Transcriber: TED Translators admin Reviewer: Chryssa R. Takahashi
This is how my story starts, in an intensive care unit, six years ago.
I was there with my wife, for ten weeks,
because our youngest son had suffered a severe brain accident.
It's amazingly unpredictable how people react to shock.
So, my wife completely took over the leadership,
was very functional and pragmatic, while I was...
Actually, when I came into the room, the only thing I knew, was,
I have to understand this environment or my son will die.
So, I started logging every piece of equipment
I took the brand. I looked up the ranges.
I saw how all these machines worked together.
It took me one week to hack through the hospital network.
I knew everything about this ICU in three weeks.
Now, it's actually very interesting once you know how an ICU works.
Because, from an ICU, you go to other departments.
And we went to many different departments
and now also many different hospitals.
And I can tell you, I have come to have an intimate knowledge of how hospitals,
these big collective centralized forts of doctors, work, and how they not work,
because I've seen it from the bottom up as a patient
and not as an observer or as a doctor.
I can tell you immediately,
and you know that our healhtcare systems all over the world, they breakdown,
and people say, "It's because of this and..."
But I can tell you, the real big reason is this:
it's staring you in the face.
There is too many humans. Now, like, where are the machines?
So, in every industry,
we have replaced humans with machines because they are more efficient,
because they're 24/7 and because we cannot ignore the cost factor.
We have replaced all relationships with transactions.
Look here.
This complete world is now decentralized thanks to our distributed technology
and here it is centralized.
And for the sake of controversy --
and I don't really mean that, because doctors are my best friends
and I'm of course also a carbon based unit --
but for the sake of controversy,
I would like to argue for silicon based units.
You see, a doctor follows [the] Heisenberg principle:
he's always somewhere else.
Patients are 24 hours waiting for two minutes of a doctor
who comes in like Superman and goes out again.
Also, you see, when my kids fall ill, it's never in office hours.
It's always at night or in a weekend,
or during ski holiday when most of the doctors are in Vermont,
or a combination of these things,
in ski holiday at night during the weekend -
(Laughter)
- when your last resort is a retired pharmacist or the local vet.
(Laughter)
So, there is a lot to say for machines and against humans.
Humans are also chaotic.
You know, we all think that some people are chaotic.
Let me tell you, everyone is chaotic.
Even accountants and those who are not chaotic...
(Laughter) (Applause)
Those who are not chaotic are called control freaks.
And I can tell you, it's one year away,
from becoming a reimbursable neurotic disease -- control freak.
So we are all chaotic. But machines are not.
You know why they say -- they don't give us our medical files?
Because they don't find them.
(Laughter)
Our medical privacy is protected by the sheer chaos of doctors and nurses.
So, everytime you introduce a human in a process,
you introduce an opportunity for error.
Now, think of these big hospitals, full of humans with intrigues,
power thirsty, with a very very small amount of machines.
You know, this has to go wrong.
And every government in the world is now talking about this,
the decentralization of healthcare.
How will this work?
Well, as you see there, in this nice picture --
and you probably will notice that the three figures,
the three doctors are of course avatars --
hospitals will decentralize.
The ICU units, you will only spend a couple of days there
and then they will put a unit at home. It will be telehealth.
Onstar from GM, 5 million subscribers, who know everything about your car.
If this exists for cars, why doesn't it exist for humans?
Most people in this room,
the only parameter they know about their health is their weight and their height.
And, you know,
their weight they under-exaggerate and their height they over-exaggerate.
(Laughter)
But for all the rest, they don't know.
We are the last generation who will know so little about our health.
Onstar will be the doctor's office of the future.
You willl call and this lady will pick up.
And she has your track, she will follow you.
She says like, "Yes, but 140 systolic pressure, you know,
this is quite normal and in your range
but your diastolic pressure, 130, that's too high.
You know, this is the pressure on the veins.
So I see that you're taking Zestril.
Can I connect you to the doctor now or do you want a diagnosis from Watson?"
This is the future. The doctor's office is going to be call centers.
And Fred Lee, Fred Lee used to be an executive at Walt Disney.
He is now setting up hospitals for revalidation.
If I have to revalidate, I want to go to Fred's hospital.
It's a hospital where everyone always smiles.
But why is everyone always in a bad mood in a hospital?
For God's sake, the sick are not worse off enough,
that everyone has to be in a bad mood.
This is e-patient Dave.
He's the head of the rebellion
against hospitals and doctors and the medical industry.
And he says, "Reclaim your rights."
We need to be empowered. We need to be medical consumers.
We have to think of ourselves as consumers.
So give us our damn records.
Let us do it ourselves. Nobody ever died by googling his health.
And let us go to hospitals with educated guesses.
And let's ask the doctors, and tell them, "Where [is] the epidemiology on this?"
And there is the quantified self.
There is a new movement, started in San Fransisco,
it's now in 30 countries already.
And it's all sorts of consumer devices
which you can have at home to measure your blood pressure,
your cholesterol, your galvanic skin response, your weight, your sleep.
You know, the only medical instrument
people in the world have since 1866 is a thermometer.
We don't have anything else.
We can't even buy it.
Your test results will look like this in the future, very appealing.
You know, if Apple had made test results, they would look like this.
(Laughter)
The problem is, Bill Gates made them.
What will this produce? Well, Cyberchondriacs.
But it's okay, we are all hypochondriancs, so it's one step more.
But the problem is, these doctors. Do you see this doctor there?
