TEDxAcademy - Walter De Brouwer - How to swallow your doctor

Uploaded by TEDxTalks on 22.10.2011

This is how my story starts, in an intensive care unit, six years ago
I was there with my wife for ten weeks
Because our youngest son has suffered a severe brain accident
It's amazingly unpredictable how people react to shock
So, my wife completely took over the leadership, was very functional and pragmatic,
While I was, actually when I came into the room
The only thing I knew was, I have to understand this environment or my son will die
So, I started logging, every piece of equipment
I took the brand, I looked at the ranges, I saw how all these machines worked together
It took me one week, to hack through every aspect of network
I knew everything about this ICU in three weeks
Now, is actually very interesting once you know how an ICU works
Because, from an ICU you go to other departments
And we went to many different departments
and now also many different hospitals
and I can tell you, I have come to have an intimate knowledge of hospitals,
these big collective centralized forts of doctors work and how they not work
because I've seen it from the bottom up as a patient
and not as an observer, as a doctor
now I can tell you immediately and you know that our healhtcare systems all over the world they breakdown
and people say this and that... I can tell you the real big reason is this
it's starring you in the face, there is too many humans
now like, where are the machines?
so, in every industry, we have replaced humans with machines because they are more efficient
because they're 24X7 and because we cannot ignore the cost factor
we have replaced all relationships with transactions
look here
this complete world is now decentralized thanks to our distributed technology and here it is centralized
and for the sake of controversy, and I don't really mean that
because you see, doctors are my best friends and I'm of course also a carbon based unit
but for the sake of controversy I'd like to argue for silicon based units
you see a doctor, follows Heisenberg principle, is always somewhere else.
patients are 24 hours waiting for 2 minutes of a doctor who comes in like superman and goes out again
also, you see when my kids fall ill is never in office hours
it's always at night or in a weekend, or during ski holiday when most of the doctors are in Vermont
or a combination of these things, in ski holiday at night during a weekend, right.
when your last resort is a retired pharmacist or the local vet
So, there is a lot to say for machines against humans. Humans are also chaotic
you know, we all think that some people are chaotic
Let me tell you, everyone is chaotic. Even accountants and those who are not chaotic [audience laughs - applause]
those who are not chaotic are called control freaks, and I can tell you
it's one year away, from becoming a reimbursable neurotic disease control freak
so we are all chaotic. But machines are not. You know why they say, they don't give us our medical files?
Because they don't find them.
Our medical privacy is protected by the sheer chaos of doctors and nurses
So, everytime you introduce a human in a process, you introduce an opportunity for error.
Now, think of these big hospitals, full of humans with intrigues,
power thirsty, with very very small amount of machines
you know, this has to go wrong, and every government in the world is now talking about this
the decentralization of healthcare and how will this work.
Well as you see there in this nice picture
and you probably will notice that the three figures, the three doctors are of course avatars,
Hospitals will decentralized
the ICU units you will only spend a couple of days there and then they will put a unit at home, it'll be telehealth
Onstar from GM, 5million subsribers who know everything about your car
it does exists for cars, why doesn't exist for humans?
the most people in this room the only parameter they know about their health is their weight and their height
and you know their weight they under-exaggerate and their height they over-exaggerate
but for all the rest they don't know. We are the last generation who will know so little about our health.
Onstar will be the doctor's office of the future.
You'll call and this lady will pick up and she has your track and she'll follow you
she'll say yes but 140 systolic pressure, you know, this is quite normal and in your range but your diastolic pressure 130, that's too high
you know, this is the pressure on the veins, so I see that you're taking this pill
can I connect you to the doctor now or do you want a diagnosis from Watson
this is the future, the doctors' office is going to be call centers
and Fred Lee, Fred Lee used to be an executive at Walt Disney and he is now setting up hospitals
for revalidation, if I have to revalidate I wanna go to Fred's hospital
it's a hospital where everyone always smile, and why is it everyone always in a bad mood in a hospital? for god sake
the sick are not worse enough, everyone has to be in a bad mood
This is e-patient Dave.
He's the head of the rebellion against hospitals and doctors and the medical industry.
and he says, Reclaim your rights. We need to be empowered. We need to be medical consumers
We have to think of ourselves as consumers. So give us our damn records
Let us do it ourselves, nobody ever died by googling his health
and let us go to hospitals with educated guesses, and let ask the doctors, and tell them like where is epidemiology on this?
and there is the QUANTIFIED SELF, there is a new movement started in San Francisco, and is now in 30 countries already
and is all sorts of consumer devices which you can have at home to measure your blood pressure, your cholesterol
your galvanic skin response, your weight, your sleep,
you know that only medical instrument people in the world have since 1866 is a thermometer
we don't have anything else
we can't even buy it
your test results will look like this in the future, very appealing,
you know like, if Apple have made test results. They would look like this. [laugh and applause]
the problem is Bill Gates made them.
What will this produce? Well, Cyberchondriacs. But it's ok, we are all hypochondriancs, this is one step more
but the problem is, these doctors. Do you see this doctor there?
