We’re here at Singularity University’s FutureMed after a dense day of exploring mind-melding medical advances. During conferences like this it’s difficult to pick and choose what we write about. So, in a similar process to how we cover TEDMED, we’ll be posting candid, informal end-of-day recaps of FutureMed to give you a high level look at the goings-on and then we’ll follow suite with individual posts on the technologies and advances we found to be most fascinating. So, stay tuned over the coming days!
Let’s start with the basics – The Singularity University (SU) mission is to explore the exponential growth in technological advances of the sort related to the hypothetical technological singularity, a point in time where progress is so rapid that the future is increasingly difficult to predict. Founded by Peter Diamandis and Ray Kurzweil, Singularity University lives and breathes exponential technologies. FutureMed, chaired by Daniel Kraft, is the executive education program exploring how these advances are changing and will continue to change medicine and benefit human health. The 5 day conference consists of lectures, field trips, work shops, and more.
Given SU’s mission, the day naturally started with a talk by the luminary of exponential change, Ray Kurzweil, who opened by noting that the evolution of health care advances have moved from linear growth into exponential growth as medicine has become increasingly an information technology. FutureMed beamed Ray in from Boston using an eerie, but spectacular, teleprompter in which Ray seemed to be floating in space in front of us all, giving everyone the feeling that this icon of the future was in fact coaching us from the future himself.
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.
Neil Jacobstein, the president of Singularity University, got on stage to talk about artificial intelligence and its implications in medicine. In the world of health care, he asked us to think of artificial intelligence as an innovation amplifier, in that it might be used to help design new drugs, help physicians form better hypotheses, and simulate the effect of therapy before it’s administered. He noted that right now we’ve got AI systems that are narrowly focused, like chess-playing or jeopardy-playing computers, but in time these will lead to increasingly broad AI. The world of medicine will benefit as this happens.
Ralph Merkle was up next to discuss nanomedicine and how manufacturing principles of larger systems are, and will move more rapidly into the atomic realm. Currently, the tools we have to manipulate atoms are only in 2D, like the famous IBM printing of xenon atoms on nickel, but will soon move to 3D. Once that happens, we’ll be able to build molecular tools such as bearings and universal joints that will allow nanotechnology to develop into something far more functional and medically useful than what we’ve seen so far. He asked us to think about some devices that might be potentially useful, one being a “respirocyte,” a nano oxygen tank of sorts that holds 10x the oxygen carrying capacity of red blood cells and deploys the gas as needed. He imagined a world where a therapeutic injection of these tiny “machines” might allow someone to hold their breath for an hour.
After Ralph, Brad Templeton, a key member of Google’s self-driving car project got on stage to tell us about the history of self driving cars and give us some insight into how Google’s car works and what this change might mean for both the safety and efficiency of transportation. Human drivers kill 34,000 people per year in the USA alone, and worldwide there are 1.2 million deaths annually from automobiles. Self-driving cars are clearly coming to consumers in the not so distant future, and our concept of transportation will change tremendously. Imagine, for instance, that city streets might seamlessly adapt to traffic needs by changing the direction of one-way streets, manipulating stoplights, etc.
The next set of talks by Dan Barry and Gabor Forgacs focused on 3D printing technologies and how they’ll change both consumer and medical products. Dan, a former astronaut, has been actively exploring how these technologies will change our future. In a world where 3D printing (using both plastics and metals) are the standard for manufacturing, increasingly, the complexity of these objects will actually not cost any additional money. Not only that, customization for the consumer and patient will be considerably easier and common. A dentist office, for instance, might be able to print replacement teeth on site. Or an orthopedic surgeon might be able to print a replacement bone that will fit perfectly into the patient. Dan passed around some incredibly complicated objects that would be nearly impossible to make through other manufacturing methods, yet were crafted with ease using 3D printers.
Gabor Forgacs, researcher and founder of Organovo, discussed how these 3D printing techniques are being applied to organs. In Gabor’s viewpoint, the world of scaffold-based tissue engineering is transitioning into both decellularized (where you use natural ECM structures) and scaffold-free (where you print tissue and let it organize) tissue engineering. He showed some absolutely remarkable research where his team printed a neural graft, severed the sciatic nerve of a mouse, and then installed the graft only to find that the mouse was able to move its hind legs again in 17 days. At the close of his talk, Gabor pointed out that printed organs are not likely to have the same shape and look of our current organs, only similar function. It’s not realistic or sensible, he says, to print a kidney that resembles anything close to a natural kidney. However, masses of tissue that function as kidneys do could potentially be engineered using his techniques.
