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I want to share some personal friends and stories with you

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that I've actually never talked about in public before

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to help illustrate the idea

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and the need and the hope

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for us to reinvent our health care system around the world.

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Twenty-four years ago, I had -- a sophomore in college,

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I had a series of fainting spells. No alcohol was involved.

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And I ended up in student health,

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and they ran some labwork and came back right away,

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and said, "Kidney problems."

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And before I knew it, I was involved and thrown into

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this six months of tests and trials and tribulations

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with six doctors across two hospitals

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in this clash of medical titans

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to figure out which one of them was right

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about what was wrong with me.

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And I'm sitting in a waiting room some time later for an ultrasound,

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and all six of these doctors actually show up in the room at once,

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and I'm like, "Uh oh, this is bad news."

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And their diagnosis was this:

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They said, "You have two rare kidney diseases

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that are going to actually destroy your kidneys eventually,

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you have cancer-like cells in your immune system

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that we need to start treatment right away,

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and you'll never be eligible for a kidney transplant,

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and you're not likely to live more than two or three years."

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Now, with the gravity of this doomsday diagnosis,

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it just sucked me in immediately,

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as if I began preparing myself as a patient

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to die according to the schedule that they had just given to me,

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until I met a patient named Verna in a waiting room,

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who became a dear friend, and she grabbed me one day

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and took me off to the medical library

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and did a bunch of research on these diagnoses and these diseases,

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and said, "Eric, these people who get this

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are normally in their '70s and '80s.

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They don't know anything about you. Wake up.

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Take control of your health and get on with your life."

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And I did.

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Now, these people making these proclamations to me

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were not bad people.

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In fact, these professionals were miracle workers,

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but they're working in a flawed, expensive system that's set up the wrong way.

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It's dependent on hospitals and clinics for our every care need.

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It's dependent on specialists who just look at parts of us.

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It's dependent on guesswork of diagnoses and drug cocktails,

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and so something either works or you die.

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And it's dependent on passive patients

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who just take it and don't ask any questions.

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Now the problem with this model

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is that it's unsustainable globally.

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It's unaffordable globally.

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We need to invent what I call a personal health system.

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So what does this personal health system look like,

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and what new technologies and roles is it going to entail?

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Now, I'm going to start by actually sharing with you

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a new friend of mine, Libby,

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somebody I've become quite attached to over the last six months.

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This is Libby, or actually, this is an ultrasound image of Libby.

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This is the kidney transplant I was never supposed to have.

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Now, this is an image that we shot a couple of weeks ago for today,

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and you'll notice, on the edge of this image,

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there's some dark spots there, which was really concerning to me.

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So we're going to actually do a live exam

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to sort of see how Libby's doing.

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This is not a wardrobe malfunction. I have to take my belt off here.

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Don't you in the front row worry or anything.

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(Laughter)

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I'm going to use a device from a company called Mobisante.

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This is a portable ultrasound.

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It can plug into a smartphone. It can plug into a tablet.

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Mobisante is up in Redmond, Washington,

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and they kindly trained me to actually do this on myself.

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They're not approved to do this. Patients are not approved to do this.

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This is a concept demo, so I want to make that clear.

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All right, I gotta gel up.

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Now the people in the front row are very nervous. (Laughter)

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And I want to actually introduce you to Dr. Batiuk,

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who's another friend of mine.

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He's up in Legacy Good Samaritan Hospital in Portland, Oregon.

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So let me just make sure. Hey, Dr. Batiuk. Can you hear me okay?

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And actually, can you see Libby?

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Thomas Batuik: Hi there, Eric.

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You look busy. How are you?

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Eric Dishman: I'm good. I'm just taking my clothes off

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in front of a few hundred people. It's wonderful.

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So I just wanted to see, is this the image you need to get?

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And I know you want to look and see if those spots are still there.

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TB: Okay. Well let's scan around a little bit here,

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give me a lay of the land.

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ED: All right.TB: Okay. Turn it a little bit inside,

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a little bit toward the middle for me.

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Okay, that's good. How about up a little bit?

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Okay, freeze that image. That's a good one for me.

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ED: All right. Now last week, when I did this,

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you had me measure that spot to the right.

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Should I do that again?

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TB: Yeah, let's do that.

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ED: All right. This is kind of hard to do

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with one hand on your belly and one hand on measuring,

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but I've got it, I think,

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and I'll save that image and send it to you.

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So tell me a little bit about what this dark spot means.

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It's not something I was very happy about.

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TB: Many people after a kidney transplant

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will develop a little fluid collection around the kidney.

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Most of the time it doesn't create any kind of mischief,

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but it does warrant looking at,

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so I'm happy we've got an opportunity to look at it today,

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make sure that it's not growing, it's not creating any problems.

