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well good afternoon everybody i'd like

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to welcome you to the first event of

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this week of innovation 2015 and of

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course we're really focusing this week

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on mars exploration

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it's an opportunity to step back from

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our day-to-day work and take some time

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to think about what we need to

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accomplish in order to explore mars with

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humans

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and give ourselves an opportunity to

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think differently about how we might go

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about doing this

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you know i've heard some people say that

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they don't have time to attend these

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innovation events or uh or to to

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innovate themselves

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as if somehow it's not connected with

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our day-to-day mission but in fact

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we are what we are concentrating on this

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week has everything to do with our

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mission and it's imperative that we are

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innovative and that we are being

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deliberate about how we choose to

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approach exploration if we're going to

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succeed in the future

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so thank you for coming today and i

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encourage you to participate in the

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other events this week

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i think you know tomorrow andy weir will

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be here the author of the martian

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on wednesday

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we have a chance to hear essentially

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elevator pitches from the people who

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have submitted projects for the

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innovation charge account that's at 11.

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there'll also be a chance after that to

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do book signing with andy weir

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on thursday in here we can learn more

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about some of our engineering and

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science efforts that will take us to

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mars

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there's going to be a

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these are kind of in the format of like

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ted talks but we can't call them ted

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talks because those are like branded so

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talk mars that's what those are going to

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be

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inflate your space about inflatable

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structures uh ones on landing humans on

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mars and ones on robotics as precursors

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to mars so hope to have you attend that

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as well

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we're also going to be uh sending out or

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opening up some challenges this year and

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we the first one is going to launch this

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week and you'll hear a little bit more

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about it um during the week but it's

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going to be aimed at identifying

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maybe hidden gaps in our mars eva

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systems and operations so thinking about

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what we've already determined

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our gaps and how we're moving forward

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but making sure there aren't other

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things that we need to be thinking about

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but really all week this is a chance to

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discuss and share how we engage all

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parts of jsc more collaboratively on our

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journey to mars

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so now i'd like to invite up jeff davis

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director of human health and performance

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who's going to introduce today's guest

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thanks ellen and as part of what human

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health performance is doing this week we

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are having a couple of days of blue sky

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events where we're

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really trying to think about disruptive

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innovation and and what does that mean

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for us to get to mars in the next 20 or

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25 years

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so to kick that off for us today it's my

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pleasure to introduce dr daniel kraft

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he and i have known each other

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over the last 25 years or so

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and

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he has 20 years of experience in

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clinical practice biomedical research

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and healthcare innovation

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he chairs the medicine track for

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singularity university some of you are

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probably familiar with that

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and is founding executive director of

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exponential medicine a program which

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explores convergent exponentially

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developing technologies and their

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potential in biomedicine and health care

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his various ted talks have over 1

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million views

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he was trained at brown university went

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to medical school at stanford

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and then attended the harvard combined

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internal medicine and pediatrics

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residency program at the mass general

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hospital in boston and the boston

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children's hospital he went on to

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complete stanford fellowships in

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hematology and oncology and bone marrow

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transplantation and has extensive

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research in stem cell biology and

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regenerative medicine

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he has multiple publications in nature

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and science and medical device

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immunology and stem cell related patents

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through faculty positions with stanford

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and his clinical faculty

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for the pediatric bone marrow

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transplantation service at the

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university of california at san

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francisco

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so i think you'll enjoy this as a very

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diverse interesting talk about the what

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the future and potential of medicine can

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be with that i'll turn it over to dr

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thank you very much dr davis and really

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appreciate the invitation to be here

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it's amazing to be back at jfc some of

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the history that wasn't in my short bio

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is that um i

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had a great workshop uh with uh this

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morning but i actually got to spend some

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time here uh in the past not quite this

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far in the past but i was a wee pup i

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was at the apollo 17 launch uh and i was

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just home in dc at my parents house and

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found some of my original elements from

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that and just just a moment to thank all

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of you from the past and the future for

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the inspiration that's been in my life

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and and many many others it's been built

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right here at jsc um here's the best

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things i found in that old box my old

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coloring book um

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and some matches match collection maybe

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that's worth something on ebay um but um

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i went on after uh being inspired as a

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kid and growing up near the air and

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space museum uh to spend time uh at

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stanford working on missions to mars and

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then actually spent a summer at

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international space university of which

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some of the crowd here are alumni and

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friends um we did a whole mission to

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mars architecture and so i spent some

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time thinking about uh the issues of

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long-duration spaceflight everything

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from micro long duration uh um partial

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gravity on the way to mars and back but

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it really helped inspire my thinking as

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a physician and scientist about the the

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convergence of technologies coming in

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different places and even when i was a

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medical student at stanford i worked and

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published an article on being a

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constructive thigh cuffs and my

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co-author uh some of you might remember

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uh recognize kell as um

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lingard flying to space station in a

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month or two so um that's a little bit

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of my past and i spent a month here as a

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medical student uh when i was at

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stanford i even published something

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on fluid

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on liquid cooling garments and um uh

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about 10 years ago came here to

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interview the astronaut course so i had

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a great experience then unfortunately

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the dock got knocked out my left eye was

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just over the 2200 uncorrected version

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so someone fix that for me please okay

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so

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let's look a little bit in the future of

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health and medicine and a broad

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perspective um that might inform some of

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your thinking about uh as we go to mars

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and beyond and it's a bit fun to go back

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to the future before we go

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dive into the

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into the future uh if you all remember

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the what year do they go into the future

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in this movie

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2015. we're actually in the future uh

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i'm waiting for my hoverboard it's under

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prototype but it's actually that's tony

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hawk on a hoverboard prototype

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but as we sort of look into the future

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it's sometimes helpful to know where we

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came from and i had a chance myself to

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go back to the future recently i trained

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at mass general hospital i was back

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there for the 200th anniversary of mgh

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those were the guys and girls i trained

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with in the trenches and of course it

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was in boston so we could joke about

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walking uphill both ways in the snow and

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i found myself after one of the

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receptions all by myself at midnight one

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of the most famous spots of healthcare

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history it's called the etherdome and

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it's called the etherdome because back

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in 1846 over 150 years ago the patient

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in this very picture was the very first

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to get general anesthesia with his

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surgery before that they used to

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literally bite the bullet this picture

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is clearly before the hip of privacy

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laws came along um but if you uh

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if you go to the etherdom today which

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you can go to it's frozen in time you

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slowly see the same actual sponge and

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medical instruments from that actual

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case

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nothing has changed there

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i wandered down the hall about four

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minutes away to the ward where i spent

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my first month as a terrified young

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intern doctor in 1996 and to my shopkins

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may that was also frozen in time and

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unchanged

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some of the alarms beeping some of the

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same nurses some the same patients

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the only difference was the poor intern

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on call was pushing around this ancient

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laptop had to type out the medical

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record electronic version and put it in

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the paper chart and the front desk was

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using the cutting edge medical

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communication technology of our day

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the fax machine right so here we are at

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a great medical institution still using

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fax machines still thinking in many ways

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like 1846 and old silos and all ways of

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thinking old departments and specialties

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kind of the way medicine has been

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structured but you know we're in this

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new age where we don't need to think

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about our doctor visit being a 37-minute

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wait on average for the 12-minute on

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average doctor visit we in this we're in

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this connected age this exponential age

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where we can think out of the bucket of

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body parts and specialties in different

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ways and i think the same thing applies

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for space flight all these different

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technologies and fields some old ways of

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thinking some new ones that can come

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together to reinvent space flight and

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aerospace medicine

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because we have challenges whether it's

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in space or on the ground and medicine

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lots of challenges rising costs the

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aging demographic 10 000 baby boomers

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turning 65 every day access to care no

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matter what you think about obamacare we

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have a lot more covered americans but a

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big shortage of primary care physicians

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in many parts of the world let alone on

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other planets

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we have issues with uh big data coming

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us lots of data like you deal with but

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how do we make that insightful and

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actionable information that you can use

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as a patient as a consumer as a

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physician and a lot of that care as you

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might know is fragmented still sometimes

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on paper sometimes electronic

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so lots of waste in the system and even

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though a lot of the innovations are here

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today the technology's here today i'll

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show you some of it our friends at the

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fda have problems regulating it our

281
00:09:17,829 --> 00:09:16,640
friends the payers who cover the costs

282
00:09:19,430 --> 00:09:17,839
don't know how to often pay for these

283
00:09:21,430 --> 00:09:19,440
things similar to you know uh the

284
00:09:22,470 --> 00:09:21,440
challenges of flying certain hardware

285
00:09:24,470 --> 00:09:22,480
so

286
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if we think about our health care system

287
00:09:28,150 --> 00:09:26,080
today it's really a bit of a sick care

288
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system it's built on a very intermittent

289
00:09:30,790 --> 00:09:29,680
and reactive model intermittent meaning

290
00:09:32,949 --> 00:09:30,800
every once in a while you get a piece of

291
00:09:34,630 --> 00:09:32,959
data blood pressure ekg

292
00:09:35,910 --> 00:09:34,640
a cholesterol level and the data you

293
00:09:37,670 --> 00:09:35,920
might get to your doctor occasionally

294
00:09:39,590 --> 00:09:37,680
very intermittently and we're very

295
00:09:41,190 --> 00:09:39,600
reactive we wait for the heart attack

296
00:09:42,870 --> 00:09:41,200
the stroke the lump to be stage three

297
00:09:44,470 --> 00:09:42,880
and detected what if we could use

298
00:09:46,310 --> 00:09:44,480
technology and you think

299
00:09:48,790 --> 00:09:46,320
new technology and new thinking to be

300
00:09:49,910 --> 00:09:48,800
much more proactive and continuous uh

301
00:09:52,310 --> 00:09:49,920
with her healthcare and that's the

302
00:09:53,750 --> 00:09:52,320
promise of technology another promise is

303
00:09:55,110 --> 00:09:53,760
to shift us from the sick care system

304
00:09:56,470 --> 00:09:55,120
where we spend 80 percent of our

305
00:09:58,470 --> 00:09:56,480
healthcare dollar on folks who already

306
00:10:00,389 --> 00:09:58,480
have chronic disease and instead of

307
00:10:02,069 --> 00:10:00,399
doing sort of what we call reimbursement

308
00:10:03,509 --> 00:10:02,079
based medicine we can do more real

309
00:10:05,350 --> 00:10:03,519
evidence-based medicine and proactive

310
00:10:06,790 --> 00:10:05,360
preventative and we can use technology

311
00:10:08,230 --> 00:10:06,800
today for ourselves and our friends and

312
00:10:09,829 --> 00:10:08,240
family to stay on the left side of the

313
00:10:12,230 --> 00:10:09,839
curve and not get those acute and

314
00:10:13,350 --> 00:10:12,240
chronic diseases in the first place

315
00:10:15,190 --> 00:10:13,360
so that means we need to shift the

316
00:10:16,550 --> 00:10:15,200
incentives but we're also shifting where

317
00:10:17,990 --> 00:10:16,560
healthcare happens it used to only be in

318
00:10:19,670 --> 00:10:18,000
the clinic and the hospital but

319
00:10:22,230 --> 00:10:19,680
increasingly healthcare is coming to our

320
00:10:24,790 --> 00:10:22,240
homes onto our bodies and as has been

321
00:10:26,949 --> 00:10:24,800
pioneered here off the planet so where

322
00:10:29,430 --> 00:10:26,959
healthcare happens can really change

323
00:10:30,710 --> 00:10:29,440
including your core walmart or cvs or

324
00:10:32,630 --> 00:10:30,720
walgreens all of them want to be your

325
00:10:34,710 --> 00:10:32,640
primary care doctor in a sense and and

326
00:10:36,710 --> 00:10:34,720
you'll see more of that uh happen uh in

327
00:10:38,630 --> 00:10:36,720
the next few years

328
00:10:40,389 --> 00:10:38,640
so let's take a step back and realize

329
00:10:42,310 --> 00:10:40,399
how fast the world is really moving

330
00:10:44,150 --> 00:10:42,320
today i came back to stanford to do

331
00:10:46,470 --> 00:10:44,160
fellowships in hematology oncology about

332
00:10:48,630 --> 00:10:46,480
10 12 years ago and so much has happened

333
00:10:50,870 --> 00:10:48,640
even the last decade uh it was only

334
00:10:53,750 --> 00:10:50,880
night 2001 that the first ipod came out

335
00:10:55,829 --> 00:10:53,760
i thought it was like 1991 so 2001. that

336
00:10:57,350 --> 00:10:55,839
feels like not so long ago and if you

337
00:10:58,949 --> 00:10:57,360
think about apple and what's changed

338
00:11:00,870 --> 00:10:58,959
with that company they didn't invent the

339
00:11:02,550 --> 00:11:00,880
mp3 player or digital music they put it

340
00:11:05,590 --> 00:11:02,560
together in smart impactful ways that's

341
00:11:07,509 --> 00:11:05,600
changed the apple's business model and

342
00:11:09,829 --> 00:11:07,519
apple has been riding this exponential

343
00:11:12,150 --> 00:11:09,839
technology trend what used to fit on an

344
00:11:14,150 --> 00:11:12,160
imac of 2000 that fits on your iphone

345
00:11:16,790 --> 00:11:14,160
and as of this week fits on an apple

346
00:11:18,150 --> 00:11:16,800
watch right and and this is an example

347
00:11:19,670 --> 00:11:18,160
um and of course the computers are

348
00:11:22,230 --> 00:11:19,680
getting even smaller that's the size of

349
00:11:24,150 --> 00:11:22,240
a grain of sand that probably has almost

350
00:11:26,230 --> 00:11:24,160
as much computational ability as what a

351
00:11:28,550 --> 00:11:26,240
polyphon on a grain of sand size

352
00:11:31,350 --> 00:11:28,560
technology we have really an ability now

353
00:11:32,870 --> 00:11:31,360
to think exponentially the the speed and

354
00:11:34,389 --> 00:11:32,880
power and computing of this little

355
00:11:36,310 --> 00:11:34,399
smartphone this is an antique now this

356
00:11:37,670 --> 00:11:36,320
is an iphone one it still works but it

357
00:11:40,069 --> 00:11:37,680
would feel antique remember smartphones

358
00:11:41,910 --> 00:11:40,079
have only been out for seven years it's

359
00:11:44,630 --> 00:11:41,920
riding moore's law moore's law was 50

360
00:11:46,150 --> 00:11:44,640
years old as of a month ago a week ago

361
00:11:48,230 --> 00:11:46,160
and it's an example of an exponential

362
00:11:50,629 --> 00:11:48,240
technology doubling in computing power

363
00:11:52,470 --> 00:11:50,639
every two years or so and our brains

364
00:11:54,069 --> 00:11:52,480
think linearly 30 linear steps i'll be

365
00:11:56,470 --> 00:11:54,079
to the exit but 30 exponential steps

366
00:11:59,190 --> 00:11:56,480
doubling 2 4 8 16 32 64.

