[Music]
so my father like many who built this
country was an immigrant from the Middle
East in the 1970s to make ends meet he
had to have two jobs so he’d get up
before we were up at the dusk and start
his first job and then come home
sometime after 11 p.m. after his second
job and we were allowed to stay up
because otherwise we wouldn’t see our
father me and my sister and brother and
wait for him and we had a routine at
about 11:00 p.m. he’d come home we’d
give him his dinner for the day and then
probably two or three times a week after
a particularly punishing day beneath
cars he was a diesel mechanic he would
then lay on the floor take off his shirt
and we would fight for who got the
opportunity to stomp all over his back
to work out all the kinks in the bugs
and the pains and and this is what his
back look like and he might see these
scars and these notches his entire back
is full of these gouges and you know
when you’re a kid I’m like six and you
see someone with a scar you’re like it’s
like so so imagine as a child seeing
that on your father and no matter how
many times I’d ask I’d have to keep
having him remind me this story of how
that happened
he was a child in the 40s he had fevers
all the time and back then you know when
he got a fever his mother would take out
the razor blade and slit his back so the
blood could come out because the
paradigm at the time was that the bad
thing causing the infection is in the
blood and you just got to get it out so
their body could grow new blood
that’s called bloodletting and IV
freaked out like I couldn’t imagine what
mother would do this to her kid and even
now as a mother I just you know but that
was the paradigm of the time and I’m I’m
convinced that that’s when I started
kind of my purpose in life which is
really in the day to tackle messy
complex wicked intractable problems that
may
no sense and bust apartness status quo
and it just ended up that that ended up
being in the field of health care and
that’s you know solving wicked problems
on steroids and that’s what I do for a
living as a health futurist so so I’m
here to talk to you about the future of
health it is going through a fundamental
shift it will look nothing like what we
know it is today
and that’s because health care unlike
any if not all other sectors of society
has not yet materialized from all the
advances in the modern digital age so
you might be thinking well you know
these health care people maybe they just
don’t know they’re too academic
no it’s not like we’re not aware of you
know what advances in the communication
have done to transform every other part
of society in fact you know we can go
back to the early 20s I think were the
first records where you know when radio
communication was a new way of
communicating
futurists could picture a world like
this of radio medicine right where a
doctor and a patient didn’t have to be
in the same place at the same time to
communicate and then a few decades later
when TV screens were the dominant
technology in everyone’s households the
Jetsons normalized this concept of
telemedicine I’m not sure why there’s a
cover on the doctors mouth in the
picture but whatevs yet
60 years later the dominant way in most
of the world that you are I have an
interaction with a clinical expert is
still the in-person visit right we knew
it was coming but it hasn’t happened and
that’s because health care as we have it
today was built on you know some basic
ingredients buildings and clinics people
doctors nurses pens papers and fax
machines okay so for the children a fax
machine stands for facsimile it’s this
like box that takes printed pages and
digitizes them through a phone line
Healthcare’s the only industry using it
still and so all these elements are a
bricks and people and paper and fax
machines and and pens are analog alright
what what does analog do analog
constrains you on time distance space
and labor it doesn’t allow you to take
the friction out of all the different
communications and touch points and
transactions you need to have with all
the people around you to live and let
alone to be healthy and that hasn’t
changed in a hundred and fifty years so
now we all know what today’s healthcare
system feels like and I’m just gonna
walk you through a typical encounter and
this actually happened to me not that
long ago so I woke up one day with a
weird growth on the back of my neck and
I’m in health care so I don’t freak out
over things very easily but I had an
aunt who died very young of brain cancer
and a lot of these things are genetic
and so that was kind of going through
the back of my mind and and so you know
I kind of let it go I work you know I
have three kids I work full-time I
travel I couldn’t deal with the
healthcare system right now couple days
it’s getting bigger it’s starting to
hurt it’s hard and so where do I go dr.
