[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:01.24,0:00:05.20,Default,,0000,0000,0000,,I want to share some personal friends and stories with you
Dialogue: 0,0:00:05.20,0:00:07.23,Default,,0000,0000,0000,,that I've actually never talked about in public before
Dialogue: 0,0:00:07.23,0:00:09.59,Default,,0000,0000,0000,,to help illustrate the idea
Dialogue: 0,0:00:09.59,0:00:11.51,Default,,0000,0000,0000,,and the need and the hope
Dialogue: 0,0:00:11.51,0:00:14.79,Default,,0000,0000,0000,,for us to reinvent our health care system around the world.
Dialogue: 0,0:00:14.79,0:00:18.18,Default,,0000,0000,0000,,Twenty-four years ago, I had -- a sophomore in college,
Dialogue: 0,0:00:18.18,0:00:21.00,Default,,0000,0000,0000,,I had a series of fainting spells. No alcohol was involved.
Dialogue: 0,0:00:21.00,0:00:23.93,Default,,0000,0000,0000,,And I ended up in student health,
Dialogue: 0,0:00:23.93,0:00:26.10,Default,,0000,0000,0000,,and they ran some labwork and came back right away,
Dialogue: 0,0:00:26.10,0:00:28.28,Default,,0000,0000,0000,,and said, "Kidney problems."
Dialogue: 0,0:00:28.28,0:00:31.72,Default,,0000,0000,0000,,And before I knew it, I was involved and thrown into
Dialogue: 0,0:00:31.72,0:00:34.94,Default,,0000,0000,0000,,this six months of tests and trials and tribulations
Dialogue: 0,0:00:34.94,0:00:37.63,Default,,0000,0000,0000,,with six doctors across two hospitals
Dialogue: 0,0:00:37.63,0:00:40.32,Default,,0000,0000,0000,,in this clash of medical titans
Dialogue: 0,0:00:40.32,0:00:42.37,Default,,0000,0000,0000,,to figure out which one of them was right
Dialogue: 0,0:00:42.37,0:00:44.83,Default,,0000,0000,0000,,about what was wrong with me.
Dialogue: 0,0:00:44.83,0:00:48.11,Default,,0000,0000,0000,,And I'm sitting in a waiting room some time later for an ultrasound,
Dialogue: 0,0:00:48.11,0:00:50.93,Default,,0000,0000,0000,,and all six of these doctors actually show up in the room at once,
Dialogue: 0,0:00:50.93,0:00:55.28,Default,,0000,0000,0000,,and I'm like, "Uh oh, this is bad news."
Dialogue: 0,0:00:55.28,0:00:56.84,Default,,0000,0000,0000,,And their diagnosis was this:
Dialogue: 0,0:00:56.84,0:00:58.75,Default,,0000,0000,0000,,They said, "You have two rare kidney diseases
Dialogue: 0,0:00:58.75,0:01:01.44,Default,,0000,0000,0000,,that are going to actually destroy your kidneys eventually,
Dialogue: 0,0:01:01.44,0:01:03.97,Default,,0000,0000,0000,,you have cancer-like cells in your immune system
Dialogue: 0,0:01:03.97,0:01:05.89,Default,,0000,0000,0000,,that we need to start treatment right away,
Dialogue: 0,0:01:05.89,0:01:08.35,Default,,0000,0000,0000,,and you'll never be eligible for a kidney transplant,
Dialogue: 0,0:01:08.35,0:01:11.76,Default,,0000,0000,0000,,and you're not likely to live more than two or three years."
