so in my early days as a junior doctor I
kind of felt that about 90% of my time
was spent on routine repetitive tasks
and of dull things and then about 10
percent of my time I was kind of
slightly terrified out of my debt
doing the kind of things that you see
doctors doing on TV and I have some
pretty vivid memories of my very early
night shifts as a junior doctor in
Bristol so I trained at Bristol
University this is a photo of the
Clifton suspension bridge and the the
Bristol balloon festival which I trained
in Bristol and I qualified in 2003 and I
was the lucky doctor on my rotor to
start to be the one who starts on night
shift so my very first shift of the
doctor was a Wednesday night on a night
shift was about a 15 hour shift and I
spent the first hour doing these kind of
routine things that I mentioned so
rewriting drug charts and going around
the wards checking what did the nurses
have list they wanted me to do and then
about an hour in there was the first
emergency blue light and I had to run
and do resuscitation and about half an
hour later another one and I have and
that was kind of typical you know and be
this routine work and then these sort of
moments of
feeling out of my depth and I have one
really vivid memory of a night where my
sh-show house was always the case so the
doctor who was sort of one year ahead of
me was doing all the medical admissions
down in the emergency department the
Registrar who worked 80 hours in a row
so started on Friday mornings and then
left and went home on a Monday evening
was asleep as it was about 2:00 in the
morning and the consultant on call was
asleep too and I couldn’t phone them
directly I could only phone the sh-show
if I needed help and have one patient or
a rant award the nurses said this
patient really needs sort of help
immediately one patient
her heart failure had rather suddenly
deteriorated sushi was really struggling
to breathe and a few minutes later on
another ward at the other end of the
hospital I was looking after about 750
patients and you know I was fresh at the
medical school so it was all kind of new
another patient was having a heart
attack and then there are a few bleeps
from other wards as well this luckily
didn’t happen all the time but I really
still remember this night shift and of
course I hadn’t actually so there’s this
kind of saying a medicine see one do one
teach one and I hadn’t actually seen
these things happening before so I’d
learnt about them at medical school I’d
written them about them in my exams but
I hadn’t seen them before so I was
running to the wards with the Oxford
Handbook of clinical medicine in my
white coat pocket this big sort of tests
at a handbook that we all used as
medical students and junior doctors and
the time and I would kind of stop in the
doctors mess or in a corner or in the
ladies loo to sort of look through flick
through the right page and make sure
that I knew what I was doing before I
got to the water you know so the nurses
and the patient weren’t sort of even
more afraid you know that I didn’t know
what I was what I was doing so so that
was that was not uncommon I would do
that and you know i think i think that
that’s not unusual that young junior
doctors you know a lot of its routine
work but then there are these moments
where they’re just you know they’re
doing things for the first time and you
really want a second set of eyes you
really want someone there helping you
someone experienced you know just
somebody else to ask but you don’t you
don’t have it a lot of the time and and
of course things did get better as i
progressed up through the years as a
junior i was a pediatrician i felt more
and more competent but they’d still be
these moments once I remember in London
as a pediatrician having 30 children in
a sort of lines up in the Aeneid waiting
I was the only pediatrician there to see
them so of course you’re always worried
you’re going to miss something there’s
something that’s going to be new to you
and I think that that’s also very often
the case for GPS and I work with a lot
of cheapies a lot of the people I
trained with the GPS it’s very similar
for them they have quite lonely jobs in
a way you know they they have
leeks but they’re all there
consultations with patients handled
alone about 90% I would say is probably
repetitive work kind of routine to some
extent they can do it in their sleep
after some years in the job but then
this is 10% or so where you really wish
you had someone there just to ask you
know this extra sort of somebody to
somebody to bounce ideas off or just to
make sure that you’re not missing
something and you know I think this is
really where there’s a huge opportunity
for doctors to leverage machine to
technology so for what for one part
let’s automate what we can of all those
repetitive tasks let’s take as much of
that sort of burden off the shoulders of
doctors a lot of those things you don’t
need six years at medical school and
then years of experience to be able to
do on the other hand let’s sort of use
machines to to provide support for
doctors and help them in those instances
where they sometimes feel out of their
depth will they need that extra bit of
support there was one instance when I
was working it was a few years after
that that nightshift incident I talked
about I was working as a geneticist at