Next up, Eythor Bender from Berkeley Bionics gave a talk about his company’s eLegs, which allow patients with spinal cord injuries to stand-up straight and walk again. The technology, demonstrated live on stage by Ted, a patient who works closely with Eythor and team, is a moving example of how robotics can affect the lives of patients.
Berekely Bionics has a audacious and remarkable goal to supplement (and in some cases replace) the wheelchair for paralyzed individuals.
eLegs work without an innervation into the patient’s nervous system, but rather automatically (based on pressure from two crutches the patient holds) move the extremities in a walking pattern that allows patients to take steps. Their first customers will be rehabilitation centers, but the company is pushing hard to bring the price down to a point where it will be attractive and optimally reimbursable for patients to use on their own.
After Eythor, we had a string of talks on web-enabled health including Thomas Goetz from Wired Magazine, Michael Gillam from Microsoft, and Roni Zeiger from Google.
If you read our TEDMED coverage, you may remember Thomas’s effort as part of Wired Magazine to re-design the lab report and make it relevant and actionable for patients. The work was exceptional and folks at TEDMED were left wondering if / when big laboratories like LabCorp and Quest Diagnostics would make this move. Yesterday we learned the great news that Thomas has started a company called 1+1 Labs to bring these reports to patients. Bravo.
After Thomas, we heard from both Michael Gillam, and then Roni Zeiger, who talked about some of the advances they’re seeing and pushing from their posts at Microsoft and Google, respectively. Michael spoke about the historically large lag between scientific discovery and translation to clinical practice, and how that has changed and improved over time, as well as how advances might be brought to patients in the future. He pointed out that there’s an emergence of consumerized medical tools and software that directly serve as an intermediary to patients and their doctors. He also noted that there are currently already 85+ devices that are sold to consumers that can connect to health records.
Roni talked about some of Google’s more recent efforts in health outside the PHR space, ranging from the simple but powerful introduction of smarter 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. He also demonstrated Google’s Body Browser, an interactive anatomy tool that lets laymen and experts alike explore the inner workings of the human body.
Next we heard from Health IT gurus Christopher Longhurst, who rolled out the EMR at the Lucile Packard Children’s Hospital, and Daniel Riskin from Vanguard Medical Technologies. Both described the power of implementing health IT smartly and some of the trends and technologies ahead.
Two pieces of information stood out most from Christopher’s talk. One was that Lucile Packard Children’s Hospital was one of the first to publish direct evidence of the reduction of all-hospital mortality after implementation of an EMR. The other was how insanely expensive it is to implement EMRs in an in-patient setting, and how he hopes and believes that these systems will become less expensive and more like commodities in the near future.
Daniel described how the most powerful analytics in health care will come from fully structuring a patient’s record. To this aim he spoke about and demonstrated an application called DocTalk that uses speech recognition to automatically translate a doctor’s dictation into structured clinical data. This allows physicians to avoid the painful process of categorizing and organizing every piece of information on patients by him- or herself.
The next section of the conference were rapid fire talks by four up and coming health startups: HealthTap, Massive Health, Basis, and Zipongo. All are working on ways to change behavior and improve health through the smart use of personalized data, feedback loops, and technology. Basis in particular stood out with their soon to be shipped ultra-watch that measures your heart rate, calorie burn, galvanic skin response, and movement. It’s a beautiful device that’s a technological marvel as well. We can’t wait to get our hands on one!
To further the discussion of wearable sensors, Astro Teller, who founded Body Media, took to the stage and spoke about his efforts building both the technology behind Body Media’s sensor and the company to sell it. His candid talk highlighted the challenges such devices have in being relevant, comfortable, and desirable enough to become routine in patients’ lives. He also noted the difficulties in getting health care insurer support for such devices, and the need to focus on “decoding the human lifestyle” to figure out the best ways to motivate people to adopt healthy behaviors.
After dinner, Lawrence Sherman spoke about the future of medical education, including the ludicrously poor state of Continuing Medical Education (CME). He noted that in the current system an obstetrician can get CME credits for learning about urology and that around 50% of CME offerings are paid for by the pharmaceutical industry. He advocates not only reformed CME, but reformed primary medical education in which budding doctors are exposed to patients from the very beginning of medical school, and alternative learning modalities are used to make medical education more engaging and efficient.
FutureMed day one wrapped up with an un-conference in which participants taught each other about things of their choosing.
Wow, it was a long but rich day! Today we start with a half day of personalized medicine and then a field trip over to Kaiser’s Garfield Innovation Center.