Medicine's future? There's an app for that | Daniel Kraft | TEDxMaastricht
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0:18 - 0:19Hi, there.
-
0:20 - 0:21A couple of years ago,
-
0:21 - 0:24when I was attending
the TED conference in Long Beach, -
0:24 - 0:26I met Harriet.
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0:26 - 0:29We'd actually met online before --
not the way you're thinking. -
0:31 - 0:34We were introduced
because we both knew Linda Avey, -
0:34 - 0:37one of the founders of the first
online personal genomic companies. -
0:37 - 0:40And because we shared
our genetic information with Linda, -
0:40 - 0:42she could see that Harriet and I shared
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0:43 - 0:47a very rare type of mitochondrial DNA,
haplotype K1a1b1a, -
0:47 - 0:49which meant we were distantly related.
-
0:49 - 0:52We actually share the same
genealogy with Ötzi the Iceman. -
0:52 - 0:53So -- Ötzi, Harriet and me.
-
0:53 - 0:57And being the current day, of course,
we started our own Facebook group. -
0:57 - 0:58You're all welcome to join.
-
0:59 - 1:02When I met Harriet in person
the next year at the TED conference, -
1:02 - 1:05she'd gone online and ordered
our own happy haplotype T-shirts. -
1:05 - 1:06(Laughter)
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1:06 - 1:08Why am I telling you this story?
-
1:08 - 1:10What does it have to do
with the future of health? -
1:10 - 1:12Well, the way I met Harriet is an example
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1:12 - 1:16of how leveraging cross-disciplinary,
exponentially growing technologies -
1:16 - 1:18is affecting our future
of health and wellness -- -
1:18 - 1:20from low-cost gene analysis
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1:20 - 1:22to the ability to do
powerful bioinformatics -
1:22 - 1:25to the connection of the Internet
and social networking. -
1:25 - 1:27What I'd like to talk about today
-
1:27 - 1:29is understanding
these exponential technologies. -
1:29 - 1:31We often think linearly.
-
1:31 - 1:33But if you think about it,
if you have a lily pad -
1:33 - 1:35and it just divided every single day --
-
1:35 - 1:39two, four, eight, sixteen --
in 15 days, you'd have 32,000. -
1:39 - 1:41What do you think you'd have in a month?
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1:41 - 1:42We're at a billion.
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1:42 - 1:44If we start to think exponentially,
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1:44 - 1:48we can see how this is starting to affect
all the technologies around us. -
1:48 - 1:51Many of these technologies,
speaking as a physician and innovator, -
1:51 - 1:54we can start to leverage,
to impact the future of our own health -
1:54 - 1:56and of health care,
-
1:56 - 1:59and to address many of the major
challenges in health care today, -
1:59 - 2:03ranging from the exponential costs
to the aging population, -
2:03 - 2:06the way we really don't use
information very well today, -
2:06 - 2:07the fragmentation of care
-
2:08 - 2:11and the often very difficult course
of adoption of innovation. -
2:12 - 2:15And one of the major things we can do
is move the curve to the left. -
2:15 - 2:18We spend most of our money
on the last 20 percent of life. -
2:18 - 2:21What if we could incentivize physicians
in the health care system -
2:21 - 2:22and our own selves
-
2:22 - 2:25to move the curve to the left
and improve our health, -
2:25 - 2:26leveraging technology as well?
-
2:26 - 2:29Now my favorite example
of exponential technology, -
2:29 - 2:30we all have in our pocket.
-
2:30 - 2:34If you think about it,
these are really dramatically improving. -
2:34 - 2:36I mean, this is the iPhone 4.
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2:36 - 2:39Imagine what the iPhone 8
will be able to do. -
2:39 - 2:41Now, I've gained some insight into this.
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2:41 - 2:43I've been the track share
for the medicine portion -
2:43 - 2:46of a new institution
called Singularity University, -
2:46 - 2:47based in Silicon Valley.