367
00:12:00,470 --> 00:11:59,200
by 15 steps i'm at 30 000 but by the

368
00:12:02,550 --> 00:12:00,480
30th step

369
00:12:04,230 --> 00:12:02,560
i'm at a billion that's 26 times you

370
00:12:06,310 --> 00:12:04,240
know in orbit around the uh around the

371
00:12:08,949 --> 00:12:06,320
planet and that's what we need to do in

372
00:12:10,949 --> 00:12:08,959
in terms of health medicine and aviation

373
00:12:12,710 --> 00:12:10,959
is to think exponentially that's where

374
00:12:14,470 --> 00:12:12,720
the disruptive opportunities from come

375
00:12:16,870 --> 00:12:14,480
from that we can use to reinvent and

376
00:12:18,629 --> 00:12:16,880
reimagine the world and of course it's

377
00:12:20,389 --> 00:12:18,639
not just moore's law it's 3d printing

378
00:12:22,310 --> 00:12:20,399
it's robotics social networks all these

379
00:12:24,069 --> 00:12:22,320
things are coming together really in

380
00:12:25,910 --> 00:12:24,079
interesting ways to enable us to

381
00:12:27,509 --> 00:12:25,920
reimagine things just like in the last

382
00:12:29,350 --> 00:12:27,519
decade we've reimagined how we read

383
00:12:31,509 --> 00:12:29,360
books we sell more ebooks than regular

384
00:12:33,350 --> 00:12:31,519
books amazon does they self-disrupted

385
00:12:34,949 --> 00:12:33,360
we've seen other companies go bust like

386
00:12:36,629 --> 00:12:34,959
kodak had their kodak moment they

387
00:12:38,069 --> 00:12:36,639
actually invented digital photography

388
00:12:39,269 --> 00:12:38,079
but didn't pay attention to the the

389
00:12:41,350 --> 00:12:39,279
curve of exponential so they were

390
00:12:42,790 --> 00:12:41,360
bankrupt and instagram sold for billion

391
00:12:44,069 --> 00:12:42,800
dollars 12 kids down the street from me

392
00:12:45,430 --> 00:12:44,079
in palo alto

393
00:12:46,790 --> 00:12:45,440
um what was the last time you went to a

394
00:12:48,150 --> 00:12:46,800
blockbuster they've gone bust they

395
00:12:50,710 --> 00:12:48,160
weren't paying attention to exponentials

396
00:12:52,550 --> 00:12:50,720
in terms of data any folks here use uber

397
00:12:53,829 --> 00:12:52,560
right uber is now a four-year-old

398
00:12:55,590 --> 00:12:53,839
company four five-year-old company worth

399
00:12:57,030 --> 00:12:55,600
over 40 billion dollars they did not

400
00:12:59,670 --> 00:12:57,040
invent any of the technology used the

401
00:13:01,269 --> 00:12:59,680
smartphone online gps mapping payments

402
00:13:03,750 --> 00:13:01,279
but they bundled it up in a smart way to

403
00:13:05,430 --> 00:13:03,760
now disrupt the traffic the the limo and

404
00:13:06,710 --> 00:13:05,440
the cab world to the point where there's

405
00:13:08,629 --> 00:13:06,720
now the the folks who are being

406
00:13:10,470 --> 00:13:08,639
disrupted like and the taxi drivers in

407
00:13:12,629 --> 00:13:10,480
berlin have a protest to get it it's

408
00:13:14,310 --> 00:13:12,639
been outlawed in in germany but that's

409
00:13:16,790 --> 00:13:14,320
an example of leveraging technologies

410
00:13:18,470 --> 00:13:16,800
together in fact yeah i was in in vegas

411
00:13:21,030 --> 00:13:18,480
and the mafia there uh i guess doesn't

412
00:13:23,350 --> 00:13:21,040
like it either but you know i asked the

413
00:13:25,509 --> 00:13:23,360
question how can you build the uber of

414
00:13:27,590 --> 00:13:25,519
of health care or even of manned space

415
00:13:29,430 --> 00:13:27,600
flight i asked a question about medicine

416
00:13:30,870 --> 00:13:29,440
and three companies said we've already

417
00:13:32,389 --> 00:13:30,880
built the uber for health care you

418
00:13:33,509 --> 00:13:32,399
download the app you press a button and

419
00:13:35,110 --> 00:13:33,519
a doctor comes to your house or

420
00:13:36,470 --> 00:13:35,120
apartment within three hours at least in

421
00:13:38,550 --> 00:13:36,480
new york not sure what kind of doctor

422
00:13:39,910 --> 00:13:38,560
you get a doctor and remember they can

423
00:13:42,069 --> 00:13:39,920
rate you and you can rate them so

424
00:13:43,509 --> 00:13:42,079
there's a transparency element and even

425
00:13:45,269 --> 00:13:43,519
uber did their own little pilot called

426
00:13:46,790 --> 00:13:45,279
uber health where you'd slide the thing

427
00:13:48,389 --> 00:13:46,800
to the right and an uber would come with

428
00:13:50,470 --> 00:13:48,399
a nurse and give you your flu vaccine so

429
00:13:51,990 --> 00:13:50,480
that kind of seamlessness of

430
00:13:53,590 --> 00:13:52,000
access knowing where the car is the

431
00:13:55,590 --> 00:13:53,600
payments is an example of the world

432
00:13:57,269 --> 00:13:55,600
shifting and where folks want technology

433
00:13:58,870 --> 00:13:57,279
to take them

434
00:14:00,470 --> 00:13:58,880
so disruptions are all around us it's

435
00:14:02,069 --> 00:14:00,480
happening in major industries including

436
00:14:03,910 --> 00:14:02,079
a spaceflight and i would encourage you

437
00:14:05,350 --> 00:14:03,920
to be the disrupter not the disruptee

438
00:14:07,110 --> 00:14:05,360
and to start thinking exponentially so

439
00:14:08,790 --> 00:14:07,120
we'll cover that as we go from into the

440
00:14:09,910 --> 00:14:08,800
the present day into the future and many

441
00:14:11,750 --> 00:14:09,920
of the elements from healthcare remember

442
00:14:13,829 --> 00:14:11,760
apply to many elements i think of

443
00:14:15,590 --> 00:14:13,839
particularly a man space flight

444
00:14:18,470 --> 00:14:15,600
so let's look at some exponentials at

445
00:14:20,150 --> 00:14:18,480
play the human genome it was only about

446
00:14:21,430 --> 00:14:20,160
12 years ago the first genome was

447
00:14:23,189 --> 00:14:21,440
sequenced to cost

448
00:14:24,629 --> 00:14:23,199
billions of dollars took several years

449
00:14:26,310 --> 00:14:24,639
the price and speed of sequencing your

450
00:14:27,829 --> 00:14:26,320
own genome has dropped at twice the rate

451
00:14:29,269 --> 00:14:27,839
of moore's law to it's about a thousand

452
00:14:30,310 --> 00:14:29,279
dollars today and can be done in a year

453
00:14:31,910 --> 00:14:30,320
and a couple years would be a hundred

454
00:14:33,670 --> 00:14:31,920
dollars or less than the price of most

455
00:14:35,350 --> 00:14:33,680
x-rays and other lab tests some of you

456
00:14:36,949 --> 00:14:35,360
might have done 23andme and other ways

457
00:14:38,310 --> 00:14:36,959
of accessing your genetic information

458
00:14:40,150 --> 00:14:38,320
there's lots of information there today

459
00:14:41,509 --> 00:14:40,160
for a hundred dollars the trick is what

460
00:14:43,030 --> 00:14:41,519
happens when you come to your doctor

461
00:14:43,750 --> 00:14:43,040
with your genome or disk drive they

462
00:14:44,870 --> 00:14:43,760
don't know what to do with this

463
00:14:46,550 --> 00:14:44,880
information needs to be part of the

464
00:14:47,670 --> 00:14:46,560
workflow just like many of you access a

465
00:14:49,269 --> 00:14:47,680
lot of information you need to be part

466
00:14:51,269 --> 00:14:49,279
of how you see it how you make sense of

467
00:14:53,110 --> 00:14:51,279
it but we can already do things with our

468
00:14:55,509 --> 00:14:53,120
pharmacogenetics this is from a hundred

469
00:14:58,150 --> 00:14:55,519
dollar test here's my genes for a blood

470
00:14:59,590 --> 00:14:58,160
thinner here's uh 18 of my different

471
00:15:01,430 --> 00:14:59,600
drugs that might affect be affected by

472
00:15:02,629 --> 00:15:01,440
my genes that information is here now i

473
00:15:03,990 --> 00:15:02,639
would encourage you

474
00:15:05,269 --> 00:15:04,000
to even try some of these consumer

475
00:15:06,629 --> 00:15:05,279
genetic testing elements you may learn

476
00:15:08,870 --> 00:15:06,639
something about yourself that might be

477
00:15:10,230 --> 00:15:08,880
useful in fact i uploaded my genetic

478
00:15:12,150 --> 00:15:10,240
data and i can look at my this is called

479
00:15:13,430 --> 00:15:12,160
athlete they look at your athletic jeans

480
00:15:14,790 --> 00:15:13,440
and i can see i'm a pr i was always a

481
00:15:16,230 --> 00:15:14,800
good sprinter never a good endurance

482
00:15:17,590 --> 00:15:16,240
runner and i didn't quite get up for the

483
00:15:19,910 --> 00:15:17,600
gym this morning but i have an excuse my

484
00:15:21,350 --> 00:15:19,920
genes for motivation are low so i got an

485
00:15:23,110 --> 00:15:21,360
excuse there

486
00:15:24,470 --> 00:15:23,120
but you know as we look at long-duration

487
00:15:26,470 --> 00:15:24,480
space missions and others well maybe

488
00:15:28,470 --> 00:15:26,480
even tune people's understanding who's

489
00:15:29,749 --> 00:15:28,480
genetically most adaptable for for

490
00:15:32,150 --> 00:15:29,759
long-duration missions and others this

491
00:15:34,150 --> 00:15:32,160
is one example in the in the in the uh

492
00:15:36,069 --> 00:15:34,160
in that world and it goes well beyond

493
00:15:38,310 --> 00:15:36,079
the genome today you know there's all

494
00:15:40,230 --> 00:15:38,320
these omics the proteome you can get 10

495
00:15:42,150 --> 00:15:40,240
000 biomarkers from a drop of blood

496
00:15:44,230 --> 00:15:42,160
there's the expose of where you've lived

497
00:15:45,910 --> 00:15:44,240
if you spent a year on space station or

498
00:15:47,670 --> 00:15:45,920
lived on a farm in idaho or by three

499
00:15:49,749 --> 00:15:47,680
mile canal you have different exposures

500
00:15:50,949 --> 00:15:49,759
radiation cancer risks others our cell

501
00:15:52,629 --> 00:15:50,959
phones know where we live they can

502
00:15:54,790 --> 00:15:52,639
measure that there's the idea of the

503
00:15:56,710 --> 00:15:54,800
microbiome we are made up of 10 times

504
00:15:58,470 --> 00:15:56,720
more bacterial cells than human cells

505
00:16:00,150 --> 00:15:58,480
and it turns out the microbiome

506
00:16:01,350 --> 00:16:00,160
particularly in our gut can play a

507
00:16:03,189 --> 00:16:01,360
really important role in everything from

508
00:16:05,590 --> 00:16:03,199
obesity to inflammatory bowel disease to

509
00:16:07,509 --> 00:16:05,600
psychiatric disorders about 14 000

510
00:16:09,430 --> 00:16:07,519
americans die every year

511
00:16:11,910 --> 00:16:09,440
from infections in the hospital and now

512
00:16:14,069 --> 00:16:11,920
we're learning at my old home base to do

513
00:16:15,110 --> 00:16:14,079
fecal transplants not too sexy but it's

514
00:16:16,870 --> 00:16:15,120
going to be part of the therapies of the

515
00:16:18,790 --> 00:16:16,880
future where you take a microbiome

516
00:16:20,230 --> 00:16:18,800
cocktail to maybe replace an augment

517
00:16:21,749 --> 00:16:20,240
that when you have so that's not science

518
00:16:24,310 --> 00:16:21,759
fiction that's coming along and that's

519
00:16:26,230 --> 00:16:24,320
just one of several ohms

520
00:16:29,110 --> 00:16:26,240
so we all want personalized medicine and

521
00:16:31,189 --> 00:16:29,120
precision medicine it's often best i

522
00:16:32,790 --> 00:16:31,199
think in terms of systems medicine this

523
00:16:34,230 --> 00:16:32,800
idea that will be predictive will be

524
00:16:35,749 --> 00:16:34,240
sequenced at birth or sometimes even

525
00:16:37,269 --> 00:16:35,759
before birth that's possible now from a

526
00:16:38,710 --> 00:16:37,279
mother's blood you can sequence the

527
00:16:39,829 --> 00:16:38,720
entire child we can then take

528
00:16:41,990 --> 00:16:39,839
preventative steps that are more

529
00:16:43,110 --> 00:16:42,000
personalized and the final p i'll

530
00:16:45,189 --> 00:16:43,120
challenge all of you is to be

531
00:16:46,710 --> 00:16:45,199
participatory to share your own data

532
00:16:48,389 --> 00:16:46,720
when it's when it's realistic to do so

533
00:16:50,069 --> 00:16:48,399
to all become part of the future of

534
00:16:52,629 --> 00:16:50,079
health and medicine by becoming data

535
00:16:54,230 --> 00:16:52,639
donors as we move forward

536
00:16:56,470 --> 00:16:54,240
so another few exponentials that play

537
00:16:57,910 --> 00:16:56,480
imaging imaging now is incredible a lot

538
00:16:59,670 --> 00:16:57,920
of this is spun off by the way from from

539
00:17:01,030 --> 00:16:59,680
nasa-based technologies we can see

540
00:17:02,710 --> 00:17:01,040
inside the body with incredible

541
00:17:04,390 --> 00:17:02,720
resolution and your surgeon or your

542
00:17:06,150 --> 00:17:04,400
interventional radiologist can now find

543
00:17:08,069 --> 00:17:06,160
the tumor and avoid the blood vessel

544
00:17:09,909 --> 00:17:08,079
that's all done on a tablet computer and

545
00:17:11,429 --> 00:17:09,919
reconstruct it in real time

546
00:17:12,630 --> 00:17:11,439
the world of neuroscience is really

547
00:17:14,150 --> 00:17:12,640
getting shaken up we can not only

548
00:17:15,590 --> 00:17:14,160
appreciate the amazing anatomy of our

549