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Based on the other images we have,

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I'm really happy how it looks today.

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ED: All right. Well, I guess we'll double check it when I come in.

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I've got my six month biopsy in a couple of weeks,

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and I'm going to let you do that in the clinic,

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because I don't think I can do that one on myself.

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TB: Good choice.ED: All right, thanks, Dr. Batiuk.

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All right. So what you're sort of seeing here

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is an example of disruptive technologies,

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of mobile, social and analytic technologies.

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These are the foundations of what's going to make personal health possible.

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Now there's really three pillars

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of this personal health I want to talk to you about now,

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and it's care anywhere, care networking and care customization.

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And you just saw a little bit of the first two

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with my interaction with Dr. Batiuk.

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So let's start with care anywhere.

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Humans invented the idea of hospitals and clinics

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in the 1780s. It is time to update our thinking.

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We have got to untether clinicians and patients

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from the notion of traveling to a special

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bricks-and-mortar place for all of our care,

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because these places are often the wrong tool,

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and the most expensive tool, for the job.

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And these are sometimes unsafe places to send our sickest patients,

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especially in an era of superbugs

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and hospital-acquired infections.

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And many countries are going to go brickless from the start

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because they're never going to be able to afford

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the mega-medicalplexes that a lot of the rest of the world has built.

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Now I personally learned that hospitals

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can be a very dangerous place at a young age.

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This was me in third grade.

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I broke my elbow very seriously, had to have surgery,

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worried that they were going to actually lose the arm.

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Recovering from the surgery in the hospital, I get bedsores.

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Those bedsores become infected,

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and they give me an antibiotic which I end up being allergic to,

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and now my whole body breaks out,

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and now all of those become infected.

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The longer I stayed in the hospital, the sicker I became,

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and the more expensive it became,

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and this happens to millions of people around the world every year.

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The future of personal health that I'm talking about

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says care must occur at home as the default model,

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not in a hospital or clinic.

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You have to earn your way into those places

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by being sick enough to use that tool for the job.

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Now the smartphones that we're already carrying

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can clearly have diagnostic devices like ultrasounds plugged into them,

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and a whole array of others, today,

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and as sensing is built into these,

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we'll be able to do vital signs monitor

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and behavioral monitoring like we've never had before.

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Many of us will have implantables that will actually look

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real-time at what's going on with our blood chemistry

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and in our proteins right now.

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Now the software is also getting smarter, right?

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Think about a coach, an agent online,

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that's going to help me do safe self-care.

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That same interaction that we just did with the ultrasound

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will likely have real-time image processing,

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and the device will say, "Up, down, left, right,

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ah, Eric, that's the perfect spot to send that image

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off to your doctor."

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Now, if we've got all these networked devices

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that are helping us to do care anywhere,

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it stands to reason that we also need a team

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to be able to interact with all of that stuff,

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and that leads to the second pillar I want to talk about,

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care networking.

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We have got to go beyond this paradigm

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of isolated specialists doing parts care

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to multidisciplinary teams doing person care.

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Uncoordinated care today is expensive at best,

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and it is deadly at worst.

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Eighty percent of medical errors are actually caused

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by communication and coordination problems

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amongst medical team members.

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I had my own heart scare years ago in graduate school,

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when we're under treatment for the kidney,

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and suddenly, they're like, "Oh, we think you have a heart problem."

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And I have these palpitations that are showing up.

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They put me through five weeks of tests --

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very expensive, very scary -- before the nurse finally notices

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the piece of the paper, my meds list

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that I've been carrying to every single appointment,

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and says, "Oh my gosh."

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Three different specialists had prescribed

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three different versions of the same drug to me.

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I did not have a heart problem. I had an overdose problem.

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I had a care coordination problem.

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And this happens to millions of people every year.

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I want to use technology that we're all working on and making happen

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to make health care a coordinated team sport.

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Now this is the most frightening thing to me.

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Out of all the care I've had in hospitals and clinics around the world,

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the first time I've ever had a true team-based care experience

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was at Legacy Good Sam these last six months

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for me to go get this.

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And this is a picture of my graduation team from Legacy.

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There's a couple of the folks here. You'll recognize Dr. Batiuk.

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We just talked to him. Here's Jenny, one of the nurses,

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Allison, who helped manage the transplant list,

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and a dozen other people who aren't pictured,

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a pharmacist, a psychologist, a nutritionist,

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even a financial counselor, Lisa,

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who helped us deal with all the insurance hassles.

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I wept the day I graduated.

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I should have been happy, because I was so well

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that I could go back to my normal doctors,

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but I wept because I was so actually connected to this team.

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And here's the most important part.

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The other people in this picture are me and my wife, Ashley.

