We’re back for our first full day of Exponential Medicine that’s sure to be packed with insightful discussions and eye-opening innovations. The first session of the day, ‘Digital, Mobile, and Connected Health’, was moderated by NPR’s Andrea Kissack, host of Quest. Andrea motivated the session by highlighting areas she thinks are ripe for disruption in the mobile health space including keeping individuals using their wearables after the initial hype wears off, getting information to caregivers and into medical records, and validating the reliability and privacy of medical data recorded on the go.
Andrea introduced Dr. John Mattison, CMIO at Kaiser Permanente who we saw last year at FutureMed. John began his talk with a survey of attendees to understand how we use wearables and clarify our awareness level about big data. The questions elicited the idea that individuals need more mindfulness when it comes to getting the full value out of wearable technologies. To achieve this mindfulness, John believes solutions should be organized based on tiers of pervasive sensing applications including athletic, acute illness, chronic illness, and wellness restoration. John also spoke to the need for solutions that improve conversations between patients and their professional care team, their personal care team, and their daily caregiver.
Dr. Alan Greene, Chief Medical Scientist at Scanadu followed with the claim that much of our healthcare system does not speak a common jargon that allows everyone to understand what is actually going on. The ability for the average individual to make that connection to their health is important, he continued, since the trend where big, expensive, valuable things eventually move into our homes (think clock towers to wrist watches) is taking place in healthcare. Alan made the bold predictions that we are at the end of the office visit as the center of primary care and we are at the end of keeping the responsibility for diagnosis with the clinician. He believes the future of primary care will be continuous,contextual, comprehensive, collaborative, closed looped, crowdsourced, and calculable.
Dr. Alan Greene segued to Sam de Brouwer, Co-Founder of Scanadu, who gave a live demo of the Scanadu Scout with a real-time heart rate and urinalysis examination. The Scanadu Scout was demoed live for the first time just last month at WSJD Live. There has yet to be an independent review of this device, though it’s been years that we’ve been hearing about it at multiple conferences and from dozens of media outlets.
Dr. Jeff Olgin, Co-Director of the UCSF Heart and Vascular Center and Chief of Cardiology, closed the session with his work on the Health eHeart Study. Like Dr. Esserman from Day 1, Jeff’s believes the old model for clinical studies is unsustainable. The Health eHeart Study attracts patients using connected medical devices like the AliveCor Heart Monitor to remotely capture cardiology data. The goal is to use big data to create cohorts, identify trends, and ultimately solve some of the biggest challenges in heart health.
After a quick break in the Innovation Lab, session four provided a series of talks on ‘Data-Driven Health, Artificial Intelligence (AI), and Analytics’. Dr. Utibe Effiong, an expert in environmental health and infectious disease epidemiology who worked in Nigeria for six years, spoke about the challenges of ebola and other epidemics. Since diseases do not respect international barriers, Utibe argues that accountable governments that should take the responsibility of proactively addressing these impending medical concerns through the infrastructure they create and the research they fund. Due to the nature of these diseases, reasonable quarantine procedures that also respect human rights are the right place to start.
Onto the next topic, Neil Jacobstein, Co-Chairman of the AI and Robotics Track at SU, discussed the growing value of AI in medicine. Artificial intelligence allows us to do things humans cannot do, like considering an entire genomic profile before making a diagnosis and keeping up on medical literature. Since the human brain hasn’t had a major upgrade in over 50,000 years, AI provides an outlet for augmentation and advancement.
Another familiar face, Dr. Marty Kohn, former Chief Medical Scientist of Care Delivery Systems at IBM Research, took the stage to speak about the role of big data in medical decision making. Touching on one of the current hot-button issues in healthcare, Marty believes the concept of 30-day readmissions is artificial and temporary. Instead of readmissions, big data allows opportunities to focus on all admissions. When it comes to intersection of big data and clinical decision support, Marty, presented the 5 P framework composed of personalized healthcare, prevention, prediction, patterns, and persistence.