00:17:17,669 --> 00:17:15,600
brains but what's often called the

550
00:17:19,909 --> 00:17:17,679
connectome how are we wired has to play

551
00:17:21,990 --> 00:17:19,919
a role in everything from autism to

552
00:17:23,669 --> 00:17:22,000
alzheimer's and speaking of being

553
00:17:25,669 --> 00:17:23,679
proactive alzheimer's we know a major

554
00:17:27,110 --> 00:17:25,679
challenge what if we instead of waiting

555
00:17:28,789 --> 00:17:27,120
for it to happen and not having much to

556
00:17:30,470 --> 00:17:28,799
do we could pick it up early well

557
00:17:32,070 --> 00:17:30,480
there's now some types of scans we can

558
00:17:33,350 --> 00:17:32,080
scan a patient and find that they're

559
00:17:35,510 --> 00:17:33,360
going to become likely to become an

560
00:17:37,270 --> 00:17:35,520
alzheimer's patient 10 years later

561
00:17:39,750 --> 00:17:37,280
or as published last year blood-based

562
00:17:40,950 --> 00:17:39,760
biomarkers or even visual eye tracking

563
00:17:42,710 --> 00:17:40,960
tests you can do with a hundred dollar

564
00:17:44,150 --> 00:17:42,720
laptop and an eye tracker that can

565
00:17:46,230 --> 00:17:44,160
predict whether someone's going to

566
00:17:47,510 --> 00:17:46,240
develop alzheimer's and as of last month

567
00:17:49,110 --> 00:17:47,520
there's now a new drug that looks like

568
00:17:51,190 --> 00:17:49,120
it's coming along that can reverse or

569
00:17:52,710 --> 00:17:51,200
stop plaques so maybe we'll identify

570
00:17:54,230 --> 00:17:52,720
folks early and then give them some of

571
00:17:55,510 --> 00:17:54,240
these therapeutics before they ever

572
00:17:57,430 --> 00:17:55,520
develop symptoms what i like to call

573
00:17:58,789 --> 00:17:57,440
stage zero medicine that's just one

574
00:18:00,070 --> 00:17:58,799
example

575
00:18:01,909 --> 00:18:00,080
another area set to shift is

576
00:18:03,430 --> 00:18:01,919
cardiovascular medicine the number one

577
00:18:05,669 --> 00:18:03,440
killer what if instead of doing the

578
00:18:07,750 --> 00:18:05,679
cardiac angiogram which takes dye and a

579
00:18:10,470 --> 00:18:07,760
catheter up the groin you could do

580
00:18:11,510 --> 00:18:10,480
computationally a 30-second ct scan send

581
00:18:13,510 --> 00:18:11,520
that data to the cloud and now

582
00:18:15,270 --> 00:18:13,520
computationally characterize is your

583
00:18:17,110 --> 00:18:15,280
blood vessel narrow or not how narrow

584
00:18:19,510 --> 00:18:17,120
does that patient need a stent or a

585
00:18:21,270 --> 00:18:19,520
bypass what kind of stent what size

586
00:18:23,190 --> 00:18:21,280
maybe we'll even 3d print that stent for

587
00:18:24,870 --> 00:18:23,200
that patient in real time in the future

588
00:18:26,549 --> 00:18:24,880
all that's now being blended from the

589
00:18:28,549 --> 00:18:26,559
convergence of imaging cloud-based

590
00:18:29,990 --> 00:18:28,559
computation mathematics a lot of this

591
00:18:31,590 --> 00:18:30,000
was actually done from nasa ames based

592
00:18:33,350 --> 00:18:31,600
fluidics technology and now it's

593
00:18:35,270 --> 00:18:33,360
translating and this was just fda

594
00:18:37,190 --> 00:18:35,280
approved last month and i think we'll be

595
00:18:39,350 --> 00:18:37,200
replacing some of our angiograms in the

596
00:18:40,870 --> 00:18:39,360
next year or a company i advise called

597
00:18:42,870 --> 00:18:40,880
morpheus they can do a four-minute

598
00:18:44,549 --> 00:18:42,880
cardiac mri completely reconstruct the

599
00:18:45,990 --> 00:18:44,559
anatomy of your chest and all the

600
00:18:48,710 --> 00:18:46,000
functions of your heart kind of like a

601
00:18:50,150 --> 00:18:48,720
an echo and this will be faster cheaper

602
00:18:52,310 --> 00:18:50,160
and give us much higher resolution

603
00:18:54,390 --> 00:18:52,320
personalized data so a few examples of

604
00:18:56,230 --> 00:18:54,400
convergent technologies coming along

605
00:18:58,230 --> 00:18:56,240
but probably the most disruptive

606
00:19:00,070 --> 00:18:58,240
technology in the future of health

607
00:19:02,710 --> 00:19:00,080
medicine is you the individual the

608
00:19:03,830 --> 00:19:02,720
consumer the patient where we're all now

609
00:19:05,270 --> 00:19:03,840
you know this is the old school

610
00:19:07,190 --> 00:19:05,280
technology 10 years ago i had a palm

611
00:19:09,110 --> 00:19:07,200
pilot that was fancy and of course now

612
00:19:10,789 --> 00:19:09,120
we're in the smartphone era and now at

613
00:19:12,390 --> 00:19:10,799
stanford my medical school every medical

614
00:19:13,909 --> 00:19:12,400
student gets an ipad their first day of

615
00:19:15,990 --> 00:19:13,919
school with their entire curriculum on

616
00:19:17,510 --> 00:19:16,000
it you're flying tablets now to iss and

617
00:19:19,029 --> 00:19:17,520
beyond that's changing the game for

618
00:19:21,510 --> 00:19:19,039
medicine almost every doc brings their

619
00:19:23,990 --> 00:19:21,520
own device to work i was just in india

620
00:19:25,190 --> 00:19:24,000
they now have 35 android tablets on sale

621
00:19:26,470 --> 00:19:25,200
for 35

622
00:19:28,070 --> 00:19:26,480
that's going to democratize everything

623
00:19:30,549 --> 00:19:28,080
from education to public health and

624
00:19:32,150 --> 00:19:30,559
beyond and in a few years the poorest of

625
00:19:34,789 --> 00:19:32,160
the planet remember 80 of the planet

626
00:19:36,710 --> 00:19:34,799
today has sms phones even the poorest

627
00:19:38,549 --> 00:19:36,720
billion individuals soon they're going

628
00:19:40,070 --> 00:19:38,559
to have the equivalent of our fancy

629
00:19:41,990 --> 00:19:40,080
smartphones that can really change

630
00:19:43,110 --> 00:19:42,000
things including in healthcare and it's

631
00:19:44,230 --> 00:19:43,120
meaning technology is sort of

632
00:19:45,029 --> 00:19:44,240
disappearing that used to be a hundred

633
00:19:46,950 --> 00:19:45,039
thousand dollars of different

634
00:19:48,710 --> 00:19:46,960
technologies now is essentially free you

635
00:19:49,830 --> 00:19:48,720
don't buy a gps device anymore you

636
00:19:51,350 --> 00:19:49,840
download it on your phone even the

637
00:19:53,029 --> 00:19:51,360
flashlights in your phone so we're

638
00:19:54,870 --> 00:19:53,039
starting to have technology disappear

639
00:19:56,150 --> 00:19:54,880
and in some cases get cheaper better and

640
00:19:57,750 --> 00:19:56,160
more functional

641
00:19:59,190 --> 00:19:57,760
even google and their new smartphone is

642
00:20:00,630 --> 00:19:59,200
modular so you can put in different

643
00:20:02,149 --> 00:20:00,640
modules if you're a diabetic or need to

644
00:20:02,950 --> 00:20:02,159
track your ekg

645
00:20:05,029 --> 00:20:02,960
so

646
00:20:06,710 --> 00:20:05,039
the new drug is really you the empowered

647
00:20:09,190 --> 00:20:06,720
patient to own your information to say

648
00:20:10,710 --> 00:20:09,200
i'm the ceo of my own health if you have

649
00:20:12,390 --> 00:20:10,720
diabetes you can now get connected

650
00:20:13,669 --> 00:20:12,400
glucometers that will record your blood

651
00:20:15,270 --> 00:20:13,679
sugar

652
00:20:16,710 --> 00:20:15,280
send that to your clinical team they're

653
00:20:18,950 --> 00:20:16,720
not patches that can transmit to your

654
00:20:20,470 --> 00:20:18,960
smartphone real-time blood glucose and

655
00:20:22,230 --> 00:20:20,480
if you are diabetic and you have a

656
00:20:24,070 --> 00:20:22,240
dashboard of your own data you can be

657
00:20:26,230 --> 00:20:24,080
much more on top of your care and your

658
00:20:27,669 --> 00:20:26,240
physician as well this is a simple app

659
00:20:29,110 --> 00:20:27,679
that they published a few years ago and

660
00:20:30,950 --> 00:20:29,120
studied they were able to lower the

661
00:20:32,310 --> 00:20:30,960
average hemoglobin a1c and diabetic

662
00:20:34,230 --> 00:20:32,320
patients by two percentage points just

663
00:20:35,830 --> 00:20:34,240
with the app and changing diet and

664
00:20:37,510 --> 00:20:35,840
tweaking the meds a bit this is now the

665
00:20:39,190 --> 00:20:37,520
first fda approved app that's getting

666
00:20:40,470 --> 00:20:39,200
paid for by insurance companies for

667
00:20:41,750 --> 00:20:40,480
diabetes

668
00:20:43,270 --> 00:20:41,760
so we're going to enter an error while

669
00:20:45,510 --> 00:20:43,280
prescribed united glucometer badou

670
00:20:46,630 --> 00:20:45,520
glucometer with the social network in it

671
00:20:50,470 --> 00:20:46,640
and

672
00:20:52,070 --> 00:20:50,480
i'll be prescribing you apps for instead

673
00:20:53,270 --> 00:20:52,080
of a drug and device you know after

674
00:20:56,149 --> 00:20:53,280
pregnancy pregnancy hasn't changed for a

675
00:20:57,350 --> 00:20:56,159
while uh pre-op apps post-op apps all

676
00:20:59,350 --> 00:20:57,360
these things are going to be kind of

677
00:21:00,549 --> 00:20:59,360
become embedded in our everyday health

678
00:21:01,669 --> 00:21:00,559
and medicine and

679
00:21:03,350 --> 00:21:01,679
just like i think you can send up

680
00:21:04,950 --> 00:21:03,360
checklists now by apps that sort of

681
00:21:06,870 --> 00:21:04,960
element will come along

682
00:21:08,789 --> 00:21:06,880
you can now make restaurant reservations

683
00:21:10,950 --> 00:21:08,799
like with opentable another company did

684
00:21:12,710 --> 00:21:10,960
that for doctors open zocdoc one of the

685
00:21:14,630 --> 00:21:12,720
most successful healthcare it companies

686
00:21:16,149 --> 00:21:14,640
making bringing that sensibility along

687
00:21:18,310 --> 00:21:16,159
even the pharmacies now allow you to

688
00:21:19,909 --> 00:21:18,320
scan your pill bottle and do a refill so

689
00:21:21,430 --> 00:21:19,919
this new application of medicine is

690
00:21:22,789 --> 00:21:21,440
quite powerful they're coming to our

691
00:21:24,630 --> 00:21:22,799
apple watches to remind you to take your

692
00:21:26,149 --> 00:21:24,640
meds which is important because 50 of

693
00:21:27,430 --> 00:21:26,159
folks don't take their medicines as they

694
00:21:29,909 --> 00:21:27,440
should and you might have an easy

695
00:21:31,990 --> 00:21:29,919
reminder we're seeing mayo clinic

696
00:21:33,350 --> 00:21:32,000
published that apps can reduce hospital

697
00:21:35,590 --> 00:21:33,360
readmissions

698
00:21:37,029 --> 00:21:35,600
dramatically so the lesson here is it's

699
00:21:38,310 --> 00:21:37,039
this integration of information

700
00:21:39,830 --> 00:21:38,320
technology and mobile that can really

701
00:21:41,669 --> 00:21:39,840
empower all of us whether you're a

702
00:21:43,350 --> 00:21:41,679
physician a patient a flight surgeon or

703
00:21:45,270 --> 00:21:43,360
what have you

704
00:21:46,950 --> 00:21:45,280
and we can make healthcare more engaging

705
00:21:48,390 --> 00:21:46,960
uh what if we make you know some people

706
00:21:49,909 --> 00:21:48,400
like points some of you have fitbits and

707
00:21:51,350 --> 00:21:49,919
compete with those technologies we can

708
00:21:52,870 --> 00:21:51,360
take off the shelf technologies like a

709
00:21:54,149 --> 00:21:52,880
microsoft connect that used to be you

710
00:21:55,830 --> 00:21:54,159
know millions of dollars now as

711
00:21:57,190 --> 00:21:55,840
consumerized and that can be used to

712
00:21:58,549 --> 00:21:57,200
help you track your physical therapy

713
00:22:00,390 --> 00:21:58,559
make it more engaging and fun maybe

714
00:22:02,630 --> 00:22:00,400
folks will actually do it for a change

715
00:22:04,870 --> 00:22:02,640
right we can now digitize all this

716
00:22:06,789 --> 00:22:04,880
information this new ear is often called

717
00:22:08,950 --> 00:22:06,799
mobile health or connected health or

718
00:22:10,630 --> 00:22:08,960
digital health because now in my pocket

719
00:22:12,870 --> 00:22:10,640
i can have the equivalent of an entire

720
00:22:14,710 --> 00:22:12,880
you know clinic in the past i can attach

721
00:22:16,870 --> 00:22:14,720
to my smartphone a little otoscope and

722
00:22:18,710 --> 00:22:16,880
look in my kids ears and send that data

723
00:22:20,870 --> 00:22:18,720
back and prescribe that to to families

724
00:22:22,710 --> 00:22:20,880
with with kids with otitis media or eye

725
00:22:24,390 --> 00:22:22,720
exams and i know uh nasa's work with

726
00:22:25,510 --> 00:22:24,400
inetra to do eye exams on your

727
00:22:26,870 --> 00:22:25,520
smartphone

728
00:22:28,310 --> 00:22:26,880
their first market was in the us

729
00:22:30,070 --> 00:22:28,320
actually or or nasa they were going to

730
00:22:31,909 --> 00:22:30,080
go to india where you could have very

731
00:22:33,510 --> 00:22:31,919
few eye doctors press a button and order

732
00:22:35,669 --> 00:22:33,520
your glasses and of last week this

733
00:22:37,350 --> 00:22:35,679
company spun off a different one called

734