Google freaks me out it’s like I don’t
even know what it said I had so so I
finally caved and did the dreaded call
the doctor’s office to make an
appointment so you know a few back and
forth on voicemail and finally you know
the dance starts so I get the
appointment and the doc says two weeks
I’m like okay take the day off work
drive park pay $20 to park wait an hour
and a half in the waiting room even
though we agreed on the appointment time
only for the doc to say I don’t know
what it is
so then writes a prescription for a
topical just in case and then proceeds
to fax their referral to a specialist to
see what’s going on she gets the
referral I don’t know two days later her
office sends a letter in the mail to me
to tell
my appointment is in six weeks at this
date in this time and I have no choice
and now this thing is getting nasty in
the back of my head and so my guy right
so six weeks later get to the
appointment she doesn’t know what it is
so says we need to take a biopsy she
does it thankfully in the office so that
goes to pathology they send her a fax
with the results her office calls me
won’t tell me the results because I have
to come to an appointment in two weeks
or I have to take a day off work drive
park $30 this time because it’s now in a
hospital for her to tell me it’s not
cancer it’s just an infection here’s
your prescription right that was about
85 days of me not knowing what’s going
on of using all these resources of the
healthcare system while other people
wait in line or don’t have and that’s
the one it takes me back to that
six-year-old kid having a like what the
healthcare experience and now I’m on
because I’m out to stop you know complex
problems so then I think imagine if in
the rest of our living life we had to
have this kind of experience right so I
counted this morning I have done 45
texts emails I’ve done a conference call
to video conference calls between my
family and my work life and it’s like
half you know way through the day right
if this was a healthcare paradigm for
any one of those interactions I would
have had to write a letter mail it and
tell that person when we’re gonna have
an appointment then we’d have the
appointment and that was a transaction
right business and society would grind
to a halt this weekend is my daughter’s
birthday I have to Saturday I got to get
pizza and cake if this was the
healthcare system I would have had to
take time out of work go to the bank
during their hours 9:00 to 4:00 never on
Fridays of course meet a teller get the
exact cash I need for this weekend so I
could then go make the purchase our
entire patterns of consumption and
commerce would be nothing like they are
today right
and then I’m thinking about my other kid
as a book report due next week we would
have had to take Saturday off
go to the library speak to the librarian
and tell her or him what we’re looking
for he or she would bring us some books
in some magazines we need a lot of
change to put change in the photocopy
machine to get the stuff and then he
would have to hand write or type and get
it right the first time
his report and then hand it in right our
access to education wouldn’t be nothing
like it is today
yet that’s what the healthcare
experience continues to be today and I
tell ya we now know that no matter what
budget we have we will never have the
number of doctors nurses buildings
hospital beds pills to meet the demand
of our population which is growing and
staying alive a lot longer than when we
designed healthcare 150 years ago
because people are staying alive along
with multiple diseases it’s just not
going to be possible so then I think
about my six-year-old self and I’m
actually positive because just like
bloodletting is no longer the paradigm
this paradigm of this analog system is
starting to go away so I’m a futurist I
spend all my time in the future and I’m
now gonna kind of walk you through what
its gonna start looking like very soon a
couple of these examples are actually in
the market right now they’re just not
the dominant paradigm and there’s
certainly not really available a wide
scale in Canada so in the future which
is you know here now I would just take a
picture of the thing and then my health
system would just allow me to you know
texted or uploaded an AI artificial
intelligence kind of algorithm behind
the scenes would compare this image to I
don’t know ten thousand a million a
hundred million like it and triangulate
that data with my genetics my background
my age my family history and decide with
pinpoint accuracy what it thinks is
going on suggest that to a doctor or a
nurse and that person would use their
judgment to see what
they want to take a look and make a
firmer diagnosis so maybe they’d show up
on a you know face chat or something or
a hologram it’s possible now hang out
with me at the Starbucks you know and
then I could show her it a little bit
better and she would confirm what the AI
diagnosed and then she would say oh
there’s a Rex all around the corner go
pick up your prescription right 15
minutes
remember 85 days soon I’m not gonna go
anywhere to pick up a prescription a
drones gonna deliver it to my house or
wherever I am right and then very soon
and this is already in the market I’m
gonna 3d print the drugs in my house