Dialogue: 0,0:01:11.76,0:01:14.73,Default,,0000,0000,0000,,Now, with the gravity of this doomsday diagnosis,
Dialogue: 0,0:01:14.73,0:01:17.13,Default,,0000,0000,0000,,it just sucked me in immediately,
Dialogue: 0,0:01:17.13,0:01:19.77,Default,,0000,0000,0000,,as if I began preparing myself as a patient
Dialogue: 0,0:01:19.77,0:01:23.87,Default,,0000,0000,0000,,to die according to the schedule that they had just given to me,
Dialogue: 0,0:01:23.87,0:01:26.51,Default,,0000,0000,0000,,until I met a patient named Verna in a waiting room,
Dialogue: 0,0:01:26.51,0:01:28.57,Default,,0000,0000,0000,,who became a dear friend, and she grabbed me one day
Dialogue: 0,0:01:28.57,0:01:30.56,Default,,0000,0000,0000,,and took me off to the medical library
Dialogue: 0,0:01:30.56,0:01:33.49,Default,,0000,0000,0000,,and did a bunch of research on these diagnoses and these diseases,
Dialogue: 0,0:01:33.49,0:01:36.01,Default,,0000,0000,0000,,and said, "Eric, these people who get this
Dialogue: 0,0:01:36.01,0:01:37.96,Default,,0000,0000,0000,,are normally in their '70s and '80s.
Dialogue: 0,0:01:37.96,0:01:41.07,Default,,0000,0000,0000,,They don't know anything about you. Wake up.
Dialogue: 0,0:01:41.07,0:01:44.20,Default,,0000,0000,0000,,Take control of your health and get on with your life."
Dialogue: 0,0:01:44.20,0:01:45.74,Default,,0000,0000,0000,,And I did.
Dialogue: 0,0:01:45.74,0:01:48.10,Default,,0000,0000,0000,,Now, these people making these proclamations to me
Dialogue: 0,0:01:48.10,0:01:49.42,Default,,0000,0000,0000,,were not bad people.
Dialogue: 0,0:01:49.42,0:01:51.98,Default,,0000,0000,0000,,In fact, these professionals were miracle workers,
Dialogue: 0,0:01:51.98,0:01:56.05,Default,,0000,0000,0000,,but they're working in a flawed, expensive system that's set up the wrong way.
Dialogue: 0,0:01:56.05,0:01:59.30,Default,,0000,0000,0000,,It's dependent on hospitals and clinics for our every care need.
Dialogue: 0,0:01:59.30,0:02:02.97,Default,,0000,0000,0000,,It's dependent on specialists who just look at parts of us.
Dialogue: 0,0:02:02.97,0:02:06.89,Default,,0000,0000,0000,,It's dependent on guesswork of diagnoses and drug cocktails,
Dialogue: 0,0:02:06.89,0:02:09.49,Default,,0000,0000,0000,,and so something either works or you die.
Dialogue: 0,0:02:09.49,0:02:13.70,Default,,0000,0000,0000,,And it's dependent on passive patients
Dialogue: 0,0:02:13.70,0:02:17.46,Default,,0000,0000,0000,,who just take it and don't ask any questions.
Dialogue: 0,0:02:17.46,0:02:19.02,Default,,0000,0000,0000,,Now the problem with this model
Dialogue: 0,0:02:19.02,0:02:21.50,Default,,0000,0000,0000,,is that it's unsustainable globally.
Dialogue: 0,0:02:21.50,0:02:23.46,Default,,0000,0000,0000,,It's unaffordable globally.
Dialogue: 0,0:02:23.46,0:02:26.95,Default,,0000,0000,0000,,We need to invent what I call a personal health system.
Dialogue: 0,0:02:26.95,0:02:29.27,Default,,0000,0000,0000,,So what does this personal health system look like,
Dialogue: 0,0:02:29.27,0:02:34.31,Default,,0000,0000,0000,,and what new technologies and roles is it going to entail?
Dialogue: 0,0:02:34.31,0:02:36.46,Default,,0000,0000,0000,,Now, I'm going to start by actually sharing with you
Dialogue: 0,0:02:36.46,0:02:38.36,Default,,0000,0000,0000,,a new friend of mine, Libby,
Dialogue: 0,0:02:38.36,0:02:41.07,Default,,0000,0000,0000,,somebody I've become quite attached to over the last six months.
Dialogue: 0,0:02:41.07,0:02:44.95,Default,,0000,0000,0000,,This is Libby, or actually, this is an ultrasound image of Libby.