Addenbrooke’s Hospital in Cambridge this
is Adam Brooks and it was my first week
as a geneticist I was the most junior
person in the team I’d never worked in
genetics only as a pediatrician general
medicine and pediatrics
there was one baby who’d been seen by
one of the most experienced professors
in the department also people across
many other departments neurologists and
others had many investigations you know
lots of tests lots of things have been
thought about for over a year and no one
knew what was going on and one of the
people in the department said Claire
maybe you’d like to have a think about
this maybe you want to do some reading
be a really interesting case you to
think about in your first few days and
know nothing I used some tools that we
had in the department a database of rare
diseases with lots of photos and
information about these diseases and I
spent some time searching and looking on
the internet and something kind of
cropped up that didn’t quite fit with
one of the tests that had been done but
otherwise really fit
better than anything else I mentioned it
to the senior professor I think it could
be this doesn’t quite fit though he said
we’ll ask them to repeat it tell them
what you’re thinking about ask them to
repeat that test I think if they know
what they’re looking for that they’ll
having it they’ll have a more heart of
more in-depth look at more cells the
chromosome tests and sure enough that
test proved that this baby had the
diagnosis very rare diagnosis that I had
spotted in this database but none of the
professor’s and lots of discussion
throughout the department and other
departments had been able to recognize
and that really really thought home for
me this potential for you know this sort
of powerful synergy between doctors and
machines and it was this insight while I
was so after working for some time as a
geneticist in the hospital I went ensued
genetics research at Cambridge
University and I was at a manual College
and I I started thinking about startups
and technology and how we could
potentially scale healthcare using
technology and this insight from back in
my days of genetics was sort of like the
seed and it led me through thinking
about to my co-founders Daniel and
Martin and thinking about how we could
use technology to support
decision-making and help doctors make
decisions and I remember talking to one
of the professors at Emmanuel College
who knew doctors who had worked on this
problem many many years ago back in the
60s 70s very early days of this sort of
decision support technology it hadn’t
worked doctors hadn’t adopted it they
haven’t wanted it and so this professor
said to me no it’ll never work it’ll
never work it’s crazy idea using
technology to help doctors make better
diagnoses better decisions if I always
think and there is a bit of a saying in
technology but it’s often the things
that people laugh at that sounds sort of
silly at first that are actually the
best ideas or at least they sound like
silly ideas but in the long-term they
have the biggest potential and they’re
and and not only that but there are
people all around the world there are
that there are billions of people who
have no access to health care no access
to a doctor
more than half the world’s population
has no access so basic essential health
care imagine what this technology could
do for those people in China really
amazes me the statistics in China the
average consultation time with a doctor
is 2 minutes in India it’s just over one
minute
in Pakistan just over one minute in
Bangladesh less than one minute and
people queue off in four hours all day
for this consultation you know to see
the doctor and then just two minutes
can you imagine what kind of care what
kind of information can adopter share
with the patient gather from a patient
share with a patient in that tiny tiny
time clock there’s just not enough time
for you know really developing a
doctor-patient relationship for empathy
compassion really making sure you’ve got
to the root of the problem and you’re
not jumping to conclusions so there’s
just so much potential there what I
think though is the most you know really
going to be probably the most
transformative transformational change
in health care over the coming years is
this sort of shift of power and
knowledge to the individual and now
enabling people to have more control of
their own health and care and I think
this change has happened you know it’s
already happening it’s been happening
for many years when I look back when I
was growing up we had a Medical
Encyclopedia on the honor on the shelf
that was all the access to medical
information we have as a family when I
was at medical school I didn’t use
Google until I’m until my third year and
actually nobody had nobody had
smartphones in those first few years we
were at medical school in not even
mobile phones actually there was one
girl on my corridor who had one of those
massive sort of phones remember in the
really early days you know in the 90s he
sort of huge mobile phones and she’d
have to lean out of the window of the
staircase in order to be able to get any
reception at all and the rest of us
would queue up in the corridor and a
Sunday night by the payphone and have
sort of 10 minutes to
looking to that parent for five minutes
with everyone listening in the queue you