00:22:38,870 --> 00:22:37,360
blink where new york a little team will

735
00:22:40,390 --> 00:22:38,880
come in a car like an uber and do your

736
00:22:42,470 --> 00:22:40,400
whole eye exam with these mobile devices

737
00:22:44,310 --> 00:22:42,480
and send you your glasses or contacts

738
00:22:46,789 --> 00:22:44,320
so new ways of bundling things are

739
00:22:48,070 --> 00:22:46,799
shifting entire industries

740
00:22:49,909 --> 00:22:48,080
one of my favorite examples is

741
00:22:51,669 --> 00:22:49,919
telemedicine was really invented here i

742
00:22:53,510 --> 00:22:51,679
mean here's uh buzz on runs actually

743
00:22:54,950 --> 00:22:53,520
actually uh buzz orders ekg when he

744
00:22:56,230 --> 00:22:54,960
landed on the moon and apollo 11 he had

745
00:22:57,669 --> 00:22:56,240
very fast out right i think neil is a

746
00:22:59,430 --> 00:22:57,679
little more chill but you were able to

747
00:23:01,430 --> 00:22:59,440
transmit an ekg from the moon why can't

748
00:23:03,430 --> 00:23:01,440
we do that on earth well finally you

749
00:23:04,549 --> 00:23:03,440
sort of can there's now uh a technology

750
00:23:06,950 --> 00:23:04,559
i have in my pocket i'll do the live

751
00:23:08,950 --> 00:23:06,960
demo a little smartphone case costs

752
00:23:11,430 --> 00:23:08,960
under ten dollars and it's going to

753
00:23:12,710 --> 00:23:11,440
stream an ekg directly on my phone i

754
00:23:13,830 --> 00:23:12,720
just hold this on my case i went to the

755
00:23:15,669 --> 00:23:13,840
live demo right here but it looks like

756
00:23:16,789 --> 00:23:15,679
this we could pass this around the room

757
00:23:18,390 --> 00:23:16,799
and probably detect people who have a

758
00:23:20,630 --> 00:23:18,400
heart issue or if someone collapses at a

759
00:23:22,549 --> 00:23:20,640
party a great party gift you can

760
00:23:23,750 --> 00:23:22,559
diagnose things or if someone has atrial

761
00:23:24,950 --> 00:23:23,760
fibrillation or you're on station and

762
00:23:26,390 --> 00:23:24,960
someone has a funny rhythm you don't

763
00:23:27,750 --> 00:23:26,400
need to wire them up with twelve ekg say

764
00:23:29,270 --> 00:23:27,760
hold the phone boom that data is

765
00:23:31,430 --> 00:23:29,280
available immediately

766
00:23:32,630 --> 00:23:31,440
and the app itself now does analysis or

767
00:23:34,549 --> 00:23:32,640
you can press a button to have an actual

768
00:23:36,390 --> 00:23:34,559
cardiologist see that data so the

769
00:23:38,230 --> 00:23:36,400
ability to collect information and gain

770
00:23:39,750 --> 00:23:38,240
insights for it because my ekg on this

771
00:23:41,750 --> 00:23:39,760
is is particularly getting faster

772
00:23:42,710 --> 00:23:41,760
cheaper and easier

773
00:23:44,470 --> 00:23:42,720
now

774
00:23:46,470 --> 00:23:44,480
some of this came from this consumer

775
00:23:48,230 --> 00:23:46,480
movement often called the quantified

776
00:23:49,510 --> 00:23:48,240
self only about six years old how many

777
00:23:50,710 --> 00:23:49,520
folks you have a fitbit or any kind of

778
00:23:52,149 --> 00:23:50,720
self-tracker

779
00:23:53,990 --> 00:23:52,159
only a few of you i'm probably lost in

780
00:23:55,190 --> 00:23:54,000
the laundry or forgot the charger well

781
00:23:56,470 --> 00:23:55,200
um i'm wearing like six of them right

782
00:23:57,990 --> 00:23:56,480
now i won't show them all of them but

783
00:23:59,430 --> 00:23:58,000
that world now where we can connect are

784
00:24:01,029 --> 00:23:59,440
scales that can tweet your weight blood

785
00:24:03,430 --> 00:24:01,039
pressure cuffs and talk to each other

786
00:24:05,669 --> 00:24:03,440
our smartphones now right these have

787
00:24:07,350 --> 00:24:05,679
these are highly uh

788
00:24:10,390 --> 00:24:07,360
instrumented devices they can track your

789
00:24:11,669 --> 00:24:10,400
heart rate your steps other elements

790
00:24:12,950 --> 00:24:11,679
blood pressure some of you might have

791
00:24:14,310 --> 00:24:12,960
high blood pressure you can now for

792
00:24:16,390 --> 00:24:14,320
sixty dollars buy a connective blood

793
00:24:18,230 --> 00:24:16,400
pressure cuff and integrate that data

794
00:24:19,909 --> 00:24:18,240
back to your doctor because companies

795
00:24:21,029 --> 00:24:19,919
like google and samsung and apple are

796
00:24:23,190 --> 00:24:21,039
now integrating that through your

797
00:24:25,190 --> 00:24:23,200
consumer devices so now that information

798
00:24:26,950 --> 00:24:25,200
can seamlessly flow and potentially

799
00:24:27,830 --> 00:24:26,960
become actionable not just another data

800
00:24:29,830 --> 00:24:27,840
point

801
00:24:31,190 --> 00:24:29,840
oh by the way you can have this data

802
00:24:33,029 --> 00:24:31,200
sometimes you might need a coach to help

803
00:24:34,470 --> 00:24:33,039
you there's now coaching apps where you

804
00:24:35,909 --> 00:24:34,480
have a real coach but we're moving to

805
00:24:37,909 --> 00:24:35,919
the era of ai coaches here's a quick

806
00:24:39,750 --> 00:24:37,919
look of something coming soon

807
00:24:42,310 --> 00:24:39,760
meet the world's first artificial

808
00:24:45,669 --> 00:24:42,320
intelligence personal robot

809
00:24:47,909 --> 00:24:45,679
she's your welcome friend at any hour

810
00:24:49,750 --> 00:24:47,919
good morning thomas time to get up good

811
00:24:51,750 --> 00:24:49,760
morning it seems like you had a good

812
00:24:53,430 --> 00:24:51,760
night's sleep eight full hours and a

813
00:24:55,269 --> 00:24:53,440
good resting heart rate

814
00:24:57,590 --> 00:24:55,279
thank you your meeting with jane is at 9

815
00:25:00,230 --> 00:24:57,600
30. i put the coffee on she can

816
00:25:02,230 --> 00:25:00,240
interface with household devices and

817
00:25:03,110 --> 00:25:02,240
she's also a personal stylist what do

818
00:25:07,110 --> 00:25:03,120
you think

819
00:25:09,029 --> 00:25:07,120
why don't you try the blue tie with it

820
00:25:11,430 --> 00:25:09,039
good idea

821
00:25:14,230 --> 00:25:11,440
she's your world-class office assistant

822
00:25:16,230 --> 00:25:14,240
using that's coming along ai assistant

823
00:25:17,830 --> 00:25:16,240
um we can even wire our youngest uh

824
00:25:19,269 --> 00:25:17,840
patients this is my son leo about six

825
00:25:21,669 --> 00:25:19,279
months ago when he's wearing a connected

826
00:25:23,029 --> 00:25:21,679
onesie so he's donating his data to

827
00:25:24,870 --> 00:25:23,039
science and i don't need that to tell me

828
00:25:26,149 --> 00:25:24,880
he's waking up every two hours but what

829
00:25:27,350 --> 00:25:26,159
if you had a child in the neonatal

830
00:25:28,950 --> 00:25:27,360
intensive care unit you could send them

831
00:25:30,950 --> 00:25:28,960
out earlier with some of these connected

832
00:25:32,470 --> 00:25:30,960
technologies and some of them used to be

833
00:25:34,230 --> 00:25:32,480
you know very futuristic this is from

834
00:25:35,669 --> 00:25:34,240
the cover of wired uh the back page

835
00:25:37,909 --> 00:25:35,679
artifacts from the future the connected

836
00:25:39,269 --> 00:25:37,919
diaper well now as of last year huggies

837
00:25:40,549 --> 00:25:39,279
came out with

838
00:25:43,269 --> 00:25:40,559
tweet p you can figure out what that

839
00:25:46,870 --> 00:25:44,789
there's also data for number two

840
00:25:49,029 --> 00:25:46,880
sometimes too much information

841
00:25:51,110 --> 00:25:49,039
it's available all right okay

842
00:25:52,710 --> 00:25:51,120
um other ways to get connected now you

843
00:25:54,070 --> 00:25:52,720
know these sensors are pretty basic

844
00:25:55,269 --> 00:25:54,080
they're little accelerometers used to be

845
00:25:56,630 --> 00:25:55,279
million dollar seminars are now two

846
00:25:58,390 --> 00:25:56,640
dollars and can live in all of our

847
00:25:59,990 --> 00:25:58,400
devices so we're moving to all this

848
00:26:01,750 --> 00:26:00,000
internet of things it's coming to the

849
00:26:03,430 --> 00:26:01,760
internet of the body internet of pills

850
00:26:05,669 --> 00:26:03,440
or pills now that can track when and if

851
00:26:07,750 --> 00:26:05,679
you took them or not right there are now

852
00:26:09,269 --> 00:26:07,760
patches uh and clothes that are being

853
00:26:10,310 --> 00:26:09,279
embedded with wearable devices and you

854
00:26:11,830 --> 00:26:10,320
know when the astronauts fly they're

855
00:26:13,510 --> 00:26:11,840
very telemetered but these now come from

856
00:26:15,669 --> 00:26:13,520
a simple take on shirt they can be part

857
00:26:16,870 --> 00:26:15,679
of our cars digital tattoos have been

858
00:26:18,870 --> 00:26:16,880
developed that can monitor and track

859
00:26:21,830 --> 00:26:18,880
your vital signs i have in my pocket

860
00:26:24,470 --> 00:26:21,840
from a company oh no um

861
00:26:25,830 --> 00:26:24,480
technology fail let's see uh

862
00:26:29,110 --> 00:26:25,840
this sometimes happens on this it's okay

863
00:26:30,230 --> 00:26:29,120
i've got a backup um

864
00:26:32,630 --> 00:26:30,240
we've seen now companies like this

865
00:26:36,230 --> 00:26:32,640
little patch i'll show you in a second

866
00:26:38,470 --> 00:26:36,240
are able to uh oh let's see

867
00:26:39,830 --> 00:26:38,480
let me get out of this for one second

868
00:26:41,830 --> 00:26:39,840
um

869
00:26:43,430 --> 00:26:41,840
we're seeing technologies like this

870
00:26:45,909 --> 00:26:43,440
smart patch i'll show you in a second if

871
00:26:48,149 --> 00:26:45,919
i can reboot this are really uh able now

872
00:26:50,149 --> 00:26:48,159
to stream what used to be intensive care

873
00:26:52,230 --> 00:26:50,159
unit level data

874
00:26:53,190 --> 00:26:52,240
right to our smartphone and into the

875
00:26:55,269 --> 00:26:53,200
cloud this would be something we're

876
00:26:56,789 --> 00:26:55,279
talking about this morning that could be

877
00:27:00,310 --> 00:26:56,799
flown on station today or in future

878
00:27:01,830 --> 00:27:00,320
missions um whereby you're able to uh

879
00:27:02,870 --> 00:27:01,840
have what's intentionally used to be an

880
00:27:04,310 --> 00:27:02,880
intensive care unit just with this

881
00:27:06,390 --> 00:27:04,320
little patch this little patch is gonna

882
00:27:08,310 --> 00:27:06,400
be about three dollars a day and you'll

883
00:27:10,310 --> 00:27:08,320
soon be able to wear this for sporting

884
00:27:12,950 --> 00:27:10,320
to optimize your uh

885
00:27:15,669 --> 00:27:12,960
activities but also be useful in a whole

886
00:27:18,389 --> 00:27:15,679
new realm of of activities to um

887
00:27:20,389 --> 00:27:18,399
to track uh and learn from so we have

888
00:27:21,990 --> 00:27:20,399
billions of data points coming from our

889
00:27:23,990 --> 00:27:22,000
mobile devices the challenge is what do

890
00:27:24,950 --> 00:27:24,000
we do with this how do we make sense of

891
00:27:26,549 --> 00:27:24,960
all this information you want to be

892
00:27:29,190 --> 00:27:26,559
overwhelmed by 12 apps and 12 different

893
00:27:31,430 --> 00:27:29,200
devices so my favorite analogy would be

894
00:27:33,269 --> 00:27:31,440
the modern car your modern car today has

895
00:27:34,950 --> 00:27:33,279
300 sensors in it you don't care about

896
00:27:36,149 --> 00:27:34,960
any one sensor you care about when your

897
00:27:37,430 --> 00:27:36,159
check engine light comes on when your

898
00:27:38,950 --> 00:27:37,440
check engine glide comes on hopefully

899
00:27:41,750 --> 00:27:38,960
you do something about it just like when

900
00:27:43,510 --> 00:27:41,760
you have master warning switches on on

901
00:27:45,830 --> 00:27:43,520
shuttle or station you're able to make

902
00:27:47,430 --> 00:27:45,840
sense of those things in a proactive way

903
00:27:49,430 --> 00:27:47,440
so i think as we as we take this data

904
00:27:50,950 --> 00:27:49,440
into the future

905
00:27:52,310 --> 00:27:50,960
and this is what the streaming data

906
00:27:54,710 --> 00:27:52,320
looks like sorry for the technology

907
00:27:55,750 --> 00:27:54,720
issue here um this is what this data

908
00:27:57,510 --> 00:27:55,760
looks like streaming from that little

909
00:27:58,950 --> 00:27:57,520
patch and that can be done and probably

910
00:28:01,990 --> 00:27:58,960
flown tomorrow with the right right

911
00:28:03,830 --> 00:28:02,000
approvals we're going from wearables to

912
00:28:05,029 --> 00:28:03,840
uh insideables contact lenses that

913
00:28:06,310 --> 00:28:05,039
google has developed google's developed

914
00:28:07,990 --> 00:28:06,320
contact lenses that can track your blood

915
00:28:09,830 --> 00:28:08,000
sugar and they partner with big pharma

916
00:28:11,350 --> 00:28:09,840
to bring that to market there's pills

917
00:28:13,510 --> 00:28:11,360
you can swallow that replace an upper

918
00:28:15,669 --> 00:28:13,520
endoscopy so the way we can collect data

919
00:28:16,870 --> 00:28:15,679