-
2:47 - 2:51We bring together each summer
about 100 very talented students -
2:51 - 2:53from around the world.
-
2:53 - 2:56And we look at these exponential
technologies from medicine, -
2:56 - 2:59biotech, artificial intelligence,
robotics, nanotechnology, space, -
2:59 - 3:01and address how we can cross-train
and leverage these -
3:01 - 3:03to impact major unmet goals.
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3:03 - 3:05We also have seven-day executive programs.
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3:05 - 3:07And coming up next month is FutureMed,
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3:07 - 3:10a program to help cross-train
and leverage technologies into medicine. -
3:10 - 3:12Now, I mentioned the phone.
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3:13 - 3:16These mobile phones have over 20,000
different mobile apps available. -
3:17 - 3:20There's one out of the UK
where you can pee on a little chip, -
3:20 - 3:22connect it to your iPhone,
-
3:22 - 3:23and check for an STD.
-
3:23 - 3:25I don't know if I'd try that,
but it's available. -
3:25 - 3:27There are other sorts of applications.
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3:27 - 3:29Merging your phone
and diagnostics, for example, -
3:29 - 3:31measuring your blood glucose
on your iPhone -
3:31 - 3:34and sending that to your physician,
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3:34 - 3:37so they can better understand
and you can better understand -
3:37 - 3:39your blood sugars as a diabetic.
-
3:40 - 3:43So let's see how exponential
technologies are taking health care. -
3:43 - 3:44Let's start with faster.
-
3:44 - 3:46It's no secret that computers,
through Moore's law, -
3:46 - 3:48are speeding up faster and faster.
-
3:48 - 3:50We can do more powerful things with them.
-
3:50 - 3:53They're really approaching --
in many cases, surpassing -- -
3:53 - 3:55the ability of the human mind.
-
3:55 - 3:59But where I think computational speed
is most applicable is in imaging. -
3:59 - 4:01The ability now to look
inside the body in real time -
4:01 - 4:03with very high resolution
-
4:03 - 4:04is really becoming incredible.
-
4:04 - 4:07And we're layering multiple
technologies -- PET scans, CT scans -
4:07 - 4:10and molecular diagnostics --
-
4:10 - 4:12to find and seek things
at different levels. -
4:13 - 4:16Here you're going to see the very highest
resolution MRI scan done today, -
4:16 - 4:20of Marc Hodosh, the curator of TEDMED.
-
4:20 - 4:22And now we can see inside of the brain
-
4:22 - 4:24at a resolution and ability
never before available, -
4:24 - 4:28and essentially learn how to reconstruct
and maybe even reengineer -
4:28 - 4:30or backwards engineer the brain,
-
4:30 - 4:33so we can better understand
pathology, disease and therapy. -
4:33 - 4:36We can look inside with real-time
fMRI in the brain at real time. -
4:36 - 4:40And by understanding these sorts
of processes and these connections, -
4:40 - 4:43we're going to understand the effects
of medication or meditation -
4:43 - 4:45and better personalize
and make effective, for example, -
4:46 - 4:47psychoactive drugs.
-
4:47 - 4:50The scanners for these are getting
smaller, less expensive -
4:50 - 4:51and more portable.
-
4:51 - 4:55And this sort of data explosion
available from these -
4:55 - 4:57is really almost becoming a challenge.
-
4:57 - 5:01The scan of today takes up
about 800 books, or 20 gigabytes. -
5:01 - 5:04The scan in a couple of years
will be one terabyte, or 800,000 books. -
5:04 - 5:06How do you leverage that information?
-
5:06 - 5:08Let's get personal.
-
5:08 - 5:11I won't ask who here's had a colonoscopy,
but if you're over age 50, -
5:11 - 5:13it's time for your screening colonoscopy.
-
5:13 - 5:15How'd you like to avoid
the pointy end of the stick? -
5:15 - 5:17Now there's essentially
virtual colonoscopy. -
5:20 - 5:21Compare those two pictures.