know so that’s how far we’ve come in
about 20 years less than 20 years you
know when I was a geneticist more than
ten years ago I think I remember once a
patient coming in having googled their
symptoms printed it out and wanting to
discuss that with me during the
consultation now I talk to my friends
who are doctors and that’s just
completely normal I talk to GPS who tell
me they’re surprised if a patient hasn’t
googled their symptoms before they go
and see the GP you know that that’s just
a change in that small amount of time
people everyone has smartphones you know
these really powerful supercomputers in
their pockets they’re downloading apps
they’re using them to track symptoms and
so forth go and see the doctor and it
really changes the relationship it
changes the conversation of course time
poor doctors who are stressed often find
that kind of inconvenience you know it
takes time to explain to a person you
probably don’t have this we don’t need
that tests and so forth but it’s
absolutely an irreversible trend you
know we’re not going back this is
happening people have more access to
information it is changing the nature of
the doctor/patient consultation it will
dramatically change healthcare and this
is very much what we’re focused on now
as a company at ADA so we started with
this doctors decision support but we’re
really now even more focused on the
consumer app we’ve translated all that
medical knowledge and reasoning that we
use in the doctor app into our patient
app and we put it in the App Store for
free and put it into the hands of
millions of people and we do have
millions of people now around the world
using ADA for a much more sort of
reliable personalized self assessment
than using internet search and finding
information and being guided in how to
understand their health manage their
health take next steps and actually now
every three seconds someone somewhere in
the world completes an eider assessment
so just think about how scalable
technology is in the hands of the
individual and so there’s there’s a
Disney Disney movie called big hero six
and I had not heard of it but we started
getting
views in the AppStore many of them
saying I found my personal baymax and
wow this is baymax so I thought well I
better have a look you know what is this
movie and watch it and this is baymax
and he’s a personal health companion and
in many ways he’s just like ADA or the
ADA that we want to build and that we’re
working on building now
I mean he’s not nap is like a big cuddly
sort of white robot but he’s friendly
kind supportive he really gets to know
the individual understands their health
risk factors genetics family history
your preferences your habits and takes
all of that into account and the care
delivered by baymax the support the
guidance that’s really focused on the
individual on the individuals needs it’s
always in the best interests of the
individual not the interests of the
system and efficiencies and pressure and
so forth you know and he’s always there
is always on he never gets tired never
forgets so we’ve really focused on
building that now at ADA these are my
two co-founders Daniel and Martin we
founded a door about seven years ago
we’ve got a team of about hundred people
here in Berlin and that’s it you know
we’re really focused on personalizing
sort of the assessment really
understanding the whole person the human
being understanding as much as possible
and then helping that individual take
more control we’re shifting our focus
much more from just reactive care sort
of assessment when you’re sick when you
have symptoms to more proactive care
prevention really understanding all your
risks and how to really manage your
health over time and let’s think about
it most of health and health care really
happens at home every day every minute
when you’re you you’re making decisions
and and looking after it’s just life
really it’s not those few minutes that
you have with a doctor discussing
something and getting a prescription you
know so so I think technology is going
to have such an impact in the hand of
and and you know at the same time going
back you know to what I talked mentioned
sort of earlier really helping doctors
so freeing up doctors so they spend less
time on things that actually doctors
don’t either aren’t needed for these
repetitive things or doctors don’t do
best so enabling doctors to let machines
do what they do best at the same time
humans human physicians do what they do
best you know really be human deliver
compassionate really carrying care and
at the same time you know wisdom
judgment experience and also put more
and more control in the hands of
individuals so that they can truly truly
manage their health in a way that sort
of personalized to them holistic a much
more effective and much more scalable
and then I just like this quote you know
there is so much change starting to
happen in healthcare we see sort of all
these ripples technology is starting to
make a difference I think you know we’ll
see some change in the next two years
but we always overestimate as Bill Gates
says you know the change that’s going to
happen in the short term the next two
years or so but really grossly
underestimate the change in the next ten
years so I think we’re gonna see
dramatic dramatic change in this space
in the next ten years or so thanks very much