Dialogue: 0,0:02:44.95,0:02:47.82,Default,,0000,0000,0000,,This is the kidney transplant I was never supposed to have.
Dialogue: 0,0:02:47.82,0:02:51.67,Default,,0000,0000,0000,,Now, this is an image that we shot a couple of weeks ago for today,
Dialogue: 0,0:02:51.67,0:02:53.61,Default,,0000,0000,0000,,and you'll notice, on the edge of this image,
Dialogue: 0,0:02:53.61,0:02:56.52,Default,,0000,0000,0000,,there's some dark spots there, which was really concerning to me.
Dialogue: 0,0:02:56.52,0:02:59.05,Default,,0000,0000,0000,,So we're going to actually do a live exam
Dialogue: 0,0:02:59.05,0:03:00.42,Default,,0000,0000,0000,,to sort of see how Libby's doing.
Dialogue: 0,0:03:00.42,0:03:03.14,Default,,0000,0000,0000,,This is not a wardrobe malfunction. I have to take my belt off here.
Dialogue: 0,0:03:03.14,0:03:05.28,Default,,0000,0000,0000,,Don't you in the front row worry or anything.
Dialogue: 0,0:03:05.28,0:03:06.56,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:03:06.56,0:03:10.28,Default,,0000,0000,0000,,I'm going to use a device from a company called Mobisante.
Dialogue: 0,0:03:10.28,0:03:11.76,Default,,0000,0000,0000,,This is a portable ultrasound.
Dialogue: 0,0:03:11.76,0:03:14.30,Default,,0000,0000,0000,,It can plug into a smartphone. It can plug into a tablet.
Dialogue: 0,0:03:14.30,0:03:16.43,Default,,0000,0000,0000,,Mobisante is up in Redmond, Washington,
Dialogue: 0,0:03:16.43,0:03:20.08,Default,,0000,0000,0000,,and they kindly trained me to actually do this on myself.
Dialogue: 0,0:03:20.08,0:03:22.29,Default,,0000,0000,0000,,They're not approved to do this. Patients are not approved to do this.
Dialogue: 0,0:03:22.29,0:03:25.10,Default,,0000,0000,0000,,This is a concept demo, so I want to make that clear.
Dialogue: 0,0:03:25.10,0:03:26.18,Default,,0000,0000,0000,,All right, I gotta gel up.
Dialogue: 0,0:03:26.18,0:03:30.64,Default,,0000,0000,0000,,Now the people in the front row are very nervous. (Laughter)
Dialogue: 0,0:03:30.64,0:03:34.68,Default,,0000,0000,0000,,And I want to actually introduce you to Dr. Batiuk,
Dialogue: 0,0:03:34.68,0:03:36.13,Default,,0000,0000,0000,,who's another friend of mine.
Dialogue: 0,0:03:36.13,0:03:40.01,Default,,0000,0000,0000,,He's up in Legacy Good Samaritan Hospital in Portland, Oregon.
Dialogue: 0,0:03:40.01,0:03:43.51,Default,,0000,0000,0000,,So let me just make sure. Hey, Dr. Batiuk. Can you hear me okay?
Dialogue: 0,0:03:43.51,0:03:45.68,Default,,0000,0000,0000,,And actually, can you see Libby?
Dialogue: 0,0:03:45.68,0:03:46.86,Default,,0000,0000,0000,,Thomas Batuik: Hi there, Eric.
Dialogue: 0,0:03:46.86,0:03:48.11,Default,,0000,0000,0000,,You look busy. How are you?
Dialogue: 0,0:03:48.11,0:03:50.84,Default,,0000,0000,0000,,Eric Dishman: I'm good. I'm just taking my clothes off
Dialogue: 0,0:03:50.84,0:03:53.40,Default,,0000,0000,0000,,in front of a few hundred people. It's wonderful.
Dialogue: 0,0:03:53.40,0:03:58.06,Default,,0000,0000,0000,,So I just wanted to see, is this the image you need to get?