right there goes the whole retail
pharmacy industry so that’s kind of
level one future already here
level two we’re not gonna wait till Xena
has the symptoms so imagine if this was
the path of that thing growing behind my
neck getting worse me kind of caving and
then you know three months later I get
some conclusion the reality is over all
that time I’ve produced a mountain of
digital exhaust just by existing in the
digital world my texts my emails what
did I search on Google what cream did I
buy at Walmart what did I say to my
mother on the phone about something in
my head all that can now be mined and
crawled through by algorithms that would
have suggested an action maybe four
months earlier to prevent it from ever
happening right that’s called predicta
lytx we’re moving to that model of
Medicine now to prevent ever needing the
formal healthcare system it changes the
whole game
now here’s level three this is crazy
science but not really because it’s here
today so there’s these new tools so
there’s this new tool called CRISPR you
think of him as molecular scissors that
if you’ve got a gene so maybe my thing
was caused by bad genes it could have
been a brain tumor if they could go in
even when I’m in my mommy’s tummy at an
embryo and snip out the bad gene put it
back together and eliminate the disease
from ever happening
we’re already doing this with children
who are born with lethal genetic
diseases right so that’s gene editing
molecular surgery so most future is
predict in the future right now the top
killers in the world are things like
cancer cardiac disease heart disease
right the number one killers will not be
medical they’re gonna be accidents and
geopolitical wars and climate change
right this is where it’s going so the
future of health is going through a
fundamental shift and just like
bloodletting is no longer the paradigm
you know this experience won’t be so
what does that mean for you well it’s
got pretty big implications you might
not be thinking about because you don’t
work in health care like me but on three
levels so first is as a user of the
system whether that’s you your family
member your friend your aunt your uncle
your grandma either if you have an
experience it’s coming right we do get
sick and die this is humans at least for
now some people think we’re never gonna
die but whatever that’s a different talk
you know you have come to expect a level
of personalization intelligence
responsiveness smartness like you have
in everything else
and you’re you’re gonna need that and
expect that from health care and when it
doesn’t offer it you’re gonna be pissed
the second level is as an employer or an
employee healthy people do awesome
things and our big employers are not
gonna count on the health care system
that hasn’t changed in 150 years to keep
their employees healthy so they’re
taking things into their own hands right
Amazon is building its own healthcare
system for its employees right now and
then the third is really as a citizen
and a taxpayer you all pay into this
collective pot of money called health
insurance what is insurance do you pay
in now when you’re healthy and working
so that when you do get sick it’s there
for you and so it’s becoming more and
more important so what do you do about
it you’re probably thinking I don’t work
in health care I can’t do this it’s too
complicated well I’ve got one task
for you to do demand more you’re in
control in a way you’ve never been
before the power is shifting to you and
my one message to you is is use it so
just to give you a cue of what’s
starting to happen with with people
starting to kind of wake up and demand
more I had the pleasure of hearing the
story of this young man a couple years
ago you might have read about him
Stephen Keating so he was an MIT student
in the Media Lab doing a PhD in
something really fancy with data and he
developed a tumor in his brain about the
size of a baseball and so he really
wanted to understand what’s going on
with his biology and all this data so he
asked for all the images the MRIs and
the CT and they proceeded to give him a
stack of 30 CDs okay for the kids a CD
it’s a compact disc it could hurt hold
about I don’t know 50 gigabytes of data
and the only industry still using it to
move data is healthcare so he got the
data
he got genetically tested for himself
his clinical team didn’t want it he had
to have ten-hour surgery he had to be
awake for the surgery so they would know
they weren’t kind of cutting bad things
he videotaped that thing and streamed it
live for the whole world he had the
nurses holding iPhones to do the audio
he opened up his data for the world’s
problem solvers to help him tackle his
cancer and it’s a whole new phenomenon
of patients being empowered with their
their data so there he is after the
surgery so this is when I heard him
speak it was actually Remembrance Day he
had a Canadian poppy but this was in San
Diego so through the images never done
before it wasn’t till he did it that he
reconstructed a 3d print out of his
tumor in the red and his entire skull
and he would like walk around and show
everybody really internalizing he ended
up making Christmas ornaments of the
tumor okay so so don’t leave her saying
Dana said make salt and pepper shakers
