WEBVTT

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Please meet Jane.

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She has a high-risk pregnancy.

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Within 24 weeks,

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she's on bed rest at the hospital,

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being monitored
for her preterm contractions.

NOTE Paragraph

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She doesn't look the happiest.

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That's in part because it requires
technicians and experts

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to apply these clunky belts on her
to monitor her uterine contractions.

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Another reason Jane is not so happy
is because she's worried.

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In particular, she's worried
about what happens

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after her 10-day stay
on bed rest at the hospital.

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What happens when she's home?

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If she were to give birth this early
it would be devastating.

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As an African-American woman,

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she's twice as likely
to have a premature birth

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or to have a stillbirth.

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So Jane basically has one of two options:

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stay at the hospital on bed rest,

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a prisoner to the technology
until she gives birth,

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and then spend the rest
of her life paying for the bill;

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or head home after her 10-day stay
and hope for the best.

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Neither of these two options
seems appealing.

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As I began to think
about stories like this

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and hear about stories like this,

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I began to ask myself and imagine:

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Is there an alternative?

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Is there a way we could have
the benefits of high-fidelity monitoring

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that we get with our trusted
partners in the hospital

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while someone is at home
living their daily life?

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With that in mind,

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I encouraged people in my research group

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to partner with some
clever material scientists,

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and all of us came together
and brainstormed.

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And after a long process,

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we came up with a vision, an idea,

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of a wearable system that perhaps
you could wear like a piece of jewelry

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or you could apply
to yourself like a Band-Aid.

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And after many trials and tribulations
and years of endeavors,

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we were able to come up
with this flexible electronic patch

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that was manufactured
using the same processes

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that they use to build computer chips,

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except the electronics are transferred
from a semiconductor wafer

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onto a flexible material
that can interface with the human body.

NOTE Paragraph

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These systems are about
the thickness of a human hair.

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They can measure the types
of information that we want,

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things such as:

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bodily movement,

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bodily temperature,

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electrical rhythms of the body

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and so forth.

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We can also engineer these systems,

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so they can integrate energy sources,

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and can have wireless
transmission capabilities.

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So as we began to build
these types of systems,

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we began to test them on ourselves
in our research group.

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But in addition, we began to reach out
to some of our clinical partners

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in San Diego,

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and test these on different patients
in different clinical conditions,

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including moms-to-be like Jane.

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Here is a picture of a pregnant woman
in labor at our university hospital

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being monitored for her uterine
contractions with the conventional belt.

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In addition,

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our flexible electronic patches are there.

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This picture demonstrates waveforms
pertaining to the fetal heart rate,

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where the red corresponds
to what was acquired

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with the conventional belts,

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and the blue corresponds to our estimates

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using our flexible electronic systems
and our algorithms.

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At this moment,

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we gave ourselves a big mental high five.

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Some of the things we had imagined
were beginning to come to fruition,

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and we were actually seeing this
in a clinical context.

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But there was still a problem.

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The problem was, the way
we manufactured these systems

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was very inefficient,

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had low yield

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and was very error-prone.

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In addition,

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as we talked to some
of the nurses in the hospital,

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they encouraged us to make sure

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that our electronics worked
with typical medical adhesives

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that are used in a hospital.

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We had an epiphany and said,
"Wait a minute.

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Rather than just making
them work with adhesives,

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let's integrate them into adhesives,

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and that could solve
our manufacturing problem."

NOTE Paragraph

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This picture that you see here

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is our ability to embed these censors
inside of a piece of Scotch tape

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by simply peeling it off of a wafer.

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Ongoing work in our research group
allows us to, in addition,

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embed integrated circuits
into the flexible adhesives

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to do things like amplifying signals
and digitizing them,

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processing them

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and encoding for wireless transmission.

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All of this integrated
into the same medical adhesives

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that are used in the hospital.

NOTE Paragraph

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So when we reached this point,

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we had some other challenges,

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from both an engineering
as well as a usability perspective,

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to make sure that we could
make it used practically.

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In many digital health discussions,

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people believe in and embrace the idea
that we can simply digitize the data,

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wirelessly transmit it,

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send it to the cloud,

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and in the cloud,

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we can extract meaningful
information for interpretation.

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And indeed, you can do all of that,

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if you're not worried
about some of the energy challenges.

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Think about Jane for a moment.

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She doesn't live in Palo Alto,

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nor does she live in Beverly Hills.

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What that means is,

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we have to be mindful about her data plan
and how much it would cost

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for her to be sending out
a continuous stream of data.

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There's another challenge

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that not everyone in the medical
profession is comfortable talking about.

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And that is, that Jane
does not have the most trust

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in the medical establishment.

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She, people like her, her ancestors,
have not had the best experiences

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at the hands of doctors and the hospital

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or insurance companies.

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That means that we have to be mindful
of questions of privacy.

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Jane might not feel that happy

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about all that data
being processed into the cloud.

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And Jane cannot be fooled;

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she reads the news.

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She knows that if the federal
government can be hacked,

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if the Fortune 500 can be hacked,

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so can her doctor.

NOTE Paragraph

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And so with that in mind,

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we had an epiphany.

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We cannot outsmart
all the hackers in the world,

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but perhaps we can present
them a smaller target.

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What if we could actually,

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rather than have those algorithms
that do data interpretation

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run in the cloud,

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what if we have those algorithms run
on those small integrated circuits

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embedded into those adhesives?

NOTE Paragraph

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And so when we integrate
these things together,

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what this means is that now
we can think about the future

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where someone like Jane can still
go about living her normal daily life,

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she can be monitored,

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it can be done in a way where
she doesn't have to get another job

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to pay her data plan,

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and we can also address
some of her concerns about privacy.

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So at this point,

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we're feeling very good about ourselves.

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We've accomplished this,

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we've begun to address some
of these questions about privacy

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and we feel like, pretty much
the chapter is closed now.

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Everyone lived happily ever after, right?

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Well, not so fast.

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(Laughter)

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One of the things we have to remember,
as I mentioned earlier,

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is that Jane does not have the most trust
in the medical establishment.

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We have to remember

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that there are increasing
and widening health disparities,

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and there's inequity in terms
of proper care management.

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And so what that means
is that this simple picture

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of Jane and her data --

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even with her being comfortable
being wirelessly transmitted to the cloud,

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letting a doctor intervene if necessary --

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is not the whole story.

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So what we're beginning to do

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is to think about ways to have
trusted parties serve as intermediaries

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between people like Jane
and her health care providers.

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For example, we've begun
to partner with churches

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and to think about nurses
that are church members,

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that come from that trusted community,

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as patient advocates and health coaches
to people like Jane.

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Another thing we have going for us

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is that insurance companies, increasingly,

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are attracted to some of these ideas.

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They're increasingly realizing

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that perhaps it's better
to pay one dollar now

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for a wearable device and a health coach,

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rather than paying 10 dollars later,

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when that baby is born prematurely

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and ends up in the neonatal
intensive care unit --

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one of the most expensive
parts of a hospital.

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This has been a long
learning process for us.

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This iterative process of breaking
through and attacking one problem

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and not feeling totally comfortable,

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and identifying the next problem,

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has helped us go along this path

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of actually trying to not only
innovate with this technology

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but make sure it can be used for people
who perhaps need it the most.

NOTE Paragraph

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Another learning lesson
we've taken from this process

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that is very humbling,

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is that as technology progresses
and advances at an accelerating rate,

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we have to remember that human beings
are using this technology,

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and we have to be mindful

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that these human beings --
they have a face,

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they have a name

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and a life.

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And in the case of Jane,

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hopefully, two.

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Thank you.

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(Applause)