Dialogue: 0,0:03:58.06,0:04:01.80,Default,,0000,0000,0000,,And I know you want to look and see if those spots are still there.
Dialogue: 0,0:04:01.80,0:04:04.53,Default,,0000,0000,0000,,TB: Okay. Well let's scan around a little bit here,
Dialogue: 0,0:04:04.53,0:04:05.80,Default,,0000,0000,0000,,give me a lay of the land.
Dialogue: 0,0:04:05.80,0:04:09.32,Default,,0000,0000,0000,,ED: All right.TB: Okay. Turn it a little bit inside,
Dialogue: 0,0:04:09.32,0:04:11.72,Default,,0000,0000,0000,,a little bit toward the middle for me.
Dialogue: 0,0:04:11.72,0:04:16.51,Default,,0000,0000,0000,,Okay, that's good. How about up a little bit?
Dialogue: 0,0:04:16.51,0:04:19.56,Default,,0000,0000,0000,,Okay, freeze that image. That's a good one for me.
Dialogue: 0,0:04:19.56,0:04:22.25,Default,,0000,0000,0000,,ED: All right. Now last week, when I did this,
Dialogue: 0,0:04:22.25,0:04:25.05,Default,,0000,0000,0000,,you had me measure that spot to the right.
Dialogue: 0,0:04:25.05,0:04:26.74,Default,,0000,0000,0000,,Should I do that again?
Dialogue: 0,0:04:26.74,0:04:27.78,Default,,0000,0000,0000,,TB: Yeah, let's do that.
Dialogue: 0,0:04:27.78,0:04:31.09,Default,,0000,0000,0000,,ED: All right. This is kind of hard to do
Dialogue: 0,0:04:31.09,0:04:33.26,Default,,0000,0000,0000,,with one hand on your belly and one hand on measuring,
Dialogue: 0,0:04:33.26,0:04:34.51,Default,,0000,0000,0000,,but I've got it, I think,
Dialogue: 0,0:04:34.51,0:04:37.06,Default,,0000,0000,0000,,and I'll save that image and send it to you.
Dialogue: 0,0:04:37.06,0:04:39.54,Default,,0000,0000,0000,,So tell me a little bit about what this dark spot means.
Dialogue: 0,0:04:39.54,0:04:41.64,Default,,0000,0000,0000,,It's not something I was very happy about.
Dialogue: 0,0:04:41.64,0:04:43.58,Default,,0000,0000,0000,,TB: Many people after a kidney transplant
Dialogue: 0,0:04:43.58,0:04:46.85,Default,,0000,0000,0000,,will develop a little fluid collection around the kidney.
Dialogue: 0,0:04:46.85,0:04:50.13,Default,,0000,0000,0000,,Most of the time it doesn't create any kind of mischief,
Dialogue: 0,0:04:50.13,0:04:52.54,Default,,0000,0000,0000,,but it does warrant looking at,
Dialogue: 0,0:04:52.54,0:04:55.52,Default,,0000,0000,0000,,so I'm happy we've got an opportunity to look at it today,
Dialogue: 0,0:04:55.52,0:04:58.44,Default,,0000,0000,0000,,make sure that it's not growing, it's not creating any problems.
Dialogue: 0,0:04:58.44,0:05:00.66,Default,,0000,0000,0000,,Based on the other images we have,
Dialogue: 0,0:05:00.66,0:05:03.04,Default,,0000,0000,0000,,I'm really happy how it looks today.
Dialogue: 0,0:05:03.04,0:05:05.44,Default,,0000,0000,0000,,ED: All right. Well, I guess we'll double check it when I come in.
Dialogue: 0,0:05:05.44,0:05:08.01,Default,,0000,0000,0000,,I've got my six month biopsy in a couple of weeks,
Dialogue: 0,0:05:08.01,0:05:09.72,Default,,0000,0000,0000,,and I'm going to let you do that in the clinic,
Dialogue: 0,0:05:09.72,0:05:12.16,Default,,0000,0000,0000,,because I don't think I can do that one on myself.
