The Future Of Exponential Technology In Healthcare
[Applause]
so
what is the most intelligent species
in the universe it turns out that it’s
not humans
it’s mice and millions of years ago
this hyper-intelligent band of
pan-dimensional beings
got so bored knowing all there was to
know about the universe
they decided to create a stupendous
supercomputer
in order to calculate the ultimate
answer
to life the universe and everything
and the computer they built was called
deep thought
that spent 6.8 million years computing
all the data in the universe to finally
find and
answer the ultimate meaning
of life the universe and everything and
what was the answer
cultured audience exactly which
is the difference between data and
wisdom but that’s
a talk for another time this of course
was a famous story by the late great
douglas adams
who happened to have given me my first
job whilst i was still training in
medical school
and douglas talked about a brilliant
thing
in his book the hitchhiker’s guide to
the galaxy he talked about
a device that would help all of us 50
years from when he wrote it
to be able to navigate our way through
life
it was about this big it had a touch
screen
it contained all the knowledge and
wisdom
in the galaxy within it and it wasn’t
written
by authorities it was written by all of
us
now who here has got a hitchhiker’s
guide to the galaxy
in their pocket i think everyone has
douglas was an incredible inspiration to
me and to also the whole world
of technology and what he was talking
about
were the exponential changes that we
were going to see
in data and computation that would help
us
unravel many things also in my
profession of medicine
for instance we went from the launch of
the world wide web
to decoding the human genome in just
eight years
when previously for the for a hundred we
had gotten almost nowhere with data
exponential advances but where is this
going to take us
with respect to medicine well
this a hundred years ago was a state of
the art
in bombay you could go to the pharmacy
and you could get
squibs malaria malaria medication
and you had doctors like william
k kellogg’s the guy who invented
cornflakes his brother
harvey was going around doing all sorts
of stuff that would be struck off
doing today but that was the state of
the art
fast forward a hundred years to today
and quite remarkable things have
happened
just in the last few years professor
anthony’s from oxford using
computer vision to look at old ct scans
to finally see why it is that so many
people
especially in india die of heart disease
even though they haven’t got any plaque
in their arteries
completely invisible to the naked eye
until very recently so
with all these exponentials where will
we be in a hundred years time from now
well to answer that question i’m gonna
go back in time
to even before hippocrates to my
favorite point in history i hope you all
know what that is
let’s see
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who’s this a very cultured audience yes
darth vader represents to me the future
of modern medical technology
and here’s why
he had 100 burns
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multi-organ failure
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no arms and no legs
some psychological issues
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some minor problems and of course
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not formally diagnosed but you get the
drift and yet
with biotechnology machine learning and
a bunch of sensors
darth vader was not only able to live
life to the full but also to rule the
galaxy
i’m sure you’ll agree with me that he is
an example of modern medical technology
but it wasn’t him that uh inspired me it
was his line manager
emperor palpatine played of course by
the great
ian mcdermott the shakespearean actor
who unfortunately in 2008
suffered fortunately a not fatal heart
attack on stage during the press opening
of a play
his managers called us up and said look
you put all these kinds of senses on
formula one drivers and athletes can’t
you tell us when our actors are going to
have a problem and we said yes but it
would cost about ten thousand dollars an
hour and there’d be wires everywhere and
batteries
so well probably not but it got us
thinking
just as an aside a personal thing here
this is the most important message
anyone has ever sent me
from the emperor himself wishing me
happy new year
and hoping my jedi instincts are still
intact this is when i officially became
the imperial physician but i don’t work
on the death star
i actually work at my medical institute
in london with 50 other people
and we work with elite athletes and
people doing extreme extreme things
including celebrities running 43
marathons in 50 days or
others who want to swim the channel and
also
rather interesting experiments like this
one where i was thrown in a cage with a
heavyweight cage fighter
in order to see whether rest ice
compression and elevation really worked
i lost
but seriously we apply what we learn not
only to
athletes but also to the very sickest
people including those with cancer
and we’re able to improve outcomes by
early detecting things going wrong but
only with a huge amount of data
much like we do in aviation
the following shows that if you plot
some of the metrics which we measure
you can actually tell when someone is
going to die
you can move the curve along by doing
good things but
it’s incredibly powerful data much like
we use an aircraft
this is the 787 that i flew over to
india on
very safely and very efficiently mined
it produced
000 gigabytes of data in its journey
that’s a hundred million pages of paper
a lot to read an award round
by 2025 we will produce
100 000 million gigabytes
a year from the aviation industry
that’s 300 000 million pages
a second that is why aviation is so safe
and so efficient but this was state of
the art when i was born
height and weight every year would you