kind of felt that about 90% of my time
was spent on routine repetitive tasks
and of dull things and then about 10
percent of my time I was kind of
slightly terrified out of my debt
doing the kind of things that you see
doctors doing on TV and I have some
pretty vivid memories of my very early
night shifts as a junior doctor in
Bristol so I trained at Bristol
University this is a photo of the
Clifton suspension bridge and the the
Bristol balloon festival which I trained
in Bristol and I qualified in 2003 and I
was the lucky doctor on my rotor to
start to be the one who starts on night
shift so my very first shift of the
doctor was a Wednesday night on a night
shift was about a 15 hour shift and I
spent the first hour doing these kind of
routine things that I mentioned so
rewriting drug charts and going around
the wards checking what did the nurses
have list they wanted me to do and then
about an hour in there was the first
emergency blue light and I had to run
and do resuscitation and about half an
hour later another one and I have and
that was kind of typical you know and be
this routine work and then these sort of
moments of
feeling out of my depth and I have one
really vivid memory of a night where my
sh-show house was always the case so the
doctor who was sort of one year ahead of
me was doing all the medical admissions
down in the emergency department the
Registrar who worked 80 hours in a row
so started on Friday mornings and then
left and went home on a Monday evening
was asleep as it was about 2:00 in the
morning and the consultant on call was
asleep too and I couldn’t phone them
directly I could only phone the sh-show
if I needed help and have one patient or
a rant award the nurses said this
patient really needs sort of help
immediately one patient
her heart failure had rather suddenly
deteriorated sushi was really struggling
to breathe and a few minutes later on
another ward at the other end of the
hospital I was looking after about 750
patients and you know I was fresh at the
medical school so it was all kind of new
another patient was having a heart
attack and then there are a few bleeps
from other wards as well this luckily
didn’t happen all the time but I really
still remember this night shift and of
course I hadn’t actually so there’s this
kind of saying a medicine see one do one
teach one and I hadn’t actually seen
these things happening before so I’d
learnt about them at medical school I’d
written them about them in my exams but
I hadn’t seen them before so I was
running to the wards with the Oxford
Handbook of clinical medicine in my
white coat pocket this big sort of tests
at a handbook that we all used as
medical students and junior doctors and
the time and I would kind of stop in the
doctors mess or in a corner or in the
ladies loo to sort of look through flick
through the right page and make sure
that I knew what I was doing before I
got to the water you know so the nurses
and the patient weren’t sort of even
more afraid you know that I didn’t know
what I was what I was doing so so that
was that was not uncommon I would do
that and you know i think i think that
that’s not unusual that young junior
doctors you know a lot of its routine
work but then there are these moments
where they’re just you know they’re
doing things for the first time and you
really want a second set of eyes you
really want someone there helping you
someone experienced you know just
somebody else to ask but you don’t you
don’t have it a lot of the time and and
of course things did get better as i
progressed up through the years as a
junior i was a pediatrician i felt more
and more competent but they’d still be
these moments once I remember in London
as a pediatrician having 30 children in
a sort of lines up in the Aeneid waiting
I was the only pediatrician there to see
them so of course you’re always worried
you’re going to miss something there’s
something that’s going to be new to you
and I think that that’s also very often
the case for GPS and I work with a lot
of cheapies a lot of the people I
trained with the GPS it’s very similar
for them they have quite lonely jobs in
a way you know they they have
leeks but they’re all there
consultations with patients handled
alone about 90% I would say is probably
repetitive work kind of routine to some
extent they can do it in their sleep
after some years in the job but then
this is 10% or so where you really wish
you had someone there just to ask you
know this extra sort of somebody to
somebody to bounce ideas off or just to
make sure that you’re not missing
something and you know I think this is
really where there’s a huge opportunity
for doctors to leverage machine to
technology so for what for one part
let’s automate what we can of all those
repetitive tasks let’s take as much of
that sort of burden off the shoulders of
doctors a lot of those things you don’t
need six years at medical school and
then years of experience to be able to
do on the other hand let’s sort of use
machines to to provide support for
doctors and help them in those instances
where they sometimes feel out of their
depth will they need that extra bit of
support there was one instance when I
was working it was a few years after
that that nightshift incident I talked
about I was working as a geneticist at
Addenbrooke’s Hospital in Cambridge this
