Future of Healthcare

By Wayne Caswell
The FUTURE of
Health Care
© Modern Health Talk

WHICH Future?

1. My Background, Perspective & Bias
2. Why Our Healthcare is So Expensive
3. Exponential Pace of Tech Innovation
4. Tech moves Down-Market with Telehealth
5. Smartphone as Health Gateway
6. Sensors, Sensors Everywhere
7. An Ounce of Prevention
8. Personalized Wellness & Treatment
9. AI in the Cloud and Phone
10. Healthcare Robots
11. Blending Man & Machine
12. Singularity and the Brain-Computer Interface
TOPICS

Eas y Acces s ib le Wireles s I n tern et
UNIVERSAL, not “Senior” Design
An iPad for All Ages
https://www.youtube.com/watch?v=htLswR9BUD4 (15:08 min)

Accessible entry
UNIVERSAL, not “Senior” Design
Zero-Step Entry for:
• Rolling Suitcases,
• Baby Strollers,
• Dollies,
• AND Wheelchairs

Unpaid Family Caregivers toll is already $480 Billion/yr.
As 11,000 Boomers turn 65/day, 90,000 Doctor Shortfall.
Governments, Cities & Homes aren’t ready.
2.0
2.5
3.0
3.5
4.0
4.5
1909 1919 1929 1939 1949 1959 1969 1979 1989
Live Births per Year (Millions)
Baby Bust
(41 Million)
Baby Boom
(76 Million)
Echo Boom
(64 Million)
World Population more than doubled in 65 years.
Average Lifespan up 30 years over last century.
Living for 1,000 years is possible, futurists say.
Costs increase with age

1. My Background, Perspective & Bias
2. Why Our Healthcare is SO Expensive
3. Exponential Pace of Tech Innovation
4. Tech moves Down-Market with Telehealth
5. Smartphone as Health Gateway
6. Sensors, Sensors Everywhere
7. An Ounce of Prevention
8. Personalized Wellness & Treatment
9. AI in the Cloud and Phone
10. Healthcare Robots
11. Blending Man & Machine
12. Singularity and the Brain-Computer Interface
TOPICS

http://www.mhealthtalk.com/expensive/ (5:41 min)
Why Our Healthcare is SO Expensive

https://www.youtube.com/watch?v=89nnsWZhkI4 (4:00 min)

http://www.mhealthtalk.com/expensive/
CONTRIBUTING FACTORS:
1. Aging Populations (11,000 Boomers retiring every day)
2. There’s No Easy Fix
3. Market Forces Don’t Work in Health Care
4. Health is seen as Political Weapon, not a Policy Objective
5. A Medical Cartel Influences Public Policy
6. Direct to Consumer Ads Influences Attitudes & Behavior
7. Profit Incentives are Misaligned with Goals
8. Fee-for-Service Business Models Need Disruption
9. Medical Schools teach Diagnosis & Treatment, not Prevention
10. Inequality affects Health, Opportunity & Influence
11. Public Health Programs are Effective but Not Priority
12. Single-Payer, even if enacted, is Not Enough
13. Tech Solutions Will Help Define the Future of Healthcare
WHY Our Healthcare is So Expensive

Linear vs. Exponential Growth
32768
16384
8192
4096
2048
1024
512
256
128
64
32
16
8
4
2
1
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
The Impact of Moore’s Law (chip density doubling every 2 years)
The exponentially accelerating pace of tech innovation
is enabling smaller, cheaper, more accurate, and easier
to use medical devices and will cause medical functions
done today by doctors in clinics and hospitals to move
down-market to consumers at hone.