is changing and there's thousands of

920
00:28:18,710 --> 00:28:16,880
these on the market now i encourage you

921
00:28:20,549 --> 00:28:18,720
just to try one that you don't ideally

922
00:28:22,549 --> 00:28:20,559
lose and start to gain insights about

923
00:28:23,830 --> 00:28:22,559
your activity or sleep that can really

924
00:28:24,710 --> 00:28:23,840
be one of the most proactive things you

925
00:28:27,029 --> 00:28:24,720
do

926
00:28:28,470 --> 00:28:27,039
that goes well beyond our blood our

927
00:28:31,350 --> 00:28:28,480
vital signs now our blood work we can

928
00:28:33,750 --> 00:28:31,360
now shrink a laboratory onto a chip this

929
00:28:35,350 --> 00:28:33,760
world of microfluidics a single drop of

930
00:28:37,190 --> 00:28:35,360
blood now can give you a hundred

931
00:28:39,269 --> 00:28:37,200
thousand biomarkers potentially and that

932
00:28:40,789 --> 00:28:39,279
can be done for pennies on the dollar we

933
00:28:43,110 --> 00:28:40,799
now have the ability to do what i often

934
00:28:44,310 --> 00:28:43,120
call a blood biopsy i'm an oncologist if

935
00:28:46,070 --> 00:28:44,320
we can get a biopsy of your blood

936
00:28:47,750 --> 00:28:46,080
instead of the tissue we can pick up

937
00:28:49,510 --> 00:28:47,760
disease early and treat it in smarter

938
00:28:50,630 --> 00:28:49,520
ways even simple things like a

939
00:28:51,830 --> 00:28:50,640
urinalysis you know the internal

940
00:28:53,510 --> 00:28:51,840
analysis strip you look at it that can

941
00:28:55,190 --> 00:28:53,520
be appaified here on the left you see a

942
00:28:56,630 --> 00:28:55,200
little dipstick with a qr code you dip

943
00:28:58,070 --> 00:28:56,640
it in the urine and you take a picture

944
00:29:00,230 --> 00:28:58,080
of your smartphone and it sends the data

945
00:29:02,149 --> 00:29:00,240
immediately up to your clinician uh to

946
00:29:03,750 --> 00:29:02,159
the cdc to the nsa whoever wants the

947
00:29:06,070 --> 00:29:03,760
data all right

948
00:29:07,350 --> 00:29:06,080
or it's flu season right flu season you

949
00:29:08,470 --> 00:29:07,360
spit in the tube and the line show up

950
00:29:10,549 --> 00:29:08,480
kind of like a pregnancy test you take a

951
00:29:12,149 --> 00:29:10,559
picture of the app it can diagnose your

952
00:29:14,630 --> 00:29:12,159
your respiratory infection whether it's

953
00:29:16,789 --> 00:29:14,640
influenza or maybe ebola and speaking of

954
00:29:18,310 --> 00:29:16,799
things like ebola we can even now print

955
00:29:20,389 --> 00:29:18,320
at the point of care lab tests which

956
00:29:22,149 --> 00:29:20,399
might be useful on long duration or on

957
00:29:23,750 --> 00:29:22,159
station you can print the lab test on

958
00:29:25,909 --> 00:29:23,760
demand in this case one developed by

959
00:29:27,909 --> 00:29:25,919
harvard to pick up ebola from saliva so

960
00:29:29,750 --> 00:29:27,919
lots of ways to get this data now and

961
00:29:32,470 --> 00:29:29,760
the implications are we can help stem

962
00:29:34,470 --> 00:29:32,480
pandemic disease by blending information

963
00:29:36,149 --> 00:29:34,480
we can essentially do what you've been

964
00:29:37,990 --> 00:29:36,159
doing in orbit for a long time a digital

965
00:29:39,990 --> 00:29:38,000
checkup you can pick up the vital sign

966
00:29:41,430 --> 00:29:40,000
information you can pick up the lab data

967
00:29:42,710 --> 00:29:41,440
you can communicate not with you know

968
00:29:44,070 --> 00:29:42,720
the flight doc but you're actually your

969
00:29:46,149 --> 00:29:44,080
own physician there's now a whole slew

970
00:29:48,310 --> 00:29:46,159
of apps you can download and do a

971
00:29:49,269 --> 00:29:48,320
telemedicine visit and so we're really

972
00:29:50,789 --> 00:29:49,279
going to enter an era where you're going

973
00:29:52,710 --> 00:29:50,799
to be able to connect in new empowering

974
00:29:55,510 --> 00:29:52,720
ways and bring smarter less expensive

975
00:29:57,190 --> 00:29:55,520
and more proactive healthcare

976
00:29:58,870 --> 00:29:57,200
and ideally remember technology is just

977
00:30:00,789 --> 00:29:58,880
an enabler i don't think we should we

978
00:30:02,310 --> 00:30:00,799
can't scale empathy this is all just to

979
00:30:03,990 --> 00:30:02,320
hopefully enable your own health and the

980
00:30:05,510 --> 00:30:04,000
patient doctor relationship and beyond

981
00:30:07,269 --> 00:30:05,520
ideally this technology gets out of the

982
00:30:08,789 --> 00:30:07,279
way and makes these things much more

983
00:30:11,029 --> 00:30:08,799
streamlined

984
00:30:12,870 --> 00:30:11,039
medical trials drug trials for example

985
00:30:14,549 --> 00:30:12,880
are still a big issue it takes a billion

986
00:30:16,389 --> 00:30:14,559
dollars 10 years

987
00:30:18,310 --> 00:30:16,399
half the drugs fail what if i could push

988
00:30:19,590 --> 00:30:18,320
you an app with an actual trial on it

989
00:30:21,110 --> 00:30:19,600
maybe it's for parkinson's and i could

990
00:30:23,990 --> 00:30:21,120
use one of these trackers to track the

991
00:30:25,669 --> 00:30:24,000
the shaking well ucsf one of my

992
00:30:27,909 --> 00:30:25,679
institutions has developed a platform

993
00:30:29,590 --> 00:30:27,919
for cardiac disease on a smartphone and

994
00:30:31,590 --> 00:30:29,600
then two months ago apple came out with

995
00:30:33,190 --> 00:30:31,600
research kit you today can go down on if

996
00:30:34,549 --> 00:30:33,200
you have an apple phone and download

997
00:30:36,789 --> 00:30:34,559
clinical trials for heart disease

998
00:30:38,149 --> 00:30:36,799
parkinson's asthma and be part of a

999
00:30:40,470 --> 00:30:38,159
clinical trial just by downloading that

1000
00:30:42,070 --> 00:30:40,480
on your smartphone new ways of engaging

1001
00:30:44,149 --> 00:30:42,080
and empowering and connecting clinical

1002
00:30:45,510 --> 00:30:44,159
trials this is my device this is the app

1003
00:30:47,430 --> 00:30:45,520
i downloaded for

1004
00:30:48,870 --> 00:30:47,440
for cardiac they signed up five thousand

1005
00:30:50,470 --> 00:30:48,880
patients in their very first day it

1006
00:30:52,470 --> 00:30:50,480
would have taken a year to do otherwise

1007
00:30:54,630 --> 00:30:52,480
and it almost was free so think about

1008
00:30:56,710 --> 00:30:54,640
the democratization there and just

1009
00:30:58,310 --> 00:30:56,720
briefly when we think about medicine and

1010
00:30:59,990 --> 00:30:58,320
therapy we're going to go beyond pills

1011
00:31:01,509 --> 00:31:00,000
we're now earning the real error of gene

1012
00:31:02,870 --> 00:31:01,519
therapy where we can start to actually

1013
00:31:04,470 --> 00:31:02,880
correct a gene

1014
00:31:06,389 --> 00:31:04,480
like for sickle cell or thalassemia and

1015
00:31:08,070 --> 00:31:06,399
have long-term cures so that's coming

1016
00:31:10,630 --> 00:31:08,080
into the clinic now and in five years

1017
00:31:12,230 --> 00:31:10,640
will be i think quite commonplace

1018
00:31:13,750 --> 00:31:12,240
so part of the lesson here as you start

1019
00:31:15,909 --> 00:31:13,760
to think exponentially and convergently

1020
00:31:17,750 --> 00:31:15,919
it's a layering of technologies that has

1021
00:31:19,350 --> 00:31:17,760
challenges the new pacemakers are

1022
00:31:21,430 --> 00:31:19,360
smaller easier to implant and they all

1023
00:31:22,870 --> 00:31:21,440
have ip addresses so what happens when

1024
00:31:25,029 --> 00:31:22,880
someone hacks your pacemaker or your

1025
00:31:26,470 --> 00:31:25,039
insulin pump or publishes your dna from

1026
00:31:28,230 --> 00:31:26,480
the cup that you had for lunch right

1027
00:31:29,909 --> 00:31:28,240
interesting implications there who owns

1028
00:31:31,110 --> 00:31:29,919
the data from our own bodies sometimes

1029
00:31:32,389 --> 00:31:31,120
the companies who make the devices don't

1030
00:31:34,549 --> 00:31:32,399
give that data away

1031
00:31:36,389 --> 00:31:34,559
so really interesting challenges there

1032
00:31:37,830 --> 00:31:36,399
one of the other challenges is there's

1033
00:31:39,590 --> 00:31:37,840
this massive amount of data how do we

1034
00:31:40,789 --> 00:31:39,600
make sense of it our brains haven't had

1035
00:31:42,950 --> 00:31:40,799
an upgrade but our technology and our

1036
00:31:44,549 --> 00:31:42,960
spacecraft getting up kept upgraded so

1037
00:31:46,230 --> 00:31:44,559
we need new tools to improve our

1038
00:31:49,190 --> 00:31:46,240
cognition and our ability to make sense

1039
00:31:50,950 --> 00:31:49,200
of this and that is already here ai

1040
00:31:52,710 --> 00:31:50,960
artificial intelligence some of you

1041
00:31:53,990 --> 00:31:52,720
might remember ibm watson beating the

1042
00:31:55,590 --> 00:31:54,000
champions of jeopardy and just beat them

1043
00:31:57,590 --> 00:31:55,600
and really beat them that was three

1044
00:31:59,269 --> 00:31:57,600
years ago ibm watson has now gone to

1045
00:32:01,029 --> 00:31:59,279
medical school and that threatened some

1046
00:32:02,630 --> 00:32:01,039
doctors oh yeah a robot ai is going to

1047
00:32:06,389 --> 00:32:02,640
take over so i like to reframe it not as

1048
00:32:07,750 --> 00:32:06,399
ai but as i a intelligence augmentation

1049
00:32:08,950 --> 00:32:07,760
and that is going to infuse everything

1050
00:32:10,630 --> 00:32:08,960
we do from

1051
00:32:12,789 --> 00:32:10,640
complex missions to how we staff a

1052
00:32:14,389 --> 00:32:12,799
hospital how we do diagnostics how we

1053
00:32:15,909 --> 00:32:14,399
pick the right therapy and we can

1054
00:32:17,190 --> 00:32:15,919
connect to watson now through our mobile

1055
00:32:19,190 --> 00:32:17,200
devices so soon you're going to have

1056
00:32:21,430 --> 00:32:19,200
like siri blended with watson on your

1057
00:32:22,950 --> 00:32:21,440
smartphone in fact ibm apple and

1058
00:32:23,830 --> 00:32:22,960
medtronic announced a partnership last

1059
00:32:25,990 --> 00:32:23,840
week where they're going to blend these

1060
00:32:27,269 --> 00:32:26,000
together so it's a really powerful time

1061
00:32:28,710 --> 00:32:27,279
and the lessons from ai i think

1062
00:32:30,870 --> 00:32:28,720
certainly apply to all the complex

1063
00:32:32,310 --> 00:32:30,880
missions that you guys build so here's

1064
00:32:34,070 --> 00:32:32,320
that check engine light idea i think

1065
00:32:35,669 --> 00:32:34,080
kind of like the ge cars have the onstar

1066
00:32:37,110 --> 00:32:35,679
for the body i think we're gonna have

1067
00:32:39,029 --> 00:32:37,120
our own check engine lights our own sort

1068
00:32:41,509 --> 00:32:39,039
of onstar that can help let us know when

1069
00:32:42,630 --> 00:32:41,519
to be proactive and be connected

1070
00:32:44,230 --> 00:32:42,640
so where does this come together a lot

1071
00:32:46,230 --> 00:32:44,240
of it's been inspired by the space world

1072
00:32:47,830 --> 00:32:46,240
and some truckies here i'm sure right

1073
00:32:49,509 --> 00:32:47,840
remember the bones mccoy with the

1074
00:32:51,110 --> 00:32:49,519
tricorder that used to be science

1075
00:32:52,470 --> 00:32:51,120
friction but now they're 100 000

1076
00:32:54,870 --> 00:32:52,480
ultrasounds that fit in your pocket and

1077
00:32:56,230 --> 00:32:54,880
do the same thing right we've seen now

1078
00:32:57,990 --> 00:32:56,240
i'm sure not many of you know the x

1079
00:32:59,990 --> 00:32:58,000
prize peter diamandis co-founded that

1080
00:33:01,830 --> 00:33:00,000
that sent spaceship one up to space

1081
00:33:03,509 --> 00:33:01,840
about 10 11 years ago there's now an x

1082
00:33:05,269 --> 00:33:03,519
prize i've been helping it with called a

1083
00:33:07,110 --> 00:33:05,279
medical tricorder x prize a 10 million

1084
00:33:09,509 --> 00:33:07,120
dollar prize to bring folks together to

1085
00:33:10,950 --> 00:33:09,519
build an actual medical tricorder and

1086
00:33:12,549 --> 00:33:10,960
one of the teams started at singularity

1087
00:33:14,070 --> 00:33:12,559
university this is actually it right

1088
00:33:15,669 --> 00:33:14,080
here this is a device you hold it to

1089
00:33:16,870 --> 00:33:15,679
your forehead as the patient at home and

1090
00:33:18,230 --> 00:33:16,880
it collects your heart rate your

1091
00:33:20,070 --> 00:33:18,240
temperature oxygen saturation your blood

1092
00:33:21,430 --> 00:33:20,080
pressure it calculates it it understands

1093
00:33:23,350 --> 00:33:21,440
your baseline it'll communicate that to

1094
00:33:25,509 --> 00:33:23,360
your clinician and what's interesting

1095
00:33:28,230 --> 00:33:25,519
about this is they crowdfunded this like

1096
00:33:29,590 --> 00:33:28,240
1.6 million dollars and 10 10 000 of

1097
00:33:31,350 --> 00:33:29,600
these shipped in the last month or so as

1098
00:33:32,310 --> 00:33:31,360
part of the trial so in a year or two i

1099
00:33:33,830 --> 00:33:32,320