out of my tumor no no I’m just saying
demand more I am convinced
work every day as a futurist and an
innovator trying to modernize our health
system trying to guide our patients and
our providers to the future I’m
convinced we are never gonna be able to
do it alone we need a patient uprising
we need a consumer awakening and so I’m
inviting you to join me to create the
future of healthcare instead of
protecting the past Thanks [Applause]
so my father like many who built this
country was an immigrant from the Middle
East in the 1970s to make ends meet he
had to have two jobs so he’d get up
before we were up at the dusk and start
his first job and then come home
sometime after 11 p.m. after his second
job and we were allowed to stay up
because otherwise we wouldn’t see our
father me and my sister and brother and
wait for him and we had a routine at
about 11:00 p.m. he’d come home we’d
give him his dinner for the day and then
probably two or three times a week after
a particularly punishing day beneath
cars he was a diesel mechanic he would
then lay on the floor take off his shirt
and we would fight for who got the
opportunity to stomp all over his back
to work out all the kinks in the bugs
and the pains and and this is what his
back look like and he might see these
scars and these notches his entire back
is full of these gouges and you know
when you’re a kid I’m like six and you
see someone with a scar you’re like it’s
like so so imagine as a child seeing
that on your father and no matter how
many times I’d ask I’d have to keep
having him remind me this story of how
that happened
he was a child in the 40s he had fevers
all the time and back then you know when
he got a fever his mother would take out
the razor blade and slit his back so the
blood could come out because the
paradigm at the time was that the bad
thing causing the infection is in the
blood and you just got to get it out so
their body could grow new blood
that’s called bloodletting and IV
freaked out like I couldn’t imagine what
mother would do this to her kid and even
now as a mother I just you know but that
was the paradigm of the time and I’m I’m
convinced that that’s when I started
kind of my purpose in life which is
really in the day to tackle messy
complex wicked intractable problems that
may
no sense and bust apartness status quo
and it just ended up that that ended up
being in the field of health care and
that’s you know solving wicked problems
on steroids and that’s what I do for a
living as a health futurist so so I’m
here to talk to you about the future of
health it is going through a fundamental
shift it will look nothing like what we
know it is today
and that’s because health care unlike
any if not all other sectors of society
has not yet materialized from all the
advances in the modern digital age so
you might be thinking well you know
these health care people maybe they just
don’t know they’re too academic
no it’s not like we’re not aware of you
know what advances in the communication
have done to transform every other part
of society in fact you know we can go
back to the early 20s I think were the
first records where you know when radio
communication was a new way of
communicating
futurists could picture a world like
this of radio medicine right where a
doctor and a patient didn’t have to be
in the same place at the same time to
communicate and then a few decades later
when TV screens were the dominant
technology in everyone’s households the
Jetsons normalized this concept of
telemedicine I’m not sure why there’s a
cover on the doctors mouth in the
picture but whatevs yet
60 years later the dominant way in most
of the world that you are I have an
interaction with a clinical expert is
still the in-person visit right we knew
it was coming but it hasn’t happened and
that’s because health care as we have it
today was built on you know some basic
ingredients buildings and clinics people
doctors nurses pens papers and fax
machines okay so for the children a fax
machine stands for facsimile it’s this
like box that takes printed pages and
digitizes them through a phone line
Healthcare’s the only industry using it
still and so all these elements are a
bricks and people and paper and fax
machines and and pens are analog alright
what what does analog do analog
constrains you on time distance space
and labor it doesn’t allow you to take
the friction out of all the different
communications and touch points and
transactions you need to have with all
the people around you to live and let
alone to be healthy and that hasn’t
changed in a hundred and fifty years so
now we all know what today’s healthcare
system feels like and I’m just gonna
walk you through a typical encounter and
this actually happened to me not that
long ago so I woke up one day with a
weird growth on the back of my neck and
I’m in health care so I don’t freak out
over things very easily but I had an
aunt who died very young of brain cancer
and a lot of these things are genetic
and so that was kind of going through
the back of my mind and and so you know
I kind of let it go I work you know I
have three kids I work full-time I
travel I couldn’t deal with the
healthcare system right now couple days
it’s getting bigger it’s starting to
hurt it’s hard and so where do I go dr.