is Adam Brooks and it was my first week
as a geneticist I was the most junior
person in the team I’d never worked in
genetics only as a pediatrician general
medicine and pediatrics
there was one baby who’d been seen by
one of the most experienced professors
in the department also people across
many other departments neurologists and
others had many investigations you know
lots of tests lots of things have been
thought about for over a year and no one
knew what was going on and one of the
people in the department said Claire
maybe you’d like to have a think about
this maybe you want to do some reading
be a really interesting case you to
think about in your first few days and
know nothing I used some tools that we
had in the department a database of rare
diseases with lots of photos and
information about these diseases and I
spent some time searching and looking on
the internet and something kind of
cropped up that didn’t quite fit with
one of the tests that had been done but
otherwise really fit
better than anything else I mentioned it
to the senior professor I think it could
be this doesn’t quite fit though he said
we’ll ask them to repeat it tell them
what you’re thinking about ask them to
repeat that test I think if they know
what they’re looking for that they’ll
having it they’ll have a more heart of
more in-depth look at more cells the
chromosome tests and sure enough that
test proved that this baby had the
diagnosis very rare diagnosis that I had
spotted in this database but none of the
professor’s and lots of discussion
throughout the department and other
departments had been able to recognize
and that really really thought home for
me this potential for you know this sort
of powerful synergy between doctors and
machines and it was this insight while I
was so after working for some time as a
geneticist in the hospital I went ensued
genetics research at Cambridge
University and I was at a manual College
and I I started thinking about startups
and technology and how we could
potentially scale healthcare using
technology and this insight from back in
my days of genetics was sort of like the
seed and it led me through thinking
about to my co-founders Daniel and
Martin and thinking about how we could
use technology to support
decision-making and help doctors make
decisions and I remember talking to one
of the professors at Emmanuel College
who knew doctors who had worked on this
problem many many years ago back in the
60s 70s very early days of this sort of
decision support technology it hadn’t
worked doctors hadn’t adopted it they
haven’t wanted it and so this professor
said to me no it’ll never work it’ll
never work it’s crazy idea using
technology to help doctors make better
diagnoses better decisions if I always
think and there is a bit of a saying in
technology but it’s often the things
that people laugh at that sounds sort of
silly at first that are actually the
best ideas or at least they sound like
silly ideas but in the long-term they
have the biggest potential and they’re
and and not only that but there are
people all around the world there are
that there are billions of people who
have no access to health care no access
to a doctor
more than half the world’s population
has no access so basic essential health
care imagine what this technology could
do for those people in China really
amazes me the statistics in China the
average consultation time with a doctor
is 2 minutes in India it’s just over one
minute
in Pakistan just over one minute in
Bangladesh less than one minute and
people queue off in four hours all day
for this consultation you know to see
the doctor and then just two minutes
can you imagine what kind of care what
kind of information can adopter share
with the patient gather from a patient
share with a patient in that tiny tiny
time clock there’s just not enough time
for you know really developing a
doctor-patient relationship for empathy
compassion really making sure you’ve got
to the root of the problem and you’re
not jumping to conclusions so there’s
just so much potential there what I
think though is the most you know really
going to be probably the most
transformative transformational change
in health care over the coming years is
this sort of shift of power and
knowledge to the individual and now
enabling people to have more control of
their own health and care and I think
this change has happened you know it’s
already happening it’s been happening
for many years when I look back when I
was growing up we had a Medical
Encyclopedia on the honor on the shelf
that was all the access to medical
information we have as a family when I
was at medical school I didn’t use
Google until I’m until my third year and
actually nobody had nobody had
smartphones in those first few years we
were at medical school in not even
mobile phones actually there was one
girl on my corridor who had one of those
massive sort of phones remember in the
really early days you know in the 90s he
sort of huge mobile phones and she’d
have to lean out of the window of the
staircase in order to be able to get any
reception at all and the rest of us
would queue up in the corridor and a
Sunday night by the payphone and have
sort of 10 minutes to
looking to that parent for five minutes
with everyone listening in the queue you
know so that’s how far we’ve come in
about 20 years less than 20 years you