expect you'll have something like this

1100
00:33:35,669 --> 00:33:33,840
in your own home which will help you

1101
00:33:37,430 --> 00:33:35,679
track your information and this has

1102
00:33:39,430 --> 00:33:37,440
design thinking built in i introduced

1103
00:33:41,269 --> 00:33:39,440
this company to ideo and we made this

1104
00:33:43,110 --> 00:33:41,279
little movie of the near future of all

1105
00:33:48,310 --> 00:33:43,120
these technologies coming together take

1106
00:33:53,509 --> 00:33:50,549
technology has given us an unprecedented

1107
00:33:55,990 --> 00:33:53,519
window into the human body

1108
00:33:59,830 --> 00:33:56,000
but on a day-to-day basis we're still in

1109
00:33:59,840 --> 00:34:03,269
we are changing that

1110
00:34:06,149 --> 00:34:04,870
what if instead of fearing the worst

1111
00:34:08,149 --> 00:34:06,159
when you noticed something out of the

1112
00:34:12,310 --> 00:34:08,159
ordinary you could identify the

1113
00:34:16,629 --> 00:34:14,149
getting the right diagnosis would save

1114
00:34:19,349 --> 00:34:16,639
you worry says it's roseola

1115
00:34:22,069 --> 00:34:19,359
and an unnecessary doctor's visit

1116
00:34:23,669 --> 00:34:22,079
rest at home it's okay

1117
00:34:26,069 --> 00:34:23,679
instead of hearing about a viral

1118
00:34:27,829 --> 00:34:26,079
outbreak on the news imagine you got an

1119
00:34:32,550 --> 00:34:27,839
alert

1120
00:34:38,710 --> 00:34:34,389
it would also give you advice about what

1121
00:34:43,190 --> 00:34:40,470
what if you had a way to identify what

1122
00:34:45,829 --> 00:34:43,200
was wrong right away

1123
00:34:47,589 --> 00:34:45,839
it says it's 103.8 a way to get all of

1124
00:34:56,230 --> 00:34:47,599
the information you need to understand

1125
00:34:59,589 --> 00:34:57,990
and in serious cases

1126
00:35:06,630 --> 00:34:59,599
you would know when and where to seek

1127
00:35:10,230 --> 00:35:08,470
we're building a way for people to check

1128
00:35:12,550 --> 00:35:10,240
their bodies as often as they check

1129
00:35:14,310 --> 00:35:12,560
their email

1130
00:35:16,950 --> 00:35:14,320
it's all possible

1131
00:35:18,550 --> 00:35:16,960
and it's only the beginning

1132
00:35:20,150 --> 00:35:18,560
but this technology is coming those you

1133
00:35:21,750 --> 00:35:20,160
like to measure your data and in fact

1134
00:35:23,190 --> 00:35:21,760
again they funded this they crowdfunded

1135
00:35:25,750 --> 00:35:23,200
the clinical trial for this so new ways

1136
00:35:27,510 --> 00:35:25,760
of funding innovation are here as well

1137
00:35:28,630 --> 00:35:27,520
and that means we're all not just silos

1138
00:35:29,990 --> 00:35:28,640
we're not individuals we're all part of

1139
00:35:32,390 --> 00:35:30,000
a connected system whether you're part

1140
00:35:34,550 --> 00:35:32,400
of a crew or a family or a community our

1141
00:35:36,150 --> 00:35:34,560
social networks play a huge role in our

1142
00:35:37,829 --> 00:35:36,160
health whether it's depression or

1143
00:35:39,349 --> 00:35:37,839
obesity and we're learning that our

1144
00:35:41,589 --> 00:35:39,359
behaviors are much more impactful than

1145
00:35:43,109 --> 00:35:41,599
our baseline genetics if we can moderate

1146
00:35:45,109 --> 00:35:43,119
our behaviors we can have a huge impact

1147
00:35:46,550 --> 00:35:45,119
on our costs of care for example and

1148
00:35:47,829 --> 00:35:46,560
there are new ways to do that if you're

1149
00:35:48,870 --> 00:35:47,839
pre-diabetic and you're discovering

1150
00:35:50,390 --> 00:35:48,880
you're about to become a diabetic and

1151
00:35:52,150 --> 00:35:50,400
have a lot of costly and expensive

1152
00:35:54,069 --> 00:35:52,160
medical issues you can now download an

1153
00:35:55,430 --> 00:35:54,079
app called armada health and be part of

1154
00:35:56,710 --> 00:35:55,440
a social network and learn to turn

1155
00:35:58,630 --> 00:35:56,720
around pre-diabetes so you're not

1156
00:36:00,390 --> 00:35:58,640
diabetic anymore that's a new way of

1157
00:36:01,910 --> 00:36:00,400
prescribing behavior change or what if

1158
00:36:03,910 --> 00:36:01,920
you could see future you you look in the

1159
00:36:05,109 --> 00:36:03,920
mirror and you see future you right

1160
00:36:07,349 --> 00:36:05,119
that's going to inspire some folks that

1161
00:36:09,430 --> 00:36:07,359
we might re write your brain or if you

1162
00:36:11,589 --> 00:36:09,440
keep having donuts for breakfast future

1163
00:36:12,790 --> 00:36:11,599
you right that might inspire you and you

1164
00:36:14,069 --> 00:36:12,800
don't need to wait for the magic mirror

1165
00:36:15,270 --> 00:36:14,079
you can download an app here's me now

1166
00:36:17,109 --> 00:36:15,280
here's me a thousand donuts later

1167
00:36:19,670 --> 00:36:17,119
featuring me you know so i vote the

1168
00:36:20,870 --> 00:36:19,680
donut or if you have a kid or a patient

1169
00:36:22,310 --> 00:36:20,880
who smokes two packs a day you can show

1170
00:36:23,910 --> 00:36:22,320
them what their skin's gonna look like

1171
00:36:24,710 --> 00:36:23,920
that might change your perceptions or if

1172
00:36:26,069 --> 00:36:24,720
you're spending too much time on

1173
00:36:28,150 --> 00:36:26,079
facebook you know lots of ways to see

1174
00:36:29,990 --> 00:36:28,160
the future

1175
00:36:31,510 --> 00:36:30,000
including now this amazing world of

1176
00:36:32,630 --> 00:36:31,520
augmented reality you know many of the

1177
00:36:34,710 --> 00:36:32,640
astronauts are training with augmented

1178
00:36:36,390 --> 00:36:34,720
reality that's a three that company was

1179
00:36:37,910 --> 00:36:36,400
acquired for three billion dollars and

1180
00:36:38,870 --> 00:36:37,920
google said hi we can build one of those

1181
00:36:40,150 --> 00:36:38,880
for ten dollars this is the cardboard

1182
00:36:41,750 --> 00:36:40,160
cardboard-based version you slot your

1183
00:36:43,030 --> 00:36:41,760
smartphone and you're in a virtual world

1184
00:36:44,310 --> 00:36:43,040
that can do everything from from

1185
00:36:46,150 --> 00:36:44,320
training on missions and maintaining

1186
00:36:48,390 --> 00:36:46,160
currency on space flight to learning

1187
00:36:49,349 --> 00:36:48,400
anatomy to treating ptsd to being all

1188
00:36:50,950 --> 00:36:49,359
sorts of new environments we're gonna

1189
00:36:53,349 --> 00:36:50,960
see a lot happen with augmented and

1190
00:36:54,710 --> 00:36:53,359
virtual reality especially in healthcare

1191
00:36:56,470 --> 00:36:54,720
and especially as you want situational

1192
00:36:58,230 --> 00:36:56,480
awareness if you're a pilot a physician

1193
00:37:00,230 --> 00:36:58,240
a surgeon or a patient think about how

1194
00:37:02,230 --> 00:37:00,240
that's going to integrate in your lives

1195
00:37:03,589 --> 00:37:02,240
and we can be telepresent as well not

1196
00:37:04,710 --> 00:37:03,599
just with wearables but telepresent

1197
00:37:06,950 --> 00:37:04,720
robotics we can already round in

1198
00:37:08,790 --> 00:37:06,960
hospitals with special robots i was

1199
00:37:09,750 --> 00:37:08,800
actually on a panel meet dr droid i

1200
00:37:11,510 --> 00:37:09,760
couldn't be there in person so i showed

1201
00:37:13,270 --> 00:37:11,520
up on the left in the panel on the robot

1202
00:37:15,109 --> 00:37:13,280
new ways to be telepresently

1203
00:37:16,550 --> 00:37:15,119
localized you guys do all that already

1204
00:37:18,950 --> 00:37:16,560
in orbit but that's going to change

1205
00:37:21,670 --> 00:37:18,960
health care we have robots delivering

1206
00:37:23,910 --> 00:37:21,680
labs and x-rays in hospitals we have

1207
00:37:25,910 --> 00:37:23,920
robots enabling the disabled one of the

1208
00:37:27,270 --> 00:37:25,920
most exciting areas now is

1209
00:37:29,270 --> 00:37:27,280
enabling the disabled with things like

1210
00:37:31,190 --> 00:37:29,280
brain computer interface this is my alma

1211
00:37:32,630 --> 00:37:31,200
mater brown university's work a small

1212
00:37:34,150 --> 00:37:32,640
chip on the motor cortex of a woman

1213
00:37:36,310 --> 00:37:34,160
who's quadriplegic can't move from the

1214
00:37:38,630 --> 00:37:36,320
neck down just enables her now to think

1215
00:37:40,390 --> 00:37:38,640
and she's able now to control a drink of

1216
00:37:42,069 --> 00:37:40,400
give herself her first coffee in 16

1217
00:37:43,829 --> 00:37:42,079
years that's transformative and we're

1218
00:37:45,750 --> 00:37:43,839
going to see brain computer interface

1219
00:37:47,510 --> 00:37:45,760
completely change how the disabled get

1220
00:37:49,270 --> 00:37:47,520
around and also enable us super enable

1221
00:37:50,710 --> 00:37:49,280
us maybe the folks uh you know when

1222
00:37:51,670 --> 00:37:50,720
they're on mars will have a chip on

1223
00:37:53,430 --> 00:37:51,680
their brain which enables them to

1224
00:37:55,510 --> 00:37:53,440
control things this is coming

1225
00:37:58,390 --> 00:37:55,520
and this also blends with health and

1226
00:37:59,829 --> 00:37:58,400
prevention yoga meditation ancient

1227
00:38:01,430 --> 00:37:59,839
practices can be

1228
00:38:03,589 --> 00:38:01,440
really good for you what if we can now

1229
00:38:05,430 --> 00:38:03,599
use brain computer interface to track

1230
00:38:07,670 --> 00:38:05,440
that for yourself well you don't need to

1231
00:38:10,150 --> 00:38:07,680
have a a version like that you can now

1232
00:38:11,910 --> 00:38:10,160
buy one for 200 wear this headset it can

1233
00:38:13,829 --> 00:38:11,920
track your brain waves here's my mind

1234
00:38:15,589 --> 00:38:13,839
being calm for a few minutes actually we

1235
00:38:16,950 --> 00:38:15,599
can prescribe meditation or mindfulness

1236
00:38:18,470 --> 00:38:16,960
that can lower depression or anxiety

1237
00:38:19,990 --> 00:38:18,480
might be useful on long-duration

1238
00:38:21,190 --> 00:38:20,000
missions all sorts of ways you might

1239
00:38:23,030 --> 00:38:21,200
think about using these in your daily

1240
00:38:24,470 --> 00:38:23,040
life it's even being used to train kids

1241
00:38:26,069 --> 00:38:24,480
who have attention attention deficit

1242
00:38:27,990 --> 00:38:26,079
disorder to get focused they learn to

1243
00:38:29,190 --> 00:38:28,000
focus with headset and when they're done

1244
00:38:30,829 --> 00:38:29,200
they don't need they get off of their

1245
00:38:32,870 --> 00:38:30,839
riddle and other

1246
00:38:35,349 --> 00:38:32,880
medications we're even learning to use

1247
00:38:36,790 --> 00:38:35,359
video games for good changing your main

1248
00:38:38,710 --> 00:38:36,800
your wiring of your brain using gaming

1249
00:38:41,109 --> 00:38:38,720
and headsets are going to be shown to be

1250
00:38:43,030 --> 00:38:41,119
very beneficial in many modalities

1251
00:38:44,390 --> 00:38:43,040
all right wearable robotics something

1252
00:38:45,750 --> 00:38:44,400
and robotics has been used in the space

1253
00:38:47,589 --> 00:38:45,760
program for years but now it's coming to

1254
00:38:49,990 --> 00:38:47,599
the disabled to enable someone who's

1255
00:38:51,190 --> 00:38:50,000
paralyzed uh to walk in this case you

1256
00:38:53,510 --> 00:38:51,200
have a woman who's wearing an

1257
00:38:54,710 --> 00:38:53,520
exoskeleton and she's able to walk and

1258
00:38:56,870 --> 00:38:54,720
what's really interesting about that is

1259
00:38:59,109 --> 00:38:56,880
part of that is 3d printed to match her

1260
00:39:00,790 --> 00:38:59,119
own personalized anatomy so we're going

1261
00:39:02,710 --> 00:39:00,800
to see a lot of changes

1262
00:39:04,470 --> 00:39:02,720
not just in treating spinal cord injury

1263
00:39:05,750 --> 00:39:04,480
with robots what about curing it my

1264
00:39:07,349 --> 00:39:05,760
field of stem cells and regenerative

1265
00:39:09,750 --> 00:39:07,359
medicine the gentleman on my left there

1266
00:39:11,430 --> 00:39:09,760
won the nobel prize two years ago for

1267
00:39:13,030 --> 00:39:11,440
now we can take a skin cell and

1268
00:39:14,790 --> 00:39:13,040
reprogram that to be your own

1269
00:39:16,390 --> 00:39:14,800
pluripotent stem cell

1270
00:39:17,990 --> 00:39:16,400
and we're blending stem cell biology

1271
00:39:19,750 --> 00:39:18,000
with the world of 3d printing something

1272
00:39:21,030 --> 00:39:19,760
many of you work with all the time but

1273
00:39:22,870 --> 00:39:21,040
3d printing is actually starting to

1274
00:39:24,630 --> 00:39:22,880
impact healthcare in powerful ways from

1275
00:39:26,310 --> 00:39:24,640
neurosurgical devices to making a

1276
00:39:28,790 --> 00:39:26,320
prosthetic limb that matches the missing

1277
00:39:30,310 --> 00:39:28,800
leg to making braces and crutches that

1278
00:39:32,470 --> 00:39:30,320
might match your own arm here i have a

1279
00:39:34,150 --> 00:39:32,480
little 3d printed uh brace for my hand

1280
00:39:35,430 --> 00:39:34,160