Take 30 LINEAR steps…
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
… 30 yards

Take 30 EXPONENTIAL steps…
01 02 04 08 16 32 64 128 256

IBM Mainframe computer, circa 1972
(System/370 Model 158-3)
Apple iPhone X, Christmas 2017
COST: $3.5 million (~$21M in 2017 dollars) COST: ~$1,000
PERFORMANCE: 1 MIPS
(million instructions per second)
PERFORMANCE: ~100,000 MIPS
(64-bit 2.4 GHz 6-core processor)
MEMORY: 4 MB max
STORAGE: typical 1.6 GB (8*200 MB/drive) STORAGE: 64-256 GB© Modern Health Talk

IBM Mainframe computer, circa 1972
(System/370 Model 158-3)
My Toothbrush
(Philips Sonicare)
COST: $3.5 million (~$21M in 2017 dollars) COST: $69.99
PERFORMANCE: 1 MIPS
(million instructions per second)
PERFORMANCE: 10 MIPS
(8-bit Zilog Z8 microprocessor)
MEMORY: 4 MB max
STORAGE: typical 1.6 GB (8*200 MB/drive) © Modern Health Talk

TeleHEALTH & TeleMEDICINE
Moving Down-Market to Kiosk,
at Office, at Home, on the Go

Broadband Access & Privacy issues
Patient, Family, Physician(s)
Video images from multiple cameras simultaneously

A Medical Tricorder?
5 Vital Signs
Body Temperature
Blood Pressure
Heart Rate/Variability
Respiratory Rate
Blood Oxygen
10 Health Conditions
Diabetes
Pneumonia
Pulmonary Disease
Atrial Fibrillation
Chronic Obstructive
Urinary Tract Infection
Leukocytosis
Sleep Apnea
Anemia

Phone as Tricorder

Phone as Health Gateway
And Home Gateway Too
Apple HealthKit in iOS8
An iTunes for Health data?
“Hay Siri”

Other Drivers?
Most & Fastest Connections?
Most Capital & Profit?
Most Need?
2014: More Mobile Devices than World Population
Phone as Health Gateway

Remotely monitor SENSORS that
already measure all sorts of things:
Tech Disappearing into Things
• Light,
• Motion,
• Contact,
• Moisture,
• Temperature,
• Acceleration,
• Chemicals (CO2, off-gassing),
• Pressure (pulse, blood pressure)

Ingestible
Disposable capsule with video camera can examine parts of the small
intestine that standard scopes can’t reach. Video images are received by a
recorder work on a belt and then downloaded to a computer for analysis.
Capsule Endoscopy

Digestible

Continuous Monitoring
Guardian Glucose Monitor
Minimally Invasive
Avoid Lows & Highs
Understand Context

around the Belly
Sense4Baby – remote fetal monitoring

on the Ankle
Owlet Baby Monitor
worn on ankle to
monitor vitals

on the Skin
Biostamp – applied like temporary tattoo

on the Skin
Biostamp or electronic tattoos
University of Illinois – MC10
Flexible patch can pick up heartbeats when stuck on the chest, skeletal
muscle activity when on the leg, and brainwaves when on the forehead.

in your Clothing

in your Cars

Evolution of MankindIn your Glasses
Looking Down at Electronics
Looking UpLooking Down

Evolution of MankindIn your Glasses
Apple Glass could replace iPhone, add AR

Google is developing contacts with continuous monitoring.
on your Eyes
Glucose sensing Contacts

• Sense other Biomarkers
• Augmented Reality
• Night Vision
• Telephoto Zoom
• See other frequencies (UV, IR & Radio)
on your Eyes

in the Mail
At-Home Blood Test

under the Skin
“Lab on a Chip” analyzes
blood, transmits wirelessly.
Self-powered Implantables

Manage Meds Below Threshold
P A I N
E V E RY 8 HO URS
Measure Drug Absorption in Blood
Avoid Delivering Too Much

Manage Meds Below Threshold
Measure Drug Absorption in Blood
LESS PAIN with lower dose & higher frequency
E V E RY 4 HO URS
Adjust Dosage For Most Benefit & Least Harmful Effect
Automatically

“An Ounce of Prevention”
SYMPTOMS
APPEAR
HEALTHY
Diagnosis-Prognosis
Drug/Device
Intervention
Post Treatment
Testing
Alternative to Disease-Treatment

AVOID
SYMPTOMS
HEALTHYPredisposition
Testing
Screening
Early Screening to Stay Below the Symptom Line

Medical School 2.0
PILLARS of Health
• Nutrition
• Exercise
• Sleep
Medical School 1.0
Doctors taught only
to Diagnose & Cure.
“You have a rare condition
called ‘Good Health.” Frankly,
I’m not sure how to treat it.”