This doctor is a general practitioner, He has 5.000 patients normally
So, this guy doesn't see this evolution as very beneficial to his business
So, and people, patients they don't want this doctor, they want THIS man
[audience laughs] They want Dr. House
they want a team of six people, they go through your house
they sit with you like a detective and they clear you and you go out like a new man.
and you know in San Franscisco and LA this is coming in rapid progression.
Because, now for $100 to $2000 a month, you can have your concierge doctor.
And I can tell you they are great. Because they have only 100 patients and they know everything about you.
and it is 24X7, and they also go have dinner with you. It's great
But of course it'll be for a niche
Because the real market, and I refrain from saying killer market [audience laughs] but the real market
is this, the real market is auto-diagnosis
the real market is, us to auto-diagnose ourselves
in a triarch, because in the end we'll want to talk to a doctor.
But we don't want to sit in waiting rooms anymore
we don't want to wait for doctors we don't want to be patronized anymore like kids
We want to auto diagnose, we want to auto educate ourselves
and for this, we need Do-it-Yourself healthcare
And I don't know if you the X PRIZE foundation
But X PRIZE foundation is American Foundation and they give a prize
if a company attains a certain level, and you know, now for instance now they have the tricorder prize
Who doesn't know that the tricorder is?
ah, So they don't have Star Trek in Greece? [speaker and audience laugh]
Well, it's a mythical instrument
it's an instrument from the tv series Star Trek, and is actually something like this
and you scan a person
and you see everything, the ultrasound, you know like...
even the CT, the MRI, he's blood pressure and you know immediately what's wrong with this person
so the tricorder, so this is an instrument we need to have for auto-diagnosis.
and the X PRIZE foundation gives $10mil to make the tricorder
Of course I can tell you that making the tricorder is going to cost 10 times that much
and it will be there and it will be there very soon
and it will change healthcare.
You see, everything that is in the bag of a doctor is going to be in the case of your smartphone.
a lot of sensors will be built into that.
and you will have apps which you can buy
which will have algorithms for the sensors
and you'll be able to diagnose yourself and then with an educated opinion go to your doctor.
and you know the tricorder it'll not prescribe medicine, it will prescribe apps, and perhaps apps will be reimbursable.
and here is Watson, Watson the super computer of IBM now reads 30.000 pages per minute
of medical literature. In a couple of years, Doctors will consult Watson to see if their diagnosis is correct.
and in a couple of years further, Watson will probably give the medical degrees.
and health data, we are now, health data must be private I don't get it.
So, if I'm healthy I don't care if everyone knows, and if I'm sick, I can't shut up about it
So, unless you are the unabomber your dental records don't mean anything to anyone, you know [audience laughs].
But is very important that health data becomes broadcasted.
Because we are before a wall of interpretation we need more epidemiological data
It should be a government law that everyone has to anonymously give his health data.
e-prescriptions, this going through the roof in the States because basically our doctor has become our drugs dealer.
He doesn't even torture us anymore. He says how much and in what quantities.
What did I give you last time? [speaker & audience laugh]
Did you like it? [speaker & audience laugh - Applause]
So e-prescriptions via the tricorder, via your doctor or via a call center is definitely going to happen
Your medical records will be in the clouds. They will not be in the possession of a hospital, or a doctor.
We will change doctors like we'd change our telecom operator.
That's what they are afraid of, of course.
and this mythical device, you know, this we'll have a lot of sensors connected to it of what we call the internet of things.
You see this is a blueprint for the bathroom.
Everything in the bathroom that will not have a display will disappear.
Everything in the bathroom that will not connect will disappear.
Your toothbrush will know your cavities, will know your discolorations
Your comb will count your hairs.
and this is the best new instrument for medical in the household for a WIRED contest.
The toilet.
It will process every time you go on it. [audience laughs]
And it'll follow you, it'll follow you with your iphone. So that you don't get processed somebody else's excrement and so forth.
Ford, is now building health data into its cars.
While you are driving in the car, the car will tell you like...
slow down maam, you drunk too much, or your allergy is up and you now
But the road map of intimacy as we call it, everything we now wear on the body we'll soon wear IN the body.
Patchables, are little patches with thousands of needles but you don't even see it
sub-dermals, under the skin, injectables, tatooables...
this will all come. And on the screen you see proteus.
they have a pill, is now going through RDA,
with a small patch that you put here, you take the pill and on your phone you can see how you ingest your medicine.
You can also see how your bowel movement works, how your internal blood flow works. You can monitor yourself
Now, last question, Who will own healthcare in the future.
Is very easy. There is only one organization, one sort of company that can own healthcare.
Not because they have the infrastructure, but because they have the billing model.
Every time you push for a diagnosis, for a second opinion
for tracking your health, for ultra sounding your baby you will pay your telecom provider
So, in the future we'll have hospital providers
So, this is our lab, in San Francisco, as it aims we are making this tricorder, I'm very very,
you know, we think we are in a mission from God to make this device
and to change healthcare and of course we know we are the first mover
[audience laugh] this will happen, but we're trying to prevent it by saying join us
not from behind, [strong laugh from speaker & audience]
and this is a vision of how we see this mythical device of the tricorder
Thank you ladies & gentlemen. [Applause]