The final speaker of the session was Dr. Issac Kokane, Co-Director of the Center for Biomedical Informatics at HMS. Issac’s central message was that we are not utilizing existing data to the fullest and as a result are missing the big picture in biomedical research and medicine. Issac expanded on this point with a couple poignant examples. First, within the last ten years, the frequency of heart attacks increased quite suddenly and lasted for multiple years. Clinicians discovered that a new drug which had been implemented right at the beginning of the increasing trend caused cardiotoxicity. When the drug was removed from the treatment regimen, the number of heart attacks returned to the historical baseline. This was all discovered and addressed retroactively because no one was paying attention to the data. A second experiment looked at the ICD-9 codes recorded for individual patients. An examination of those codes revealed that some patients were receiving treatment for injuries that closely resembled domestic abuse. This analysis was conducted two years after the data had been collected. When investigated, it was revealed that those patients had indeed been the victims of domestic abuse that went unreported until well after the patients had presented at the clinic. Again, the data existed and intervention could have been provided, but no one was looking. Issac believes these opportunities and more can be achieved with an information commons designed with the patient as the common coordinate system.
Stepping in to provide a brief respite, Andy Puddicombe, Founder of Headspace and a former Tibetan monk, walked the audience through a 10 minute meditation session.
Before breaking for lunch, Dr. Peter Diamandis returned to the stage with Nokia CTO Henry Tirri to announce the winners of the Nokia Sensing XCHALLENGE 2 winners. See our announcement about the competition winners for more details.
Following lunch, attendees had the opportunity to participate in one of sixteen different workshops touching on topics including ebola prevention, robotics, and Quantified Self as well as longer discussions and demos with Scanadu and the Nokia Sensing XCHALLENGE winner.
Attendees came back together for session six, ‘The Future of Intervention and Entrepreneurship’. Back again this year, Dr. Catherine Mohr, Senior Director of Medical Research at Intuitive Surgical, delved into how surgery is becoming digitized through her company’s continued improvement on the Da Vinci robotic surgical system.
Following Catherine, our very own, Sean Duffy, Founder and CEO of Omada Health and former Medgadget editor, revealed how his company is championing evidence-based digital therapeutics, the next step in the evolution of behavioral medicine that transforms behavioral therapy into an immersive online experience. While Omada focuses on diabetes, Sean pointed to other companies in the industry including Propeller Health, Lantern, Sleepio, and Fearless who are tackling other diseases based on digital therapies.
Next up was Dr. Anthony Chang, a pediatric cardiologist, who spoke about three areas where he thinks there is potential for innovation to occur in pediatric cardiology: pediatric pharmacogenetics, medical devices designed with children in mind, and personalizing health immediately from birth. Anthony believes innovation needs to recognize that treatments designed for adults cannot always be applied to pediatric patients with similar diseases. Conversely, solutions designed for pediatrics, like the magnetic removal of bacteria from the blood stream, can often be reengineered for adult applications.
Dr. Marty Kohn returned to the stage with Dr. Jack Kreindler and Dean Sawyer to recognize the public announcement of Sentrian made earlier today. Sentrian is a VC-backed remote patient intelligence company founded by Jack after he was inspired to develop a solution at the intersection of big data and healthcare at FutureMed 2013. Meeting Jack at FutureMed, Marty is now Chief Medical Scientist at Sentrian showing how the ideas generated at this event have the potential to result in real-world impact and opportunities. Marty explained how the new company will improve healthcare while controlling costs by integrating home monitoring data with longitudinal data to identify patients with multiple chronic diseases. By looking for patterns in the data, Sentrian will identify high-risk patients who could benefit most from intervention.
While not on the schedule, up next was MIT Media Lab Professor Dr. Ramesh Raskar, developer of EyeNetra and EyeMITRA, a finalist in the Nokia Sensing XCHALLENGE. Ramesh discussed how his research team and students at MIT took the concept of the tricorder XPRIZE challenge as a catalyst to create the world’s first class on developing integrated sensing technology which has now expanded into an open lab for MIT students and interested individuals that has already created 20 viable concepts ripe for startup. Continuing to expand on opportunities to educate and inspire, Ramesh also runs ReDx (rethinking engineering design execution) to incubate and support innovative healthtech ideas and make them a reality.