for example that can be printed out at

1281
00:39:37,109 --> 00:39:35,440
the point of care

1282
00:39:39,190 --> 00:39:37,119
we're seeing those for scoliosis we're

1283
00:39:40,630 --> 00:39:39,200
seeing them make new knee and hip

1284
00:39:42,790 --> 00:39:40,640
implants that completely match the

1285
00:39:44,310 --> 00:39:42,800
patient's anatomy we can see them being

1286
00:39:45,349 --> 00:39:44,320
used for surgical planning and actual

1287
00:39:46,390 --> 00:39:45,359
surgeries

1288
00:39:47,829 --> 00:39:46,400
and you can even take something like a

1289
00:39:49,030 --> 00:39:47,839
microsoft connect and print yourself

1290
00:39:51,270 --> 00:39:49,040
i've got many of me in my pocket he's

1291
00:39:52,550 --> 00:39:51,280
kind of cute and small doesn't eat much

1292
00:39:53,829 --> 00:39:52,560
but what if i have a patient who's lost

1293
00:39:55,589 --> 00:39:53,839
part of his face from cancer we can make

1294
00:39:56,950 --> 00:39:55,599
a prosthetic that matches so really

1295
00:39:58,550 --> 00:39:56,960
powerful ways of moving there and i was

1296
00:39:59,670 --> 00:39:58,560
just at the ted conference and they

1297
00:40:01,510 --> 00:39:59,680
announced their

1298
00:40:03,270 --> 00:40:01,520
motive doing that a thousand a hundred a

1299
00:40:04,950 --> 00:40:03,280
thousand times faster in terms of

1300
00:40:07,109 --> 00:40:04,960
printing actual objects so watch that

1301
00:40:08,710 --> 00:40:07,119
space we'll be on station or on mars and

1302
00:40:09,910 --> 00:40:08,720
able to press a button and really print

1303
00:40:11,670 --> 00:40:09,920
something within minutes this is a bit

1304
00:40:13,750 --> 00:40:11,680
of a spit up version but this is coming

1305
00:40:16,069 --> 00:40:13,760
uh really quickly and is disrupting even

1306
00:40:17,109 --> 00:40:16,079
the 3d printing industry itself

1307
00:40:18,309 --> 00:40:17,119
all right

1308
00:40:20,069 --> 00:40:18,319
and what we're going to blend 3d

1309
00:40:21,829 --> 00:40:20,079
printing with tissue biology whether

1310
00:40:23,589 --> 00:40:21,839
it's the early days of making tracheas

1311
00:40:25,270 --> 00:40:23,599
and bladders all the way to making more

1312
00:40:26,470 --> 00:40:25,280
complex organs like kidneys livers and

1313
00:40:28,069 --> 00:40:26,480
hearts which are in the early stages

1314
00:40:29,430 --> 00:40:28,079
today but might be in the clinic within

1315
00:40:31,510 --> 00:40:29,440
10 years

1316
00:40:33,750 --> 00:40:31,520
so why am i talking to you as a

1317
00:40:35,990 --> 00:40:33,760
as a former nasa jsc medical student and

1318
00:40:37,190 --> 00:40:36,000
hemoglobin transplant doctor well i've

1319
00:40:39,030 --> 00:40:37,200
been sharing the medicine track at

1320
00:40:41,589 --> 00:40:39,040
singularity university since it started

1321
00:40:43,430 --> 00:40:41,599
in 2009 we bring amazing folks together

1322
00:40:45,589 --> 00:40:43,440
to cross-train in medicine biotech

1323
00:40:47,270 --> 00:40:45,599
robotics ai 3d printing space and beyond

1324
00:40:48,630 --> 00:40:47,280
co-founded by peter dumanis from xprize

1325
00:40:50,230 --> 00:40:48,640
and ray kurzweil who's now the director

1326
00:40:51,589 --> 00:40:50,240
of engineering at google our head of

1327
00:40:53,190 --> 00:40:51,599
faculty for the first few years was

1328
00:40:55,349 --> 00:40:53,200
astronaut physician dan barry who some

1329
00:40:57,510 --> 00:40:55,359
of you might remember uh great guys

1330
00:40:58,630 --> 00:40:57,520
still involved in our faculty and we we

1331
00:41:00,069 --> 00:40:58,640
start to ask the question how do you

1332
00:41:02,150 --> 00:41:00,079
take these technologies to address grand

1333
00:41:04,390 --> 00:41:02,160
challenges in in space exploration

1334
00:41:06,150 --> 00:41:04,400
energy poverty global health and we've

1335
00:41:07,589 --> 00:41:06,160
had some amazing innovations come from

1336
00:41:09,430 --> 00:41:07,599
using drones to deliver drugs and

1337
00:41:10,950 --> 00:41:09,440
vaccines already now doing this uh

1338
00:41:12,230 --> 00:41:10,960
piloting this in the developing world

1339
00:41:13,670 --> 00:41:12,240
and speaking of drones you can have one

1340
00:41:14,950 --> 00:41:13,680
in your pocket now right there are

1341
00:41:17,030 --> 00:41:14,960
drones that are being delivering

1342
00:41:18,069 --> 00:41:17,040
defibrillators even in san francisco

1343
00:41:19,829 --> 00:41:18,079
there's a company that wants to deliver

1344
00:41:20,950 --> 00:41:19,839
your drugs by drone not sure what kind

1345
00:41:23,589 --> 00:41:20,960
of drugs in san francisco but they're

1346
00:41:24,870 --> 00:41:23,599
delivered by drone drones in your pocket

1347
00:41:26,630 --> 00:41:24,880
so lots is happening there from

1348
00:41:27,589 --> 00:41:26,640
telepresent gloves and beyond and

1349
00:41:29,430 --> 00:41:27,599
because

1350
00:41:30,870 --> 00:41:29,440
3d printing is interesting one of our

1351
00:41:32,950 --> 00:41:30,880
student teams one of our student teams

1352
00:41:35,030 --> 00:41:32,960
from three years ago flew with you guys

1353
00:41:37,109 --> 00:41:35,040
made in space just this fall the first

1354
00:41:38,950 --> 00:41:37,119
3d printer went to space station and i

1355
00:41:40,390 --> 00:41:38,960
think that has amazing implications

1356
00:41:42,069 --> 00:41:40,400
including one of our other colleagues

1357
00:41:43,270 --> 00:41:42,079
was the first to 3d print on the ground

1358
00:41:44,790 --> 00:41:43,280
medical instruments so what do you have

1359
00:41:47,030 --> 00:41:44,800
a medical case on station or beyond and

1360
00:41:48,550 --> 00:41:47,040
you can print devices medical devices on

1361
00:41:49,670 --> 00:41:48,560
demand i think that's coming and that's

1362
00:41:51,109 --> 00:41:49,680
something that came out of singularity

1363
00:41:52,630 --> 00:41:51,119
university

1364
00:41:53,910 --> 00:41:52,640
so because so many folks were interested

1365
00:41:55,829 --> 00:41:53,920
in health care and the blending of

1366
00:41:57,349 --> 00:41:55,839
technologies i put together a program

1367
00:41:59,109 --> 00:41:57,359
called exponential medicine we have it

1368
00:42:00,829 --> 00:41:59,119
every fall now it's at the hotel del

1369
00:42:02,390 --> 00:42:00,839
coronado please come join us

1370
00:42:04,550 --> 00:42:02,400
exponentialmedicine.com is the website

1371
00:42:05,990 --> 00:42:04,560
and it's that thinking now of different

1372
00:42:08,069 --> 00:42:06,000
technologies thinking exponentially

1373
00:42:09,670 --> 00:42:08,079
thinking convergently it helps bring us

1374
00:42:11,190 --> 00:42:09,680
to this future right and it's new

1375
00:42:13,510 --> 00:42:11,200
thinking it's not just

1376
00:42:14,950 --> 00:42:13,520
docs and drug device people it's

1377
00:42:16,550 --> 00:42:14,960
robotics folks all you folks have

1378
00:42:18,309 --> 00:42:16,560
amazing skills that might be applied to

1379
00:42:19,670 --> 00:42:18,319
spaceflight but also apply to healthcare

1380
00:42:22,309 --> 00:42:19,680
so i encourage you to get involved in

1381
00:42:23,910 --> 00:42:22,319
hackathons and startup incubators and

1382
00:42:25,430 --> 00:42:23,920
bring folks here from other worlds to

1383
00:42:26,390 --> 00:42:25,440
help you innovate the future space

1384
00:42:28,390 --> 00:42:26,400
flight

1385
00:42:30,069 --> 00:42:28,400
even designers play a role right design

1386
00:42:32,150 --> 00:42:30,079
thinking can infuse everything from how

1387
00:42:33,990 --> 00:42:32,160
you design a cane to the future of a

1388
00:42:36,230 --> 00:42:34,000
hospital room to the future of a crew

1389
00:42:37,190 --> 00:42:36,240
cabin all that requires new integrative

1390
00:42:38,790 --> 00:42:37,200
thinking

1391
00:42:41,510 --> 00:42:38,800
and since i've been a pilot since since

1392
00:42:42,870 --> 00:42:41,520
college i love the idea of lessons from

1393
00:42:43,910 --> 00:42:42,880
aviation and space flight applied to

1394
00:42:44,870 --> 00:42:43,920
health healthcare because you know if

1395
00:42:45,910 --> 00:42:44,880
you fly in virgin america it's a

1396
00:42:47,589 --> 00:42:45,920
different experience than others that's

1397
00:42:48,710 --> 00:42:47,599
the design of the whole flight

1398
00:42:50,550 --> 00:42:48,720
experience

1399
00:42:53,829 --> 00:42:50,560
and um thanks to one of the former

1400
00:42:55,190 --> 00:42:53,839
flight surgeons here uh oh gosh

1401
00:42:57,670 --> 00:42:55,200
pat mcgenis i joined the air national

1402
00:42:59,430 --> 00:42:57,680
guard as a flight surgeon

1403
00:43:01,910 --> 00:42:59,440
when i was a resident at mass general

1404
00:43:03,750 --> 00:43:01,920
and what i learned there is technology

1405
00:43:05,270 --> 00:43:03,760
sometimes fails us

1406
00:43:07,990 --> 00:43:05,280
but

1407
00:43:11,270 --> 00:43:08,000
flight surgeon i've had some amazing

1408
00:43:13,109 --> 00:43:11,280
experiences flying into f-16s and f-15s

1409
00:43:15,270 --> 00:43:13,119
and the lessons from there uh are

1410
00:43:16,550 --> 00:43:15,280
powerful right many of you uh developed

1411
00:43:18,950 --> 00:43:16,560
them yourself here's some fun flying

1412
00:43:20,710 --> 00:43:18,960
photos but lessons from aviation and

1413
00:43:22,150 --> 00:43:20,720
medicine so one of them that you all use

1414
00:43:24,150 --> 00:43:22,160
every day are checklists checklists have

1415
00:43:25,349 --> 00:43:24,160
now transformed the operating room we

1416
00:43:28,069 --> 00:43:25,359
don't cut off the wrong leg which has

1417
00:43:30,390 --> 00:43:28,079
happened right um and uh whether the

1418
00:43:32,309 --> 00:43:30,400
checklist on shuttle or checklist for a

1419
00:43:33,910 --> 00:43:32,319
patient this is changing the way we do

1420
00:43:35,670 --> 00:43:33,920
healthcare and those checklists can now

1421
00:43:36,870 --> 00:43:35,680
be personalized and tuned to the

1422
00:43:38,550 --> 00:43:36,880
individual to you you can have your own

1423
00:43:39,990 --> 00:43:38,560
personal checklist we're seeing lessons

1424
00:43:42,069 --> 00:43:40,000
from simulation something you guys do

1425
00:43:43,589 --> 00:43:42,079
really well has made space flight safer

1426
00:43:45,670 --> 00:43:43,599
is now coming to the operating room and

1427
00:43:48,069 --> 00:43:45,680
every medical student now trains on uh

1428
00:43:50,309 --> 00:43:48,079
not cadavers but on on simulation this

1429
00:43:51,750 --> 00:43:50,319
is the sim center at stanford here we go

1430
00:43:53,109 --> 00:43:51,760
and now we bring teams together just

1431
00:43:54,950 --> 00:43:53,119
like you bring crews together to train

1432
00:43:56,950 --> 00:43:54,960
on procedures and dramatically improves

1433
00:43:58,150 --> 00:43:56,960
outcomes we can even simulate organs on

1434
00:43:59,430 --> 00:43:58,160
chips

1435
00:44:01,750 --> 00:43:59,440
a couple last lessons i've got two

1436
00:44:04,470 --> 00:44:01,760
minutes left is heads up display how do

1437
00:44:06,150 --> 00:44:04,480
we see data differently you know the old

1438
00:44:07,910 --> 00:44:06,160
round dials now we're in the glass

1439
00:44:09,750 --> 00:44:07,920
cockpit era that gives the pilot and the

1440
00:44:11,270 --> 00:44:09,760
crew situational awareness how do we

1441
00:44:13,270 --> 00:44:11,280
bring situational awareness to the

1442
00:44:14,630 --> 00:44:13,280
intensive care unit lockheed martin the

1443
00:44:16,309 --> 00:44:14,640
fighter pilot company

1444
00:44:18,309 --> 00:44:16,319
is working with hopkins to make the new

1445
00:44:20,230 --> 00:44:18,319
intensive care unit how do we think take

1446
00:44:22,230 --> 00:44:20,240
the heads up display of the of the

1447
00:44:24,230 --> 00:44:22,240
flying world and bring it down and how

1448
00:44:25,510 --> 00:44:24,240
do we bring the other clues like like

1449
00:44:26,390 --> 00:44:25,520
bitching bob or bitching betty tells you

1450
00:44:27,750 --> 00:44:26,400
to pull up and you're about to hit a

1451
00:44:29,670 --> 00:44:27,760
mountain

1452
00:44:31,030 --> 00:44:29,680
right outside we bring that sensibility

1453
00:44:32,390 --> 00:44:31,040
to our health care because we need

1454
00:44:34,630 --> 00:44:32,400
different data if we're landing in bad

1455
00:44:35,910 --> 00:44:34,640
weather or we're in a dog fight

1456
00:44:37,190 --> 00:44:35,920
and we have dashboards already that

1457
00:44:39,430 --> 00:44:37,200
influence our behavior in some of our

1458
00:44:41,670 --> 00:44:39,440
cars we can drive to hit the right speed

1459
00:44:43,990 --> 00:44:41,680
uh an element and we want our own

1460
00:44:46,069 --> 00:44:44,000
personal gps to be like daniel go right

1461
00:44:47,109 --> 00:44:46,079
to the gym not let the mcdonald's all

1462
00:44:48,309 --> 00:44:47,119
right that's going to come you can have

1463
00:44:50,069 --> 00:44:48,319