Personalized Wellness &
The Right Procedure
for the Right Patient
The Right Drug & Dose
at the Right Time
Treatment

May help us detect cancer DNA
and deadly infections in real-time
As pieces of genome pass through the
nanopores, they produce minute
fluctuations in an electrical current.
Scientists used this pocket-sized DNA-
scanner to sequence the most complete
human genome ever assembled with a
single device. (99.88% accuracy)
MinION – $1,000 DNA Sequencer
by Oxford Nanopore Technologies
Personal DNA

Heal Organs with a Touch
Tissue Nanotransfection can generate any cell type of
interest for treatment within the patient’s own body.
https://www.youtube.com/watch?v=tMQ51Kj2tS0 (2:16 min)

WATSON
Watson famously beat the top players in the world.
It can parse & analyze 300 M books in 3 seconds.
Artificial Intelligence

AI in the Cloud
WATSON
Now being applied to Health Care & Medical Research.
The newest systems are 250x faster and 8x smaller.
Medical Knowledge Doubles every 5 Years.

AI on Smartphones too
IBM & Apple want to bring Watson to the iPhone,
putting A Doctor in your Pocket.
Siri
WATSON

Healthcare Robots

Xiaoyi is a Chinese robot doctor that just made history
as the first machine to pass a medical licensing exam.
Would you go to a Robot MD?
© Modern Health Talkhttps://www.youtube.com/watch?v=L96CUJapsbo (1:49 min )

Our Cars will
be Robots too.
Would you ride in a Robot Car?

Would you Enhance Yourself?

Blending Man & Machine
Mechanical
Prosthetics

Electronic
Prosthetics

3D-printed
Prosthetics

3D-printed prosthetics are Great for Growing Kids

Evan, Troop 774, Encinitas, CA
printed and assembled dozens
of custom prosthetics

Easton LaChappelle gives TED Talk
At age 14, Easton used the Internet to learn about electronics,
sensor technologies, programming & modeling software, 3D
printing & industrial design, and wireless networking.
https://www.youtube.com/watch?v=CfmNXPMjChs (10:40 min)

3D Printed Body Parts
LIVER EARS
BONES
Also:
• bladder,
• trachea,
• cartilage,
• urine tubes,
• spinal cords
Still Researching
3D printer can now print cells that can multiply into
tissues used in medical research … and to create organs.

Transhumanism
Average Lifespan nearly
Doubled in 200 years.
What will the next 200
bring?
Who Influences that
Future? You or Them?
How Long do you
WANT to Live?
Can you afford it?
Hacking
Human Evolution
Genetic
Engineering
StemCell
Research
INFO+NANO+BIO+NEURO

Brain-Computer Interface
Command a Robot or Fly a Helicopter with your thoughts.

Bulky sensors no loner needed.
Command a Robot or Fly a Helicopter with your thoughts.

Neural Implants will Need Convergent Technologies
Metin Akay, MD
INFO NANO
BIO NEURO

By 2013, a Supercomputer will exceed the
computational & analytical power of the
Human Brain. (Ray Kurzweil)
By 2023, a $1,000 computer will; and
by 2037, a $0.01 computer will.
By 2049, a $1,000 computer will exceed the
computational & analytical power of the Human Race.
And by 2059 a $0.01 computer will.
What IMPLICATIONS: Health, Career, Social, Political?
Singularity is Near

“… right now is
one of those
moments that
YOU are
influencing the
future.”
Steve Jobs

WayneCaswell@mHealthTalk.com
512-507-6011
The FUTURE
of Health Care

Future of Healthcare

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