Google freaks me out it’s like I don’t
even know what it said I had so so I
finally caved and did the dreaded call
the doctor’s office to make an
appointment so you know a few back and
forth on voicemail and finally you know
the dance starts so I get the
appointment and the doc says two weeks
I’m like okay take the day off work
drive park pay $20 to park wait an hour
and a half in the waiting room even
though we agreed on the appointment time
only for the doc to say I don’t know
what it is
so then writes a prescription for a
topical just in case and then proceeds
to fax their referral to a specialist to
see what’s going on she gets the
referral I don’t know two days later her
office sends a letter in the mail to me
to tell
my appointment is in six weeks at this
date in this time and I have no choice
and now this thing is getting nasty in
the back of my head and so my guy right
so six weeks later get to the
appointment she doesn’t know what it is
so says we need to take a biopsy she
does it thankfully in the office so that
goes to pathology they send her a fax
with the results her office calls me
won’t tell me the results because I have
to come to an appointment in two weeks
or I have to take a day off work drive
park $30 this time because it’s now in a
hospital for her to tell me it’s not
cancer it’s just an infection here’s
your prescription right that was about
85 days of me not knowing what’s going
on of using all these resources of the
healthcare system while other people
wait in line or don’t have and that’s
the one it takes me back to that
six-year-old kid having a like what the
healthcare experience and now I’m on
because I’m out to stop you know complex
problems so then I think imagine if in
the rest of our living life we had to
have this kind of experience right so I
counted this morning I have done 45
texts emails I’ve done a conference call
to video conference calls between my
family and my work life and it’s like
half you know way through the day right
if this was a healthcare paradigm for
any one of those interactions I would
have had to write a letter mail it and
tell that person when we’re gonna have
an appointment then we’d have the
appointment and that was a transaction
right business and society would grind
to a halt this weekend is my daughter’s
birthday I have to Saturday I got to get
pizza and cake if this was the
healthcare system I would have had to
take time out of work go to the bank
during their hours 9:00 to 4:00 never on
Fridays of course meet a teller get the
exact cash I need for this weekend so I
could then go make the purchase our
entire patterns of consumption and
commerce would be nothing like they are
today right
and then I’m thinking about my other kid
as a book report due next week we would
have had to take Saturday off
go to the library speak to the librarian
and tell her or him what we’re looking
for he or she would bring us some books
in some magazines we need a lot of
change to put change in the photocopy
machine to get the stuff and then he
would have to hand write or type and get
it right the first time
his report and then hand it in right our
access to education wouldn’t be nothing
like it is today
yet that’s what the healthcare
experience continues to be today and I
tell ya we now know that no matter what
budget we have we will never have the
number of doctors nurses buildings
hospital beds pills to meet the demand
of our population which is growing and
staying alive a lot longer than when we
designed healthcare 150 years ago
because people are staying alive along
with multiple diseases it’s just not
going to be possible so then I think
about my six-year-old self and I’m
actually positive because just like
bloodletting is no longer the paradigm
this paradigm of this analog system is
starting to go away so I’m a futurist I
spend all my time in the future and I’m
now gonna kind of walk you through what
its gonna start looking like very soon a
couple of these examples are actually in
the market right now they’re just not
the dominant paradigm and there’s
certainly not really available a wide
scale in Canada so in the future which
is you know here now I would just take a
picture of the thing and then my health
system would just allow me to you know
texted or uploaded an AI artificial
intelligence kind of algorithm behind
the scenes would compare this image to I
don’t know ten thousand a million a
hundred million like it and triangulate
that data with my genetics my background
my age my family history and decide with
pinpoint accuracy what it thinks is
going on suggest that to a doctor or a
nurse and that person would use their
judgment to see what
they want to take a look and make a
firmer diagnosis so maybe they’d show up
on a you know face chat or something or
a hologram it’s possible now hang out
with me at the Starbucks you know and
then I could show her it a little bit
better and she would confirm what the AI
diagnosed and then she would say oh
there’s a Rex all around the corner go
pick up your prescription right 15
minutes
remember 85 days soon I’m not gonna go
anywhere to pick up a prescription a
drones gonna deliver it to my house or
wherever I am right and then very soon
and this is already in the market I’m
gonna 3d print the drugs in my house
right there goes the whole retail
pharmacy industry so that’s kind of
level one future already here
level two we’re not gonna wait till Xena
has the symptoms so imagine if this was
the path of that thing growing behind my