-
5:21 - 5:24As a radiologist, you can basically
fly through your patient's colon, -
5:24 - 5:27and augmenting that
with artificial intelligence, -
5:27 - 5:29potentially identify a lesion
that we might have missed, -
5:29 - 5:31but using AI on top of radiology,
-
5:31 - 5:33we can find lesions
that were missed before. -
5:33 - 5:35Maybe this will encourage
people to get colonoscopies -
5:35 - 5:37that wouldn't have otherwise.
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5:37 - 5:39This is an example of this paradigm shift.
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5:39 - 5:42We're moving to this integration
of biomedicine, information technology, -
5:42 - 5:46wireless and, I would say, mobile now --
this era of digital medicine. -
5:46 - 5:49Even my stethoscope is now digital,
and of course, there's an app for that. -
5:50 - 5:52We're moving, obviously,
to the era of the tricorder. -
5:52 - 5:55So the handheld ultrasound
is basically surpassing -
5:55 - 5:57and supplanting the stethoscope.
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5:57 - 6:01These are now at a price point
of what used to be 100,000 euros -
6:01 - 6:02or a couple hundred-thousand dollars.
-
6:02 - 6:04For about 5,000 dollars,
-
6:04 - 6:07I can have the power of a very powerful
diagnostic device in my hand. -
6:07 - 6:10Merging this now with the advent
of electronic medical records -- -
6:10 - 6:13in the US, we're still
less than 20 percent electronic; -
6:13 - 6:16here in the Netherlands,
I think it's more than 80 percent. -
6:16 - 6:19Now that we're switching
to merging medical data, -
6:19 - 6:20making it available electronically,
-
6:20 - 6:23we can crowd-source the information,
and as a physician, -
6:23 - 6:26I can access my patients' data
from wherever I am, -
6:27 - 6:29just through my mobile device.
-
6:29 - 6:32And now, of course, we're in the era
of the iPad, even the iPad 2. -
6:32 - 6:33Just last month,
-
6:33 - 6:36the first FDA-approved
application was approved -
6:36 - 6:39to allow radiologists to do actual
reading on these sorts of devices. -
6:40 - 6:42So certainly, the physicians
of today, including myself, -
6:42 - 6:44are completely reliable on these devices.
-
6:44 - 6:46And as you saw just about a month ago,
-
6:46 - 6:49Watson from IBM beat
the two champions in "Jeopardy." -
6:49 - 6:52So I want you to imagine
when, in a couple of years, -
6:52 - 6:54we've started to apply
this cloud-based information, -
6:54 - 6:58when we really have the AI physician
and leverage our brains to connectivity -
6:58 - 7:02to make decisions and diagnostics
at a level never done. -
7:04 - 7:08Already today, you don't need to go
to your physician in many cases. -
7:08 - 7:11Only in about 20 percent of visits
do you need to lay hands on the patient. -
7:11 - 7:13We're now in the era of virtual visits.
-
7:13 - 7:16From Skype-type visits
you can do with American Well, -
7:16 - 7:19to Cisco, that's developed a very complex
health presence system, -
7:19 - 7:22the ability to interact with
your health care provider is different. -
7:22 - 7:25And these are being augmented
even by our devices, again, today. -
7:25 - 7:28My friend Jessica sent me
a picture of her head laceration, -
7:28 - 7:30so I can save her a trip
to the emergency room, -
7:30 - 7:32and do diagnostics that way.
-
7:32 - 7:34Or maybe we can leverage
today's gaming technology, -
7:34 - 7:35like the Microsoft Kinect,
-
7:35 - 7:39hack that to enable diagnostics,
for example, in diagnosing stroke, -
7:39 - 7:42using simple motion detection,
using $100 devices. -
7:43 - 7:46We can actually now visit
our patients robotically. -
7:46 - 7:48This is the RP7;
-
7:50 - 7:53if I'm a hematologist,
I can visit another clinic or hospital. -
7:55 - 7:57These are being augmented
by a whole suite of tools -
7:57 - 7:58actually in the home now.