With so many new and growing companies taking the stage this afternoon, it was only fitting for Steven Krein, Founder of StartUp Health, to provide a discussion on the importance of finding and supporting entrepreneurs. In this day and age, Steven believes that shorter timelines, lower costs, more access to capital, and active networks of experts and support all allow startups to quickly iterate and validate ideas. While already playing a big role in supporting startups, StartUp Health’s 10 year goal is to build 1000 start-ups and link those startups with tens of thousands of connections and resources.
After another short break in the Innovation Lab, David Bolinsky of e*Mersion Learning Company prefaced the next session with an animation of the blood clotting cascade developed in collaboration with the Netter School of Medicine.
David Ewing Duncan, best-selling author, radio host, and writer for numerous publications, hosted the last session of the day on ‘Personalized, Crowdsourced, and Precision Medicine’. Duncan is one of the most quantified individuals having completed a full genome sequencing, 1000+ environmental toxin texts, full brain and body MRI and CT scans, and a number of proteomic and microbiome examinations. The result is over 10T of information some of which is useful but most of which is currently unusable or confusing, including three separate exams indicating that Duncan has, concurrently, low, medium, and high risks for heart attack. Duncan is a perfect example of how there is still a gap between being able to capture important medical information and making that information meaningful.
David introduced Dr. Larry Smarr, Founding Director of the California Institute for Telecommunications and Information Technology (Calit2) who we saw onstage last year. Larry spoke about how detailed knowledge of the microbome ecology will radically change health and wellness given that 99% of DNA genes are in microbe cells, not human cells.
Larry’s discussion on the value of the microbiome was appropriately followed by Jessica Richman, a graduate of the SU graduate studies program as well as Founder and CEO of uBiome, a company in this year’s Innovation Lab. Jessica is an advocate for crowdscience, using people at large rather than just the limited population of scientists, only 0.01% of individuals on the planet, to drive innovation. For Jessica, crowdscience began with crowdfunding uBiome through a wildly successful Indiegogo campaign that raised $350k, the most money ever raised at the time for a citizen scientist project. From sample swabs, uBiome captures patient microbiomes and makes that data available to support learning from crowdsourced big data. Jessica announced uBiome’s new clinical service for microbiome analysis.
The final speaker of the session was Dr. Cigall Kadoch, Assistant Professor of Pediatric Oncology at the Dana-Farber Cancer Institute and HMS as well as an Associate Member in the Center for the Science of Therapeutics Broad Institute. Cigall gave a Daniel Kraft-paced scientific presentation on her pre-doctoral work at Stanford where she identified a new protein that may play a role in the suppression of certain types of cancer through biochemical experimentation and data mining.
The final presentation of the day and the closing keynote was given by Dr. J. Craig Venter, one of the leading scientists in genomic research, the Founder, Chairman, and CEO of the J. Craig Venter Institute, and the Founder and CEO of Synthetic Genomics. Craig first walked us through the work he and his various teams have done over the years to redefine and advance the field of genomics. Despite all this work, Craig made the point that integrating and mining existing information and generating more data is still an important need. We currently know less than 1% of the insights in genomics because there’s not enough data to make meaningful comparisons. It doesn’t matter if 1000s of genomes have been sequenced if we’re trying to find variations on the order of 1 in 50,000. This means we need great quality, high volume data and the ability to mine that data effectively. Craig’s teams have set the goal to achieve one million integrated health records by 2020.
After dinner, attendees had a chance to take a deep dive with their peers in Exponential Medicine’s “Unconferences”. The idea of the Unconference is that anyone at the event can take an idea that they have or which might have been inspired during the event and run a small workshop based on that idea. This year 29 unconferences took place including topics such as quantum computing, medical education, and neurorecovery.
That concludes Day 2 at Exponential Medicine, be sure to stay tuned for complete coverage of Day 3!