a gps that's going to help guide you

1464
00:44:51,910 --> 00:44:50,079
through your your life based on your own

1465
00:44:53,349 --> 00:44:51,920
information not too much data starbucks

1466
00:44:55,109 --> 00:44:53,359
squirrels be a little overwhelmed you

1467
00:44:56,870 --> 00:44:55,119
need to tune that to the individual as

1468
00:44:57,750 --> 00:44:56,880
we go

1469
00:44:59,589 --> 00:44:57,760
and we're going to see the world

1470
00:45:01,910 --> 00:44:59,599
differently we're already in the era of

1471
00:45:03,430 --> 00:45:01,920
basically bionic eyes

1472
00:45:05,030 --> 00:45:03,440
but even those who are lucky what those

1473
00:45:06,470 --> 00:45:05,040
of us are lucky to see normally we're

1474
00:45:07,750 --> 00:45:06,480
going to see augmented vision contact

1475
00:45:10,150 --> 00:45:07,760
lenses that can bring the internet to

1476
00:45:11,829 --> 00:45:10,160
our eyeball which also has a dark side

1477
00:45:12,710 --> 00:45:11,839
some interesting applications here's a

1478
00:45:13,990 --> 00:45:12,720
vision of the future you have your

1479
00:45:15,510 --> 00:45:14,000
contact lens on and you're on a tough

1480
00:45:20,470 --> 00:45:15,520
date you so you bring up some little

1481
00:45:22,390 --> 00:45:21,589
you can figure out what that does so

1482
00:45:24,550 --> 00:45:22,400
there's a dark side of these

1483
00:45:25,750 --> 00:45:24,560
technologies but these sorts of ways of

1484
00:45:27,190 --> 00:45:25,760
seeing the world differently are already

1485
00:45:29,190 --> 00:45:27,200
transforming healthcare google glass has

1486
00:45:30,550 --> 00:45:29,200
had a bit of a bad rap but one of its

1487
00:45:32,390 --> 00:45:30,560
best applications and this is still like

1488
00:45:34,150 --> 00:45:32,400
a version 1.0 remember

1489
00:45:35,589 --> 00:45:34,160
is in healthcare so your doctor can know

1490
00:45:37,190 --> 00:45:35,599
you and some more information about you

1491
00:45:38,150 --> 00:45:37,200
when they see them or the surgeon can

1492
00:45:40,230 --> 00:45:38,160
have the right information as they're

1493
00:45:41,510 --> 00:45:40,240
operating on you or the anesthesiologist

1494
00:45:43,270 --> 00:45:41,520
has vital sign data sort of this

1495
00:45:45,030 --> 00:45:43,280
heads-up display in our environment can

1496
00:45:46,230 --> 00:45:45,040
be used in all sorts of ways and this

1497
00:45:47,670 --> 00:45:46,240
again this is the very early days of

1498
00:45:49,430 --> 00:45:47,680
this sort of technology we're going to

1499
00:45:51,109 --> 00:45:49,440
see it become ubiquitous to the point

1500
00:45:52,870 --> 00:45:51,119
where you see your breakfast in one way

1501
00:45:54,390 --> 00:45:52,880
maybe you've seen a different way and

1502
00:45:55,670 --> 00:45:54,400
maybe a little warning before you dive

1503
00:45:57,829 --> 00:45:55,680
in

1504
00:46:02,870 --> 00:45:57,839
pull up pull up

1505
00:46:04,309 --> 00:46:02,880
would be radar when we fly

1506
00:46:05,430 --> 00:46:04,319
we are we're on air traffic control we

1507
00:46:06,550 --> 00:46:05,440
know where all the airplanes are what if

1508
00:46:08,790 --> 00:46:06,560
you knew where all the patients were

1509
00:46:10,470 --> 00:46:08,800
like you or if part of a clinical trial

1510
00:46:11,589 --> 00:46:10,480
what if we could crowdsource our medical

1511
00:46:13,670 --> 00:46:11,599
data just like we crowdsource our

1512
00:46:14,870 --> 00:46:13,680
driving data you give up a little

1513
00:46:16,069 --> 00:46:14,880
privacy when you drive with google by

1514
00:46:17,750 --> 00:46:16,079
the way they know your speed and

1515
00:46:19,829 --> 00:46:17,760
location and from that you can build in

1516
00:46:21,829 --> 00:46:19,839
this case a map of rome this is waze

1517
00:46:23,109 --> 00:46:21,839
this is just from driver data and you

1518
00:46:24,790 --> 00:46:23,119
now know the best drop to work how to

1519
00:46:26,309 --> 00:46:24,800
avoid the traffic that's crowd source

1520
00:46:28,710 --> 00:46:26,319
information i think we can apply that

1521
00:46:30,230 --> 00:46:28,720
same thinking health medicine and even

1522
00:46:32,470 --> 00:46:30,240
the future space flight crowdsourcing

1523
00:46:34,150 --> 00:46:32,480
the wisdom of the crowd and changes from

1524
00:46:35,349 --> 00:46:34,160
this era of flying seat of the pants

1525
00:46:36,710 --> 00:46:35,359
where we have limited data we're

1526
00:46:38,630 --> 00:46:36,720
practicing medicine it's the art of

1527
00:46:39,990 --> 00:46:38,640
medicine where we can use all these new

1528
00:46:42,390 --> 00:46:40,000
technologies and bring them together in

1529
00:46:44,470 --> 00:46:42,400
smart ways even our social networks can

1530
00:46:45,750 --> 00:46:44,480
give us clues as to who's healthy and

1531
00:46:47,349 --> 00:46:45,760
who's not healthy in what particular

1532
00:46:48,309 --> 00:46:47,359
neighborhood just by people's google

1533
00:46:50,069 --> 00:46:48,319
searches

1534
00:46:51,829 --> 00:46:50,079
or their social network data and believe

1535
00:46:53,910 --> 00:46:51,839
it or not you can mine facebook now and

1536
00:46:55,829 --> 00:46:53,920
say who might you want to avoid shaking

1537
00:46:57,990 --> 00:46:55,839
hands with that day that data's there uh

1538
00:47:00,150 --> 00:46:58,000
just not accessible quite yet

1539
00:47:01,430 --> 00:47:00,160
so just like you have dashboards with

1540
00:47:03,510 --> 00:47:01,440
many of your day-to-day jobs we have

1541
00:47:05,750 --> 00:47:03,520
dashboards for our health for our entire

1542
00:47:07,829 --> 00:47:05,760
life missions that can apply obviously

1543
00:47:09,270 --> 00:47:07,839
to the to the aviation space world we

1544
00:47:11,430 --> 00:47:09,280
can take these wearable devices now and

1545
00:47:13,270 --> 00:47:11,440
crowdsource data this is a wearable

1546
00:47:14,870 --> 00:47:13,280
jawbone and we can tell

1547
00:47:16,150 --> 00:47:14,880
near an earthquake this was in napa last

1548
00:47:17,670 --> 00:47:16,160
summer who woke up folks near the

1549
00:47:18,950 --> 00:47:17,680
earthquake woke up you can tell that you

1550
00:47:20,950 --> 00:47:18,960
can tell from this crowd source data

1551
00:47:23,349 --> 00:47:20,960
where folks go to sleep at what time on

1552
00:47:25,349 --> 00:47:23,359
average so new ways of gathering

1553
00:47:27,349 --> 00:47:25,359
information and being more proactive and

1554
00:47:29,430 --> 00:47:27,359
hitting disease and picking it up before

1555
00:47:30,950 --> 00:47:29,440
it becomes a problem so i'd encourage

1556
00:47:32,069 --> 00:47:30,960
you to start thinking in a contextual

1557
00:47:34,309 --> 00:47:32,079
form you already do that with space

1558
00:47:36,230 --> 00:47:34,319
flight in terms of systems in terms of

1559
00:47:38,309 --> 00:47:36,240
design thinking as we go

1560
00:47:40,470 --> 00:47:38,319
and thinking exponentially layering

1561
00:47:42,390 --> 00:47:40,480
these technologies together and thinking

1562
00:47:43,589 --> 00:47:42,400
about how they overlap and as we invent

1563
00:47:45,030 --> 00:47:43,599
the future don't just think about

1564
00:47:47,349 --> 00:47:45,040
technology today move to where it's

1565
00:47:48,549 --> 00:47:47,359
going to be and if we do that we can

1566
00:47:50,790 --> 00:47:48,559
move from this era where we've been

1567
00:47:52,950 --> 00:47:50,800
stuck in healthcare since 1846 or beyond

1568
00:47:53,990 --> 00:47:52,960
very episodic and reactive to one that's

1569
00:47:55,829 --> 00:47:54,000
much more

1570
00:47:57,030 --> 00:47:55,839
continual and proactive and you can all

1571
00:47:58,069 --> 00:47:57,040
start doing that today with your own

1572
00:47:59,109 --> 00:47:58,079
health and that of your friends and

1573
00:48:00,630 --> 00:47:59,119
family

1574
00:48:02,630 --> 00:48:00,640
and i think as you think into the future

1575
00:48:04,790 --> 00:48:02,640
of space flight these lessons apply

1576
00:48:06,630 --> 00:48:04,800
whether it's taking being an organ or

1577
00:48:09,270 --> 00:48:06,640
blood donor and being a data donor

1578
00:48:11,030 --> 00:48:09,280
sharing data between issa and nasa and

1579
00:48:11,829 --> 00:48:11,040
others how we can think differently

1580
00:48:13,670 --> 00:48:11,839
about

1581
00:48:14,950 --> 00:48:13,680
not just the overlap but looking at to

1582
00:48:16,390 --> 00:48:14,960
where the puck is going the wayne

1583
00:48:18,069 --> 00:48:16,400
gretzky code skate to where the puck is

1584
00:48:19,589 --> 00:48:18,079
going to be as you're designing systems

1585
00:48:20,950 --> 00:48:19,599
for 2020

1586
00:48:22,549 --> 00:48:20,960
take a look at the trend of where

1587
00:48:24,710 --> 00:48:22,559
moore's law will take smartphones and

1588
00:48:25,910 --> 00:48:24,720
mobile and i would encourage all of us

1589
00:48:28,150 --> 00:48:25,920
again then to start thinking

1590
00:48:30,710 --> 00:48:28,160
exponentially in the context of

1591
00:48:33,270 --> 00:48:30,720
integration and realize that like with

1592
00:48:34,630 --> 00:48:33,280
many of the technologies in my pocket

1593
00:48:36,470 --> 00:48:34,640
they're actually already here they're

1594
00:48:38,630 --> 00:48:36,480
just not evenly distributed and it's up

1595
00:48:40,470 --> 00:48:38,640
to us whether it's the future of space

1596
00:48:42,390 --> 00:48:40,480
or medicine not to just predict the

1597
00:48:43,990 --> 00:48:42,400
future but go out there and create it

1598
00:48:45,750 --> 00:48:44,000
together so with that

1599
00:48:46,870 --> 00:48:45,760
huge thanks real honor to be here i'm

1600
00:48:47,990 --> 00:48:46,880
happy to help out in any ways with

1601
00:48:49,109 --> 00:48:48,000
anything you're doing in the future you

1602
00:48:51,589 --> 00:48:49,119
can reach me

1603
00:48:53,829 --> 00:48:51,599
through that email or download my

1604
00:49:07,670 --> 00:48:53,839
ask for the presentation and

1605
00:49:10,630 --> 00:49:08,950
yeah i think we have time for a couple

1606
00:49:12,790 --> 00:49:10,640
of questions if there's some mics up

1607
00:49:14,710 --> 00:49:12,800
here if any of you uh have a question

1608
00:49:16,390 --> 00:49:14,720
you'd like to ask daniel and

1609
00:49:18,710 --> 00:49:16,400
he'll also be around this afternoon in a

1610
00:49:19,910 --> 00:49:18,720
variety of places but um i think we have

1611
00:49:21,349 --> 00:49:19,920
time for a couple of questions before

1612
00:49:22,390 --> 00:49:21,359
the one o'clock meetings start if

1613
00:49:24,069 --> 00:49:22,400
anybody

1614
00:49:25,109 --> 00:49:24,079
wants to ask questions debate there's

1615
00:49:26,390 --> 00:49:25,119
you know there's a lot happening there

1616
00:49:29,190 --> 00:49:26,400
that was sort of overwhelming you with

1617
00:49:31,990 --> 00:49:29,200
things again a lot of those elements uh

1618
00:49:33,910 --> 00:49:32,000
can cross over between fields so um

1619
00:49:35,430 --> 00:49:33,920
love to sort of hear any any thoughts or

1620
00:49:37,109 --> 00:49:35,440
questions yeah

1621
00:49:41,510 --> 00:49:37,119
very

1622
00:49:43,190 --> 00:49:41,520
i'm not sure that i'd want my children

1623
00:49:45,510 --> 00:49:43,200
or my grandchildren have a chip on their

1624
00:49:48,309 --> 00:49:45,520
neck right and as i read more and more

1625
00:49:50,309 --> 00:49:48,319
things about internet being hacked and i

1626
00:49:52,470 --> 00:49:50,319
don't file my taxes

1627
00:49:53,190 --> 00:49:52,480
online

1628
00:50:06,870 --> 00:49:53,200
i

1629
00:50:08,230 --> 00:50:06,880
those get hacked we haven't stopped

1630
00:50:09,270 --> 00:50:08,240
using credit cards i think we do know

1631
00:50:11,109 --> 00:50:09,280
need to pay a lot of attention to

1632
00:50:12,630 --> 00:50:11,119
medical privacy let people opt in and

1633
00:50:14,309 --> 00:50:12,640
use smarter ways to lock down our

1634
00:50:15,750 --> 00:50:14,319
medical information but also enable it

1635
00:50:17,670 --> 00:50:15,760
to be connected in smart ways in a

1636
00:50:19,430 --> 00:50:17,680
de-identified manner but clearly that's

1637
00:50:21,109 --> 00:50:19,440
a huge issue i mean i could literally

1638
00:50:22,069 --> 00:50:21,119
sequence your dna from shaking your hand

1639
00:50:23,270 --> 00:50:22,079
today

1640
00:50:24,390 --> 00:50:23,280
or i could potentially you know hack

1641
00:50:26,549 --> 00:50:24,400
your smartphone and know where you've

1642
00:50:28,390 --> 00:50:26,559
been so just i think there's a blend

1643
00:50:30,309 --> 00:50:28,400
between being mindful of that and also

1644
00:50:32,150 --> 00:50:30,319
enabling these technologies to take us

1645
00:50:34,390 --> 00:50:32,160
forward but it's a great point

1646
00:50:36,630 --> 00:50:34,400
it's a great lecture thank you thank you

1647
00:50:37,910 --> 00:50:36,640
yes

1648
00:50:40,549 --> 00:50:37,920
all right well i think you have one