-
7:58 - 8:00We already have wireless scales.
-
8:00 - 8:03You step on the scale,
tweet your weight to your friends, -
8:03 - 8:04they can keep you in line.
-
8:04 - 8:06We have wireless blood pressure cuffs.
-
8:06 - 8:08A whole gamut of technologies
are being put together. -
8:08 - 8:11Instead of wearing kludgy devices,
we put on a simple patch. -
8:11 - 8:13This was developed at Stanford.
-
8:13 - 8:16It's called iRhythm; it completely
supplants the prior technology -
8:16 - 8:20at a much lower price point,
with much more effectivity. -
8:20 - 8:23We're also in the era today
of quantified self. -
8:23 - 8:26Consumers now can basically buy
$100 devices, like this little Fitbit. -
8:26 - 8:28I can measure my steps,
my caloric outtake. -
8:28 - 8:30I can get insight into that
on a daily basis -
8:31 - 8:33and share it with my friends or physician.
-
8:33 - 8:36There's watches that measure
your heart rate, Zeo sleep monitors, -
8:36 - 8:38a suite of tools
that enable you to leverage -
8:38 - 8:40and have insight into your own health.
-
8:40 - 8:42As we start to integrate this information,
-
8:42 - 8:45we'll know better what to do with it,
and have better insight -
8:45 - 8:47into our own pathologies,
health and wellness. -
8:47 - 8:50There's even mirrors
that can pick up your pulse rate. -
8:50 - 8:52And I would argue, in the future,
-
8:52 - 8:55we'll have wearable devices
in our clothes, monitoring us 24/7. -
8:55 - 8:58And just like the OnStar system
in cars, your red light might go on. -
8:58 - 9:01It won't say "check engine";
it'll be a "check your body" light, -
9:01 - 9:03and you'll go get it taken care of.
-
9:04 - 9:05Probably in a few years,
-
9:05 - 9:08you'll look in your mirror
and it'll be diagnosing you. -
9:08 - 9:09(Laughter)
-
9:09 - 9:11For those of you with kiddos at home,
-
9:12 - 9:14how would you like a wireless
diaper that supports your -- -
9:14 - 9:16(Laughter)
-
9:16 - 9:18More information, I think,
than you might need, -
9:18 - 9:19but it's going to be here.
-
9:20 - 9:23Now, we've heard a lot today
about technology and connection. -
9:23 - 9:25And I think some of these technologies
-
9:25 - 9:28will enable us to be more connected
with our patients, to take more time -
9:28 - 9:31and do the important
human-touch elements of medicine, -
9:31 - 9:33as augmented by these technologies.
-
9:34 - 9:36Now, we've talked about
augmenting the patient. -
9:36 - 9:38How about augmenting the physician?
-
9:38 - 9:41We're now in the era
of super-enabling the surgeon, -
9:41 - 9:44who can now go into the body and do
robotic surgery, which is here today, -
9:44 - 9:48at a level that was not really possible
even five years ago. -
9:48 - 9:51And now this is being augmented
with further layers of technology, -
9:51 - 9:52like augmented reality.
-
9:52 - 9:55So the surgeon can see
inside the patient, through their lens, -
9:55 - 9:57where the tumor is,
where the blood vessels are. -
9:57 - 9:59This can be integrated
with decision support. -
9:59 - 10:03A surgeon in New York can help
a surgeon in Amsterdam, for example. -
10:03 - 10:06And we're entering an era
of truly scarless surgery called NOTES, -
10:06 - 10:09where the robotic endoscope
can come out the stomach -
10:09 - 10:11and pull out that gallbladder,
-
10:11 - 10:13all in a scarless way and robotically.
-
10:13 - 10:16This is called NOTES, and it's coming --
basically scarless surgery, -
10:16 - 10:18as mediated by robotic surgery.
