truly disabed to move with robotics brain computer interfaces for less than a hundred dollars are emerging now that will allow us to control our environments, as well as, treat ADHD So, for example, there is an app where you can try to focus your attention and learn while you focus, so, no more ritalin for some kids Another prediction is that the stem cell world, and the Nobel Prize came out this year for the person who invented induced pluripotent stem cells is gonna merge with other technologies, like 3D printing which is moving very very quicly, it has been covered by The Economist we're starting the early age of printing organs, with the first few this last year we'll see more that, with more complex organs in the year ahead I teach at the Singularity University and chair the Medicine track there we are re-inventing other elements I think we're gonna see UAV used to delivery drugs and vaccines in the developing world. We're bringing new people in the healthcare who traditionally not been in healthcare. So, for example, fishermen. We're bringing folks together from different spheres and that's what is really powerful. There is no new programs, folks, like designers coming together to healthcare to think how to do things differently In 2013 we're gonna see design thinking more applicably just like in the world of aviation. And I've been a pilot and a flight surgeon for the last decade. We're taking lessons and applying them in healthcare. For example, I usually run a checklist in aviation and increasingly, they are being put into the operating room and beyond and those are now being amplified We're starting to see the application now of dashboard, so all this data I'm sorry, simulation. Just like your pilot in the airline. Simulation is becoming the norm in the medical schools. ??? WHATAHELL ??? Increasingly, changing how we do healthcare Heads-up displays, the data is now glassified just like the heads-up display we have we have for our fire pals we'll have that for our own healthcare kind of GPS coaches we want just the right amount of information not too much information. We'd be overwhelmed and one thing that's gonna impact that is the world of Google Glass Google Glass is gonna come out next year and we're gonna see that applied into healthcare in a variety of ways So, I can see my patients in different ways. I can, utilized heads-up display data. That's gonna be a particularly interesting tool in healthcare coming ahead. You try to loose weight and seeing your breakfast in a new form, as well. Last example would be the example of radar In this new world of sort of, hopefully, crowdsourced information-based science if we can see, for example, our cars, we drive our self-driving apps will enable us to crowdsource, for example, the map of Rome What if you can use healthcare data, un-silo it and understand where the roadbloacks are where the plessor ham, the best route to work That's the opportunity through big data and big analytics put together in smart ways For example, to know where the influenza is pouring it to your own personal app and saying what to do with that Leveraging your social network again to know who not to shake hands with, that day based on integration So, dashboards are coming to healthcare and we're gonna move using some of these new tools From an era that's episodic and reactive to one, which is continuous and proactive And that can make a huge difference Instead of practicing stage 3 and stage 4 medicine, we will pick things up earlier I think that's, for example, my world, oncology. We can start to be data-donors, not just organ donors We will enter this, we're starting to be the world of personalized oncology where every tumor is sequenced, for example And pooling all this things together, converging, fast new technologies I think will help us re-invent healthcare in 2013, because in many ways, the future is already here, just not evenly distributed So, thanks a lot

Video Details

Duration: 14 minutes and 28 seconds
Country: United States
Language: English
Producer: The Economist
Views: 67
Posted by: fabriciopamplona on Feb 27, 2013

Short talks of Esther Dyson and Daniel Kraft in The Economist Conference "World in 2013"

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