get in an aircraft hadn’t been checked
for 50 years
because that’s how long we wait before
we start measuring ourselves
fast forward to 2014 exponential
technology applications
we’ve built a system that could take
loads of different biosensors including
this one
robbie savage and alan shearer sat on
every seat in wembley stadium
and we could tell that alan shearer was
going to win two days in advance
because of the signal this is a device
that for five days can measure ecg
respiratory rate heart rate heart rate
variability stress body posture
accelerometry ten thousand dollars an
hour
just ten years ago how much today
i’m wearing one now i could take it off
and i could throw it away
a dollar a day exponentially advancing
technologies
this is a very important point we’re
spending trillions of dollars on
healthcare
and about a third of it is completely
wasted
we have to do something about it and our
thesis is
that we can save trillions of dollars
eventually
for about a dollar a day
health systems are wasting a tremendous
amount of money
where is india though india is only
spending 1.6 percent of its gdp
so in order to prove outcomes surely we
just make the country richer and spend
more money but the answer is no
because the richer you get the sicker
you get
three times more likely to have diabetes
50 percent higher hypertension rates
eleven hundred percent greater obesity
problems the richer you get
wealth is not the answer the problem is
that we suffer
from aging we are all getting older
and to crack that part of biology as a
data and computation problem we’re
working on but we’re far away from it
and even if we crack that there’s also
health systems they’re complex too
and if we crack that then there’s
politics
i like photoshop
so maybe we should all move to
california the home of medical
technology the place where exponentials
all begin
but there are problems in america too
regulation is there to protect us but
also it stops us from moving
or perhaps we can let go of all
regulation together
and then we end up in other problems
we’re between a rock and a hard place
but i believe we can strike a balance
we shouldn’t panic because
we do have the power of exponential
technologies that are happening
even if we like it or not so please
don’t underestimate the power of
exponential technologies
please do not underestimate the power of
yourselves
and please never underestimate the power
of the dark side
before i go i want to tell you a story
about a patient of ours
and it’s an important one because all of
this about big health systems and
trillions of dollars and so forth
is irrelevant unless we can apply it to
human beings and start doing that today
this woman was a patient who in 2011
couldn’t get pregnant and so she asked
us if we knew any specialists
i said well i’m gonna pick out a piece
of technology and find some few and
within
a couple of days she had seen a
fertility specialist
who said to her well can’t see anything
wrong i’m gonna start you on fertility
treatment
but before i do i’ve just got a hunch i
don’t know why i’m going to do an mri
scan of your uterus
and she came back with the answer to us
that
she either had a normal uterus that was
a bit thicker or she had tuberculosis of
the womb
how can that be so radically different
in today’s age
couldn’t understand it the specialist
decided to do
an exploratory investigation because
this was a bit weird
and so off protocol he did the
investigation
and he gave her the answer the answer to
why she couldn’t get pregnant
the answer to why she could never get
pregnant and that’s what and that’s
because
she had cancer throughout the entirety
of her womb
an emergency operation was planned her
chances of pregnancy dashed
but just before she did she asked us to
get together some people
we got mathematicians together not
doctors to to determine whether it would
spread through one quick
emergency cycle of ivf to harvest some
eggs to put them on ice to give her a
chance
and she did and then she had an
operation
and she got back even worse news it was
ovarian cancer that had spread
to her uterus she was given a terrible
prognosis
of a year or two to live and so she
asked for our help again
and once again with exponential
technology
we gave her an answer we sequenced
quite cheaply both tissues from both her
ovary and her uterus
and we determined that it hadn’t spread
from the ovary to the uterus
she didn’t need a yet bigger operation
and nine months of chemo that probably
wouldn’t have made a difference
the gene sequence showed that she had
two
genetically diverse cancers they were
not
the same cancer she had two stage 1a
primaries and by removing them she lived
she was not cured by medicine she was
cured
by data
in late 2013 this happened
surrogate mother was kind enough to
carry her child and had become pregnant
and on may the 1st 2014
this happened she received her child
who was born from a surrogate mother
and that date is a date i remember very
well because just a few days before
i received really what was the most
important text message
of my life and that was this
everyone’s looking for you please come
home
i asked is there anything serious and
she said yes
your daughter is about to be born
this lady is not my wife not my she is
my wife
she’s not my patient she’s my wife and
sienna is our baby daughter
and the reason i wanted to share this
story with you is because
it’s incredibly important for us when we
talk about all these technologies
to not just think about big health
systems and how much money we can make
or how much money we can save
but to remember that we have to use all
of our efforts to put these things into
place today
because individual lives count on it not
only to
save costs and so forth but sometimes to
save lives by doing less
sometimes to save lives by doing
something
and sometimes even to not just save a
life
but to create new ones
[Applause]
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