-
10:19 - 10:21Now, how about controlling other elements?
-
10:21 - 10:24For those who have
disabilities -- the paraplegic, -
10:24 - 10:27there's the brain-computer
interface, or BCI, -
10:27 - 10:29where chips have been put
on the motor cortex -
10:29 - 10:31of completely quadriplegic patients,
-
10:33 - 10:36and they can control
a cursor or a wheelchair -
10:36 - 10:37or, potentially, a robotic arm.
-
10:37 - 10:39These devices are getting smaller
-
10:39 - 10:41and going into more and more
of these patients. -
10:41 - 10:43Still in clinical trials,
-
10:43 - 10:45but imagine when we can connect
these, for example, -
10:45 - 10:47to the amazing bionic limb,
-
10:47 - 10:49such as the DEKA Arm,
built by Dean Kamen and colleagues, -
10:49 - 10:51which has 17 degrees
of motion and freedom, -
10:51 - 10:54and can allow the person who's lost a limb
-
10:54 - 10:58to have much higher dexterity or control
than they've had in the past. -
10:58 - 11:02So we're really entering the era
of wearable robotics, actually. -
11:02 - 11:04If you haven't lost a limb
but had a stroke, -
11:04 - 11:06you can wear these augmented limbs.
-
11:06 - 11:09Or if you're a paraplegic -- I've visited
the folks at Berkeley Bionics -- -
11:09 - 11:11they've developed eLEGS.
-
11:11 - 11:12I took this video last week.
-
11:12 - 11:16Here's a paraplegic patient, walking
by strapping on these exoskeletons. -
11:16 - 11:18He's otherwise completely
wheelchair-bound. -
11:18 - 11:20This is the early era
of wearable robotics. -
11:20 - 11:22And by leveraging
these sorts of technologies, -
11:22 - 11:25we're going to change
the definition of disability -
11:25 - 11:27to, in some cases, be superability,
or super-enabling. -
11:27 - 11:30This is Aimee Mullins, who lost
her lower limbs as a young child, -
11:30 - 11:33and Hugh Herr, who's a professor at MIT,
-
11:33 - 11:35who lost his limbs in a climbing accident.
-
11:35 - 11:38And now both of them can climb better,
move faster, swim differently -
11:39 - 11:42with their prosthetics
than us normal-abled persons. -
11:42 - 11:44How about other exponentials?
-
11:44 - 11:46We've heard a bit today
about obesity. -
11:46 - 11:49Clearly the obesity trend is exponentially
going in the wrong direction, -
11:49 - 11:50including with huge costs.
-
11:50 - 11:54But the trend in medicine
is to get exponentially smaller. -
11:54 - 11:57A few examples: we're now in the era
of "Fantastic Voyage," the iPill. -
11:57 - 12:00You can swallow this
completely integrated device. -
12:00 - 12:02It can take pictures of your GI system,
-
12:02 - 12:04help diagnose and treat
as it moves through your GI tract. -
12:04 - 12:06We get into even smaller micro-robots
-
12:06 - 12:09that will eventually, autonomously,
move through your system, -
12:09 - 12:12and be able to do things surgeons can't do
-
12:12 - 12:14in a much less invasive manner.
-
12:15 - 12:17Sometimes these might
self-assemble in your GI system, -
12:17 - 12:20and be augmented in that reality.
-
12:20 - 12:22On the cardiac side,
pacemakers are getting smaller -
12:22 - 12:24and much easier to place,
-
12:24 - 12:27so no need to train an interventional
cardiologist to place them. -
12:27 - 12:30And they'll be wirelessly telemetered
to your mobile devices, -
12:30 - 12:32so you can go places
and be monitored remotely. -
12:33 - 12:35These are shrinking even further.