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Legacy trained us on how to do care for me at home

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so that they could offload the hospitals and clinics.

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That's the only way that the model works.

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My team is actually working in China

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on one of these self-care models

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for a project we called Age-Friendly Cities.

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We're trying to help build a social network

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that can help track and train the care of seniors

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caring for themselves

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as well as the care provided by their family members

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or volunteer community health workers,

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as well as have an exchange network online,

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where, for example, I can donate three hours of care a day to your mom,

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if somebody else can help me with transportation to meals,

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and we exchange all of that online.

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The most important point I want to make to you about this

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is the sacred and somewhat over-romanticized

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doctor-patient one-on-one

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is a relic of the past.

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The future of health care is smart teams,

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and you'd better be on that team for yourself.

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Now, the last thing that I want to talk to you about

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is care customization,

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because if you've got care anywhere and you've got care networking,

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those are going to go a long way towards improving our health care system,

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but there's still too much guesswork.

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Randomized clinical trials were actually invented in 1948

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to help invent the drugs that cured tuberculosis,

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and those are important things, don't get me wrong.

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These population studies that we've done have created

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tons of miracle drugs that have saved millions of lives,

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but the problem is that health care

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is treating us as averages, not unique individuals,

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because at the end of the day,

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the patient is not the same thing as the population

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who are studied. That's what's leading to the guesswork.

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The technologies that are coming,

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high-performance computing, analytics,

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big data that everyone's talking about,

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will allow us to build predictive models for each of us

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as individual patients.

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And the magic here is, experiment on my avatar

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in software, not my body in suffering.

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Now, I've had two examples I want to quickly share with you

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of this kind of care customization on my own journey.

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The first was quite simple. I finally realized some years ago

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that all my medical teams were optimizing my treatment for longevity.

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It's like a badge of honor to see how long they can get the patient to live.

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I was optimizing my life for quality of life,

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and quality of life for me means time in snow.

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So on my chart, I forced them to put, "Patient goal:

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low doses of drugs over longer periods of time,

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side effects friendly to skiing."

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And I think that's why I achieved longevity.

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I think that time-in-snow therapy was as important

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as the pharmaceuticals that I had.

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Now the second example of customization -- and by the way,

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you can't customize care if you don't know your own goals,

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so health care can't know those until you know your own health care goals.

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But the second example I want to give you is,

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I happened to be an early guinea pig,

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and I got very lucky to have my whole genome sequenced.

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Now it took about two weeks of processing

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on Intel's highest-end servers to make this happen,

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and another six months of human and computing labor

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to make sense of all of that data.

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And at the end of all of that, they said, "Yes,

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those diagnoses of that clash of medical titans

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all of those years ago were wrong,

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and we have a better path forward."

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The future that Intel's working on now is to figure out

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how to make that computing for personalized medicine

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go from months and weeks to even hours,

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and make this kind of tool available,

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not just in the mainframes of tier-one research hospitals around the world,

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but in the mainstream -- every patient, every clinic

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with access to whole genome sequencing.

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And I tell you, this kind of care customization

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for everything from your goals to your genetics

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will be the most game-changing transformation

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that we witness in health care during our lifetime.

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So these three pillars of personal health,

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care anywhere, care networking, care customization,

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are happening in pieces now,

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but this vision will completely fail if we don't step up

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as caregivers and as patients to take on new roles.

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It's what my friend Verna said:

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Wake up and take control of your health.

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Because at the end of the day these technologies

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are simply about people caring for other people

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and ourselves in some powerful new ways.

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And it's in that spirit that I want to introduce you

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to one last friend, very quickly.

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Tracey Gamley stepped up to give me the impossible kidney

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that I was never supposed to have.

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(Applause)

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So Tracey, just tell us a little bit quickly about what the donor experience was like with you.

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Tracey Gamley: For me, it was really easy.

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I only had one night in the hospital.

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The surgery was done laparoscopically,

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so I have just five very small scars on my abdomen,

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and I had four weeks away from work

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and went back to doing everything I'd done before

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without any changes.

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ED: Well, I probably will never get a chance to say this to you

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in such a large audience ever again.

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So "thank you" feel likes a really trite word,

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but thank you from the bottom of my heart for saving my life.

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(Applause)

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This TED stage and all of the TED stages

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are often about celebrating innovation

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and celebrating new technologies,

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and I've done that here today,

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and I've seen amazing things coming from TED speakers,

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I mean, my gosh, artificial kidneys, even printable kidneys, that are coming.

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But until such time that these amazing technologies

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are available to all of us, and even when they are,

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it's up to us to care for, and even save, one another.

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I hope you will go out and make personal health happen

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for yourselves and for everyone. Thanks so much.

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(Applause)