know when I was a geneticist more than
ten years ago I think I remember once a
patient coming in having googled their
symptoms printed it out and wanting to
discuss that with me during the
consultation now I talk to my friends
who are doctors and that’s just
completely normal I talk to GPS who tell
me they’re surprised if a patient hasn’t
googled their symptoms before they go
and see the GP you know that that’s just
a change in that small amount of time
people everyone has smartphones you know
these really powerful supercomputers in
their pockets they’re downloading apps
they’re using them to track symptoms and
so forth go and see the doctor and it
really changes the relationship it
changes the conversation of course time
poor doctors who are stressed often find
that kind of inconvenience you know it
takes time to explain to a person you
probably don’t have this we don’t need
that tests and so forth but it’s
absolutely an irreversible trend you
know we’re not going back this is
happening people have more access to
information it is changing the nature of
the doctor/patient consultation it will
dramatically change healthcare and this
is very much what we’re focused on now
as a company at ADA so we started with
this doctors decision support but we’re
really now even more focused on the
consumer app we’ve translated all that
medical knowledge and reasoning that we
use in the doctor app into our patient
app and we put it in the App Store for
free and put it into the hands of
millions of people and we do have
millions of people now around the world
using ADA for a much more sort of
reliable personalized self assessment
than using internet search and finding
information and being guided in how to
understand their health manage their
health take next steps and actually now
every three seconds someone somewhere in
the world completes an eider assessment
so just think about how scalable
technology is in the hands of the
individual and so there’s there’s a
Disney Disney movie called big hero six
and I had not heard of it but we started
getting
views in the AppStore many of them
saying I found my personal baymax and
wow this is baymax so I thought well I
better have a look you know what is this
movie and watch it and this is baymax
and he’s a personal health companion and
in many ways he’s just like ADA or the
ADA that we want to build and that we’re
working on building now
I mean he’s not nap is like a big cuddly
sort of white robot but he’s friendly
kind supportive he really gets to know
the individual understands their health
risk factors genetics family history
your preferences your habits and takes
all of that into account and the care
delivered by baymax the support the
guidance that’s really focused on the
individual on the individuals needs it’s
always in the best interests of the
individual not the interests of the
system and efficiencies and pressure and
so forth you know and he’s always there
is always on he never gets tired never
forgets so we’ve really focused on
building that now at ADA these are my
two co-founders Daniel and Martin we
founded a door about seven years ago
we’ve got a team of about hundred people
here in Berlin and that’s it you know
we’re really focused on personalizing
sort of the assessment really
understanding the whole person the human
being understanding as much as possible
and then helping that individual take
more control we’re shifting our focus
much more from just reactive care sort
of assessment when you’re sick when you
have symptoms to more proactive care
prevention really understanding all your
risks and how to really manage your
health over time and let’s think about
it most of health and health care really
happens at home every day every minute
when you’re you you’re making decisions
and and looking after it’s just life
really it’s not those few minutes that
you have with a doctor discussing
something and getting a prescription you
know so so I think technology is going
to have such an impact in the hand of
and and you know at the same time going
back you know to what I talked mentioned
sort of earlier really helping doctors
so freeing up doctors so they spend less
time on things that actually doctors
don’t either aren’t needed for these
repetitive things or doctors don’t do
best so enabling doctors to let machines
do what they do best at the same time
humans human physicians do what they do
best you know really be human deliver
compassionate really carrying care and
at the same time you know wisdom
judgment experience and also put more
and more control in the hands of
individuals so that they can truly truly
manage their health in a way that sort
of personalized to them holistic a much
more effective and much more scalable
and then I just like this quote you know
there is so much change starting to
happen in healthcare we see sort of all
these ripples technology is starting to
make a difference I think you know we’ll
see some change in the next two years
but we always overestimate as Bill Gates
says you know the change that’s going to
happen in the short term the next two
years or so but really grossly
underestimate the change in the next ten
years so I think we’re gonna see
dramatic dramatic change in this space
in the next ten years or so thanks very much
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