-
12:35 - 12:39This one is in prototyping
by Medtronic; it's smaller than a penny. -
12:40 - 12:43Artificial retinas, the ability to put
arrays on the back of the eyeball -
12:43 - 12:44and allow the blind to see --
-
12:44 - 12:47also in early trials,
but moving into the future. -
12:47 - 12:49These are going to be game-changing.
-
12:49 - 12:50Or for those of us who are sighted,
-
12:51 - 12:53how about having
the assisted-living contact lens? -
12:53 - 12:57Bluetooth, Wi-Fi available --
beams back images to your eye. -
12:58 - 12:59(Laughter)
-
12:59 - 13:01Now, if you have trouble
maintaining your diet, -
13:01 - 13:03it might help to have some extra imagery
-
13:03 - 13:07to remind you how many calories
are going to be coming at you. -
13:08 - 13:11How about enabling the pathologist
to use their cell phone -
13:11 - 13:13to see at a microscopic level
-
13:13 - 13:16and to lumber that data back to the cloud
and make better diagnostics? -
13:16 - 13:19In fact, the whole era
of laboratory medicine -
13:19 - 13:20is completely changing.
-
13:20 - 13:22We can now leverage microfluidics,
-
13:22 - 13:24like this chip made
by Steve Quake at Stanford. -
13:24 - 13:27Microfluidics can replace
an entire lab of technicians; -
13:29 - 13:32put it on a chip, enable thousands
of tests at the point of care, -
13:32 - 13:33anywhere in the world.
-
13:33 - 13:37This will really leverage technology
to the rural and the underserved -
13:37 - 13:40and enable what used to be thousand-dollar
tests to be done for pennies, -
13:40 - 13:42and at the point of care.
-
13:42 - 13:45If we go down the small
pathway a little bit further, -
13:45 - 13:46we're entering the era of nanomedicine,
-
13:46 - 13:48the ability to make devices super-small,
-
13:48 - 13:51to the point where we can
design red blood cells -
13:51 - 13:54or microrobots that monitor
our blood system or immune system, -
13:54 - 13:57or even those that might clear out
the clots from our arteries. -
13:57 - 13:59Now how about exponentially cheaper?
-
13:59 - 14:02Not something we usually think
about in the era of medicine, -
14:02 - 14:07but hard disks used to be 3,400 dollars
for 10 megabytes -- exponentially cheaper. -
14:08 - 14:10In genomics now, the genome
cost about a billion dollars -
14:10 - 14:12about 10 years ago,
when the first one came out. -
14:12 - 14:16We're now approaching essentially
a $1,000 genome, probably next year. -
14:16 - 14:17And in two years, a $100 genome.
-
14:17 - 14:20What will we do with $100 genomes?
-
14:20 - 14:22Soon we'll have millions
of these tests available. -
14:22 - 14:26Then it gets interesting, when we start
to crowd-source that information, -
14:26 - 14:28and enter the era
of true personalized medicine: -
14:28 - 14:30the right drug for the right person
at the right time, -
14:31 - 14:34instead of what we're doing now,
which is the same drug for everybody, -
14:34 - 14:37blockbuster drug medications,
which don't work for the individual. -
14:37 - 14:40Many different companies are working
on leveraging these approaches. -
14:40 - 14:43I'll show you a simple example,
from 23andMe again. -
14:43 - 14:45My data indicates
I've got about average risk -
14:45 - 14:47for developing macular degeneration,
a kind of blindness. -
14:47 - 14:50But if I take that same data,
upload it to deCODEme, -
14:50 - 14:55I can look at my risk for type 2 diabetes;
I'm at almost twice the risk. -
14:55 - 14:58I might want to watch how much dessert
I have at lunch, for example. -
14:58 - 14:59It might change my behavior.
-
14:59 - 15:01Leveraging my knowledge
of my pharmacogenomics: -
15:01 - 15:05how my genes modulate,
what my drugs do and what doses I need -
15:05 - 15:07will become increasingly important,
-
15:07 - 15:09and once in the hands
of individuals and patients, -
15:09 - 15:11will make better drug dosing
and selection available. -
15:11 - 15:14So again, it's not just genes,
it's multiple details -- -
15:14 - 15:18our habits, our environmental exposures.