This doctor is a general practitioner. He has 5,000 patients normally.
So, this guy doesn't see this evolution as very beneficial to his business.
So, and people, patients, they don't want this doctor, they want this man.
(Laughter)
They want Dr. House.
(Applause)
They want a team of six people, they go through your house,
they sit with you like a detective and they clear you
and you go out like a new man.
And you know, in San Franscisco and L.A., this is coming in rapid progression.
Because, now, for 100 to 2,000 dollars a month,
you can have your concierge doctor.
And I can tell you, they are great.
Because they have only 100 patients and they know everything about you.
And it is 24/7. And they also go and have dinner with you. It's great.
But of course, it will be for a niche.
Because the real market -- and I refrain from saying killer market --
(Laughter)
-- but the real market is this, the real market is auto-diagnosis.
The real market is, us to auto-diagnose ourselves
in a triage, because in the end, we will want to talk to a doctor.
But we don't want to sit in waiting rooms anymore.
We don't want to wait for doctors.
We don't want to be patronized anymore like kids.
We want to auto-diagnose, we want to auto-educate ourselves,
and for this, we need Do-it-Yourself healthcare.
And I don't know if you know the XPRIZE foundation,
but XPRIZE foundation is an American Foundation,
and they give a prize if a company attains a certain level.
And, you know, for instance, now they have the tricorder prize.
Who doesn't know what the tricorder is?
Ah, so they don't have Star Trek in Greece?
(Laughter)
Well, it's a mythical instrument.
It's an instrument from the TV series Star Trek,
and is actually something like this. And you scan a person,
and you see everything, the ultrasound, you know, like,
even the CT, the MRI, his blood pressure.
And you know immediately what's wrong with this person.
So the tricorder is an instrument we need to have for auto-diagnosis.
And the XPRIZE foundation gives 10 million dollars to make the tricorder.
Of course, I can tell you that making the tricorder
is going to cost 10 times that much.
And it will be there, and it will be there very soon,
and it will change healthcare.
You see, everything that is in the bag of a doctor
is going to be in the case of your smartphone.
A lot of sensors will be built into that,
and you will have apps which you can buy,
which will have algorithms for the sensors
and you'll be able to diagnose yourself
and then with an educated opinion go to your doctor.
And, you know, the tricorder, it will not prescribe medicine,
it will prescribe apps, and perhaps apps will be reimbursable.
And here is Watson. Watson, the super computer of IBM,
now reads 30,000 pages per minute of medical literature.
In a couple of years, doctors will consult Watson
to see if their diagnosis is correct.
And in a couple of years further, Watson will probably give the medical degrees.
And health data, we are now -- health data must be private.
I don't get it.
So, if I'm healthy, I don't care if everyone knows,
and if I'm sick, I can't shut up about it.
So, unless you are the Unabomber,
your dental records don't mean anything to anyone.
(Laughter)
But it's very important that health data becomes broadcasted.
Because we are before a wall of interpretation.
We need more epidemiological data.
It should be a government law
that everyone has to anonymously give his health data.
E-prescriptions, this is going through the roof in the States,
because basically our doctor has become our drugs dealer.
He doesn't even touch us anymore.
He says how much and in what quantities.
What did I give you last time?
(Laughter)
Did you like it?
(Laughter) (Applause)
So e-prescriptions via the tricorder, via your doctor or via a call center,
are definitely going to happen.
Your medical records, they will be in the cloud.
They will not be in the possession of a hospital, or a doctor.
We will change doctors like we will change our telecom operator.
That's what they are afraid of, of course.
And this mythical device, you know, this,
will have a lot of sensors connected to it,
what we call the internet of things.
You see, this is a blueprint for the bathroom.
Everything in the bathroom that will not have a display will disappear.
Everything in the bathroom that will not connect will disappear.
Your toothbrush will know your cavities, will know your discolorations.
Your comb will count your hairs.
And this is the best new instrument for medical in the household
for a WIRED contest.
The toilet.
It will process every time you go on it.
(Laughter)
And it will follow you, it will follow you with your iPhone.
So that you don't process somebody else's excrement and so forth.
Ford is now building health data into its cars.
While you are driving in the car, the car will tell you,
"Slow down, man, you drank too much" or "Your allergy is up" and you know...
But the roadmap of intimacy, as we call it,
everything we now wear on the body, we will soon wear in the body.
Patchables are little patches with thousands of needles,
but you don't even see it.
Sub-dermals, under the skin, injectables, tattooables,
this will all come. And on the screen you see Proteus.
They have a pill, it's now going through FDA,
with a small patch which you put here. You take the pill,
and on your phone, you can see how you ingest your medicine.
You can also see how your bowel movement works,
how your internal blood flow works.
You can monitor yourself.
Now, last question. Who will own healthcare in the future?
It's very easy.
There is only one organization, one sort of company that can own healthcare.
Not because they have the infrastructure, but because they have the billing model.
Every time you push for a diagnosis, for a second opinion,
for tracking your health, for ultra sounding your baby,
you will pay your telecom provider.
So, in the future, we'll have hospital providers.
So, this is our lab, it's in San Francisco, it's in NASA Ames,
we are making this tricorder.
We think we are on a mission from God to make this device
and to change healthcare.
And of course we know we are the first mover.
(Laughter)
This will happen, but we're trying to prevent it
by saying: join us, not from behind --
(Laughter) (Applause)
And this is a vision of how we see this mythical device of the tricorder.
Thank you ladies and gentlemen.
(Applause)