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Wanted to wish you a wonderful 2013 and use the opportunity to share a few thoughts.
Q) In a lake, there is a patch of lily pads. Every day, the patch doubles in size. If it takes 48 days for the patch to cover the entire lake, how long would it take for the patch to cover half of the lake? (answer below)
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Q) In a lake, there is a patch of lily pads. Every day, the patch doubles in size. If it takes 48 days for the patch to cover the entire lake, how long would it take for the patch to cover half of the lake? (answer below)
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This past quarter, I attended an executive program at Singularity University (SU) and experienced a future that is not yet evenly distributed - but it soon will. SU has the objective of generating ideas that will impact a billion people or more over the next decade. Here are 8 developments that I experienced as it relates to accessing or giving medical care in the very near future.
1) Prescribing an app:
With 5.3B mobile users, doctors are soon expected to prescribe not just drugs but apps. For example, if a patient has to follow a certain diet regimen - it would be prescribed as an app that tracks patient compliance daily and uploads into the medical record. Not just that, dropping cost of sensors is spurring a slew of medical applications. See FDA approved Proteus ingestible sensors that tracks and informs doctors whether a pill has been taken. It uses digestive juices to produce voltage and therefore needs no batteries. SkinVision mobile app detects early changes in skin and helps patients send a photo and receive instant dermatology analysis.2) DNA sequencing will drop to less than $1,000 by next year:
Over the next five years, it's expected that patients will routinely have their DNA sequenced and therefore will include it as part of their health record. This might mean that patients will expect their doctors to read, understand, explain and act on the implications of their sequenced DNA. I met programmers who were tinkering with ATCG and writing higher-level gene-programming languages just as they did a few decades ago with computer programming. This would take us into the bizarre world of gene synthesis (imagine we could program DNA and get a lab to ship it back). This recent book Regenesis was written in DNA (yes, in DNA).3) 3D printing of drugs:
At NextServices, we recently printed a green shoe using a $1,200 3D printer called Cubify. Autodesk and Organovo are printing artificial limbs. Modern Meadow is printing meat and leather. Soon, a physician would eRx a prescription and patients would print their drugs at home.4) Ubiquity of monitoring devices:
Using devices such as Fitbit to Basis to Jawbone, more and more patients are tracking foot steps to heart rate to BP to insulin readings often and sometimes continuously (this is now called the Quantified Self movement). iBGStar is a Glucose meter integrated with the iPhone. Withings measures BP and weight and integrates with the iPad. AliveCor connects to the iPhone and provides an EKG. Zio is a cardiac rhythm monitor that tracks for 14 days continuously. Zeo is a sleep monitor. Internet of things is allowing these devices to upload data continuously to the cloud. This in turn, creates a dynamic health record (v/s static) and changing care from episodic and periodic to continuous and proactive.5) Medical data explosion:
If yesterday, a patient had 50MB of imaging data (or 50 books), tomorrow she would have 1 terrabyte data (or 800,000 books). This would impact procedures such as colonoscopy where virtual colonoscopy aided with artificial intelligence readers will provide much more reliable analysis than traditional colonoscopy.6) Robots and Robotic surgery:
I operated the da Vinci unit at Intuitive Surgical's headquarters. It was a shocker to find the ease and clarity with which a lay person could operate the unit for the first time. It combines augmented reality, decision support, remote mentoring and performs a scarless surgery. Separately, it's expected that every household will soon have 10-20 robots (big and small). I was at a gathering where one of the panelists virtually partied via a Beam telepresence robot. Think if you would make hospital calls using telepresence. My ultimate mobile experience was when I sat in Google's self-driving car that's legal in the states of California and Nevada. See its first customer Steve Mahan. Would this change how we think about ambulance?7) X-Prize and the medical tricorder:
The Qualcomm Tricorder X Prize is a $10M prize for a team that creates a 5 pound portable medical device that can diagnose 15 medical conditions better than a group of board certified physicians by 2015-16. If this were to become a reality, patients will not approach doctors for basic diagnoses (it's a different question whether that would be the right thing to do). I met people from Scanadu, the company that is developing a tricorder. Lab-on-a-chip technology that enables remote testing is becoming more and more a reality (see Cellscope). Over the decade, in-person visits are expected to drop by 50% due acceleration of these developments.8) Augmented Medical Intelligence:
We have more computing power in an iPhone than the Apollo guidance computer that put a man on the moon. Recently, IBM's Watson won Jeopardy. It can read 200million papers in 3 seconds, monitor real-time articles and access a variety of information from electronic records to genomics to peer-reviewed publications. Watson is even going to Cleveland Clinic Lerner College of Medicine. Potentially, this knowledge can be converted to a specific diagnosis accessible by a smartphone search. A physician in the near future would need augmented intelligence to perform daily tasks just as we need glasses today to see better.More?
I'm happy to share additional and detailed information if you are interested in one or more of these developments.*
A) By the way, it takes 47 days to cover half the lake. By the next day, the patch would cover the entire lake.
The overarching message is the impact of how quickly these exponential developments could become a reality. If on the 47th day, we think linearly that we still have half the amount of time - we would be dead wrong. The game ends tomorrow.