-
15:18 - 15:21When was the last time your doctor
asked where you've lived? -
15:21 - 15:23Geomedicine: where you live,
what you've been exposed to, -
15:23 - 15:25can dramatically affect your health.
-
15:25 - 15:27We can capture that information.
-
15:27 - 15:29Genomics, proteomics, the environment --
-
15:29 - 15:31all this data streaming at us
individually and as physicians: -
15:31 - 15:33How do we manage it?
-
15:33 - 15:36We're now entering the era
of systems medicine, systems biology, -
15:36 - 15:38where we can start to integrate
all this information. -
15:38 - 15:41And by looking at the patterns,
for example, in our blood, -
15:41 - 15:43of 10,000 biomarkers in a single test,
-
15:43 - 15:46we can look at patterns and detect disease
at a much earlier stage. -
15:47 - 15:51This is called by Lee Hood,
the father of the field, P4 Medicine. -
15:51 - 15:53We'll be predictive and know
what you're likely to have. -
15:53 - 15:56We can be preventative;
that prevention can be personalized. -
15:56 - 15:59More importantly,
it'll be increasingly participatory. -
15:59 - 16:00Through websites like PatientsLikeMe
-
16:00 - 16:05or managing your data on Microsoft
HealthVault or Google Health, -
16:05 - 16:07leveraging this together
in participatory ways -
16:07 - 16:08will be increasingly important.
-
16:08 - 16:10I'll finish up with exponentially better.
-
16:10 - 16:13We'd like to get therapies
better and more effective. -
16:13 - 16:16Today we treat high blood pressure
mostly with pills. -
16:16 - 16:17What if we take a new device,
-
16:17 - 16:21knock out the nerve vessels
that help mediate blood pressure, -
16:21 - 16:24and in a single therapy,
basically cure hypertension? -
16:24 - 16:26This is a new device
doing essentially that. -
16:26 - 16:28It should be on the market
in a year or two. -
16:28 - 16:30How about more targeted
therapies for cancer? -
16:30 - 16:33I'm an oncologist and know that most
of what we give is essentially poison. -
16:33 - 16:37We learned at Stanford and other places
that we can discover cancer stem cells, -
16:37 - 16:41the ones that seem to be really
responsible for disease relapse. -
16:41 - 16:43So if you think of cancer as a weed,
-
16:43 - 16:46we often can whack the weed away
and it seems to shrink, -
16:46 - 16:48but it often comes back.
-
16:48 - 16:49So we're attacking the wrong target.
-
16:49 - 16:51The cancer stem cells remain,
-
16:51 - 16:53and the tumor can return
months or years later. -
16:53 - 16:56We're now learning to identify
the cancer stem cells -
16:56 - 16:59and identify those as targets
and go for the long-term cure. -
16:59 - 17:01We're entering the era
of personalized oncology, -
17:01 - 17:03the ability to leverage
all of this data together, -
17:03 - 17:05analyze the tumor
-
17:05 - 17:08and come up with a real, specific cocktail
for the individual patient. -
17:08 - 17:10I'll close with regenerative medicine.
-
17:10 - 17:12I've studied a lot about stem cells.
-
17:12 - 17:14Embryonic stem cells
are particularly powerful. -
17:14 - 17:16We have adult stem cells
throughout our body; -
17:16 - 17:18we use those in bone marrow
transplantation. -
17:19 - 17:24Geron, last year, started the first trial
using human embryonic stem cells -
17:24 - 17:25to treat spinal cord injuries.
-
17:25 - 17:27Still a phase I trial, but evolving.