neck getting worse me kind of caving and
then you know three months later I get
some conclusion the reality is over all
that time I’ve produced a mountain of
digital exhaust just by existing in the
digital world my texts my emails what
did I search on Google what cream did I
buy at Walmart what did I say to my
mother on the phone about something in
my head all that can now be mined and
crawled through by algorithms that would
have suggested an action maybe four
months earlier to prevent it from ever
happening right that’s called predicta
lytx we’re moving to that model of
Medicine now to prevent ever needing the
formal healthcare system it changes the
whole game
now here’s level three this is crazy
science but not really because it’s here
today so there’s these new tools so
there’s this new tool called CRISPR you
think of him as molecular scissors that
if you’ve got a gene so maybe my thing
was caused by bad genes it could have
been a brain tumor if they could go in
even when I’m in my mommy’s tummy at an
embryo and snip out the bad gene put it
back together and eliminate the disease
from ever happening
we’re already doing this with children
who are born with lethal genetic
diseases right so that’s gene editing
molecular surgery so most future is
predict in the future right now the top
killers in the world are things like
cancer cardiac disease heart disease
right the number one killers will not be
medical they’re gonna be accidents and
geopolitical wars and climate change
right this is where it’s going so the
future of health is going through a
fundamental shift and just like
bloodletting is no longer the paradigm
you know this experience won’t be so
what does that mean for you well it’s
got pretty big implications you might
not be thinking about because you don’t
work in health care like me but on three
levels so first is as a user of the
system whether that’s you your family
member your friend your aunt your uncle
your grandma either if you have an
experience it’s coming right we do get
sick and die this is humans at least for
now some people think we’re never gonna
die but whatever that’s a different talk
you know you have come to expect a level
of personalization intelligence
responsiveness smartness like you have
in everything else
and you’re you’re gonna need that and
expect that from health care and when it
doesn’t offer it you’re gonna be pissed
the second level is as an employer or an
employee healthy people do awesome
things and our big employers are not
gonna count on the health care system
that hasn’t changed in 150 years to keep
their employees healthy so they’re
taking things into their own hands right
Amazon is building its own healthcare
system for its employees right now and
then the third is really as a citizen
and a taxpayer you all pay into this
collective pot of money called health
insurance what is insurance do you pay
in now when you’re healthy and working
so that when you do get sick it’s there
for you and so it’s becoming more and
more important so what do you do about
it you’re probably thinking I don’t work
in health care I can’t do this it’s too
complicated well I’ve got one task
for you to do demand more you’re in
control in a way you’ve never been
before the power is shifting to you and
my one message to you is is use it so
just to give you a cue of what’s
starting to happen with with people
starting to kind of wake up and demand
more I had the pleasure of hearing the
story of this young man a couple years
ago you might have read about him
Stephen Keating so he was an MIT student
in the Media Lab doing a PhD in
something really fancy with data and he
developed a tumor in his brain about the
size of a baseball and so he really
wanted to understand what’s going on
with his biology and all this data so he
asked for all the images the MRIs and
the CT and they proceeded to give him a
stack of 30 CDs okay for the kids a CD
it’s a compact disc it could hurt hold
about I don’t know 50 gigabytes of data
and the only industry still using it to
move data is healthcare so he got the
data
he got genetically tested for himself
his clinical team didn’t want it he had
to have ten-hour surgery he had to be
awake for the surgery so they would know
they weren’t kind of cutting bad things
he videotaped that thing and streamed it
live for the whole world he had the
nurses holding iPhones to do the audio
he opened up his data for the world’s
problem solvers to help him tackle his
cancer and it’s a whole new phenomenon
of patients being empowered with their
their data so there he is after the
surgery so this is when I heard him
speak it was actually Remembrance Day he
had a Canadian poppy but this was in San
Diego so through the images never done
before it wasn’t till he did it that he
reconstructed a 3d print out of his
tumor in the red and his entire skull
and he would like walk around and show
everybody really internalizing he ended
up making Christmas ornaments of the
tumor okay so so don’t leave her saying
Dana said make salt and pepper shakers
out of my tumor no no I’m just saying
demand more I am convinced
work every day as a futurist and an
innovator trying to modernize our health
system trying to guide our patients and
our providers to the future I’m
convinced we are never gonna be able to
do it alone we need a patient uprising
we need a consumer awakening and so I’m
inviting you to join me to create the
future of healthcare instead of
protecting the past Thanks [Applause]
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