The Future of Health and Medicine: In Your Pocket, Continuous, and Connected to the Cloud

Take a deep dive into the convergence of technology and the future of healthcare at Singularity University’s sixth Exponential Medicine program November 9-12th at the magical Hotel Del Coronado in San Diego. Join over 60 world class faculty, 50 startups, for main stage talks, breakout workshops, demos, beachside bonding and more. We are down to our last 50 participant seats, so apply soon. (And to learn more, be sure to check out Singularity Hub’s coverage of last year’s Exponential Medicine.)

This short video (with some fun integrated graphics) is from an interview I did with El País (the largest newspaper in Spain). It highlights some of the emerging technologies and approaches which have the potential to shift health, medicine and biopharma from an intermittent and reactive physician-centric mode, to an era of more continuous data and a proactive approach in which the individual is increasingly empowered and integrated into personalized wellness, diagnosis and therapy.

The video is below and some associated thoughts follow.

Diagnostics: Era of the Digital Black Bag

Digital diagnostics is coming to the home. Examples range from an eye, ear and throat exam—using connected devices designed for the patient like CellScopeMedWand and Tyto—to cardiac exams enabled by low-cost EKGs (AliveCor and Kito). Some devices will even do automated interpretations (i.e., the EKG interpreted by the app and sent to the cloud) where the diagnosis and management of disease will increasingly be enabled outside of the usual clinic, ER or hospital. Wearable patches that integrate multiple vital signs, such as those developed by Vital Connect and Proteus Digital Health, will enable more complex disease management and monitoring with ICU-level data—EKG, respiratory rate, temperature, position and more—outside of the clinical environment.

Connected, continuous and contextual measurements integrating behaviors detected by smartphone and internet of things (IoT) metrics—ranging from movement to social network activity—will be increasingly used in proactive mental health. Pioneers in this space include and technology platforms like Beyond Verbal (which analyzes the voice to detect emotion).

Altogether, as the sensors, wearables and other elements become commoditized, it will be those platforms that can leverage the data to manage, interpret and create the “check engine light,” or “OnStar for the Body” that will have the real value in bringing better care at lower costs.

Telemedicine: Beyond Video Chat

Clinical care will increasingly utilize technologies in the home or pocket of the patient or caregiver. The era of the “medical tricorder” (currently being spurred by the $10M Qualcomm Tricorder XPRIZE) will enable far better triage, diagnosis and guiding of therapy than we have available today—often, at best, a digital thermometer. All this will be combined with AI to make sense of the information and trends. Scanadu, with their Scout device, is already in FDA-sanctioned clinical trials with thousands of devices being tested in the field and as part of the XPRIZE competition.

While live chats with a clinician are now common (from MDLive to Doctor On Demand), asynchronous care is coming. New platforms include Curely which enables you to send text and images and allows the clinician to take their time, do research, and provide guidance. Don’t want to wait for a dermatologist? Try iDoc24, and send an image of your skin to a dermatologist for a consult.

As payors, payment incentives and larger healthcare systems increasingly get on board with value-based incentives, it will increasingly be your own clinician, not a random virtual one, that you may connect to. Feedback loops connecting patient and clinical care team will also be utilized—as exemplified by HealthLoop—to interact and proactively take action with patients following interventions. This will range from surgery to antibiotic prescriptions to tracking (enhanced with machine learning) chronic disease patients at home as is being pioneered by Sentrian Remote Patient Intelligence.

‘Digiceuticals’ Pill + App

As apps, the internet of things (IoT) blends with the internet of medicine (IoM), we will go “beyond the pill.” Apps will be prescribed with many drugs and other interventions as a means to track, tune and optimize, from diabetes to skin conditions.

Managing anxiety and depression, ADHD and sleep disorders and improving mindfulness and cognition with brain computer interfaces (like the Interaxon Muse) will be integrated with video gaming (as pioneered by Dr. Adam Gazzaley and his UCSF lab). Sometimes the app alone will be the therapy. Omada Health and their app plus connected wearables and a social network aimed at turning around pre-diabetic individuals is an example of effectively prescribing behavior change.

Workflow Is Key for the Clinician

More of healthcare is becoming mediated by digital, connected and mobile health (all buzzwords…soon it will just be health) and augmented with AI and machine learning—but these capabilities won’t really become useful until they enter into the clinical workflow. No clinician wants to log into multiple apps or have more raw data to sift.

We are still in the early days. Wearable and other health data is just beginning to flow through smartphones and into the EMR through platforms such as HealthKit. As incentives shift increasingly to value- and outcome-based care, the impetus to prescribe and connect the devices, apps, data and analytics into the clinician dashboard and workflow will become commonplace.

Daniel Kraft, MD is a physician-scientist, chair for medicine at Singularity University, and founder and chair of Singularity University’s Exponential Medicine conference.

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Daniel Kraft, MD
Daniel Kraft, MD
Daniel Kraft is a Stanford and Harvard trained physician-scientist, inventor, entrepreneur, and innovator and is serving as the chair of the XPRIZE Pandemic Alliance Task Force. With over 25 years of experience in clinical practice, biomedical research, and healthcare innovation, Kraft has chaired the medicine track for Singularity University since its inception in 2008 and is founder and chair of Exponential Medicine, a program that explores convergent, rapidly developing technologies and their potential in biomedicine and healthcare. Following undergraduate degrees from Brown University and medical school at Stanford, Daniel was board certified in both Internal Medicine and Pediatrics after completing a Harvard residency at the Massachusetts General Hospital and Boston Children’s Hospital, and fellowships in hematology, oncology, and bone marrow transplantation at Stanford. Daniel chairs the XPRIZE Pandemic Alliance Task Force. He is often called upon to speak to the future of health, medicine, and technology and has given five TED and TEDMED talks. He has multiple scientific publications and medical device, immunology, and stem cell-related patents through faculty positions with Stanford University School of Medicine and as clinical faculty for the pediatric bone marrow transplantation service at the University of California San Francisco. Daniel is a member of the Kaufman Fellows Society (Class 13) and member of the Inaugural (2015) class of the Aspen Institute Health Innovators Fellowship. Daniel’s academic research has focused on: stem cell biology and regenerative medicine, stem cell derived immunotherapies for cancer, bioengineering human T-cell differentiation, and humanized animal models. His research has been published in journals that include Nature and Science. His clinical work has focused on: bone marrow / hematopoietic stem cell transplantation for malignant and non-malignant diseases in adults and children, medical devices to enable stem cell-based regenerative medicine, including marrow-derived stem cell harvesting, processing, and delivery. He also implemented the first text-paging system at Stanford Hospital. He is heavily involved in digital health, founded Digital.Health, and is on the board of and advises several digital health-related startups and established healthcare organizations. Daniel recently founded IntelliMedicine, focused on personalized, data-driven, precision medicine. He is also the inventor of the MarrowMiner, an FDA approved device for the minimally invasive harvest of bone marrow, and founded RegenMed Systems, a company developing technologies to enable adult stem cell based regenerative therapies. Daniel is an avid pilot and has served in the Massachusetts and California Air National Guard as an officer and flight surgeon with F-15 and F-16 fighter squadrons. He has conducted research on aerospace medicine that was published with NASA, with whom he was a finalist for astronaut selection.
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