-
17:27 - 17:31We've been using adult stem cells
in clinical trials for about 15 years -
17:31 - 17:35to approach a whole range of topics,
particularly cardiovascular disease. -
17:35 - 17:38If we take our own bone marrow cells
and treat a patient with a heart attack, -
17:38 - 17:41we can see much improved
heart function and better survival -
17:41 - 17:44using our own bone marrow derived cells
after a heart attack. -
17:45 - 17:46As mentioned earlier,
-
17:46 - 17:48I invented a device
called the MarrowMiner, -
17:48 - 17:50a much less invasive way
for harvesting bone marrow. -
17:50 - 17:54It's now been FDA approved;
hopefully on the market in the next year. -
17:54 - 17:55Hopefully you can appreciate the device
-
17:56 - 17:59going through the patient's body removing
bone marrow, not with 200 punctures, -
17:59 - 18:02but with a single puncture,
under local anesthesia. -
18:02 - 18:03Where is stem-cell therapy going?
-
18:03 - 18:04If you think about it,
-
18:05 - 18:09every cell in your body has the same DNA
you had when you were an embryo. -
18:09 - 18:11We can now reprogram your skin cells
-
18:11 - 18:14to actually act like a pluripotent
embryonic stem cell -
18:14 - 18:17and utilize those, potentially, to treat
multiple organs in the same patient, -
18:17 - 18:19making personalized stem cell lines.
-
18:19 - 18:22I think there'll be a new era
of your own stem cell banking -
18:22 - 18:25to have in the freezer your own cardiac
cells, myocytes and neural cells -
18:25 - 18:28to use them in the future,
should you need them. -
18:28 - 18:31We're integrating this now
with a whole era of cellular engineering, -
18:31 - 18:35and integrating exponential technologies
for essentially 3D organ printing, -
18:35 - 18:36replacing the ink with cells,
-
18:36 - 18:39and essentially building
and reconstructing a 3D organ. -
18:39 - 18:41That's where things are heading.
-
18:41 - 18:42Still very early days,
-
18:42 - 18:45but I think, as integration
of exponential technologies, -
18:45 - 18:46this is the example.
-
18:46 - 18:49So in closing, as you think
about technology trends -
18:49 - 18:51and how to impact health and medicine,
-
18:51 - 18:53we're entering an era of miniaturization,
-
18:53 - 18:55decentralization and personalization.
-
18:55 - 18:57And by pulling these things together -
-
18:57 - 18:59we heard at the beginning
of this event about the why - -
18:59 - 19:02if we start to think about
how to understand and leverage them, -
19:02 - 19:06we're going to empower the patient,
enable the doctor, enhance wellness -
19:06 - 19:08and begin to cure the well
before they get sick. -
19:08 - 19:12Because I know as a doctor, if someone
comes to me with stage I disease, -
19:12 - 19:14I'm thrilled; we can often cure them.
-
19:14 - 19:15But often it's too late,
-
19:15 - 19:17and it's stage III or IV
cancer, for example. -
19:17 - 19:19So by leveraging
these technologies together, -
19:19 - 19:22I think we'll enter a new era
that I like to call stage 0 medicine. -
19:22 - 19:26And as a cancer doctor,
I'm looking forward to being out of a job. -
19:26 - 19:27Thanks very much.
-
19:27 - 19:29(Applause)
-
19:29 - 19:31Host: Thank you. Thank you.
-
19:31 - 19:32(Applause)
-
19:32 - 19:34Take a bow, take a bow.
-
19:35 - 19:37Daniel Kraft, ladies and gentleman.
- Title:
- Medicine's future? There's an app for that | Daniel Kraft | TEDxMaastricht
- Description:
-
Daniel Kraft offers a fast-paced look at the next few years of innovations in medicine, powered by new tools, tests and apps that bring diagnostic information right to the patient's bedside.
This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDxTalks
- Duration:
- 19:53
TED Translators admin edited English subtitles for TEDxMaastricht - Daniel Kraft - "What's next in healthcare?" | ||
TED Translators admin edited English subtitles for TEDxMaastricht - Daniel Kraft - "What's next in healthcare?" |