Dialogue: 0,0:05:12.16,0:05:14.80,Default,,0000,0000,0000,,TB: Good choice.ED: All right, thanks, Dr. Batiuk.
Dialogue: 0,0:05:14.80,0:05:16.93,Default,,0000,0000,0000,,All right. So what you're sort of seeing here
Dialogue: 0,0:05:16.93,0:05:19.04,Default,,0000,0000,0000,,is an example of disruptive technologies,
Dialogue: 0,0:05:19.04,0:05:22.24,Default,,0000,0000,0000,,of mobile, social and analytic technologies.
Dialogue: 0,0:05:22.24,0:05:25.15,Default,,0000,0000,0000,,These are the foundations of what's going to make personal health possible.
Dialogue: 0,0:05:25.15,0:05:27.73,Default,,0000,0000,0000,,Now there's really three pillars
Dialogue: 0,0:05:27.73,0:05:29.63,Default,,0000,0000,0000,,of this personal health I want to talk to you about now,
Dialogue: 0,0:05:29.63,0:05:33.42,Default,,0000,0000,0000,,and it's care anywhere, care networking and care customization.
Dialogue: 0,0:05:33.42,0:05:35.10,Default,,0000,0000,0000,,And you just saw a little bit of the first two
Dialogue: 0,0:05:35.10,0:05:36.64,Default,,0000,0000,0000,,with my interaction with Dr. Batiuk.
Dialogue: 0,0:05:36.64,0:05:39.52,Default,,0000,0000,0000,,So let's start with care anywhere.
Dialogue: 0,0:05:39.52,0:05:42.25,Default,,0000,0000,0000,,Humans invented the idea of hospitals and clinics
Dialogue: 0,0:05:42.25,0:05:46.15,Default,,0000,0000,0000,,in the 1780s. It is time to update our thinking.
Dialogue: 0,0:05:46.15,0:05:49.65,Default,,0000,0000,0000,,We have got to untether clinicians and patients
Dialogue: 0,0:05:49.65,0:05:52.26,Default,,0000,0000,0000,,from the notion of traveling to a special
Dialogue: 0,0:05:52.26,0:05:54.84,Default,,0000,0000,0000,,bricks-and-mortar place for all of our care,
Dialogue: 0,0:05:54.84,0:05:57.14,Default,,0000,0000,0000,,because these places are often the wrong tool,
Dialogue: 0,0:05:57.14,0:05:59.61,Default,,0000,0000,0000,,and the most expensive tool, for the job.
Dialogue: 0,0:05:59.61,0:06:03.16,Default,,0000,0000,0000,,And these are sometimes unsafe places to send our sickest patients,
Dialogue: 0,0:06:03.16,0:06:05.30,Default,,0000,0000,0000,,especially in an era of superbugs
Dialogue: 0,0:06:05.30,0:06:07.42,Default,,0000,0000,0000,,and hospital-acquired infections.
Dialogue: 0,0:06:07.42,0:06:10.30,Default,,0000,0000,0000,,And many countries are going to go brickless from the start
Dialogue: 0,0:06:10.30,0:06:12.26,Default,,0000,0000,0000,,because they're never going to be able to afford
Dialogue: 0,0:06:12.26,0:06:16.78,Default,,0000,0000,0000,,the mega-medicalplexes that a lot of the rest of the world has built.
Dialogue: 0,0:06:16.78,0:06:19.54,Default,,0000,0000,0000,,Now I personally learned that hospitals
Dialogue: 0,0:06:19.54,0:06:22.06,Default,,0000,0000,0000,,can be a very dangerous place at a young age.
Dialogue: 0,0:06:22.06,0:06:23.90,Default,,0000,0000,0000,,This was me in third grade.
Dialogue: 0,0:06:23.90,0:06:26.31,Default,,0000,0000,0000,,I broke my elbow very seriously, had to have surgery,
Dialogue: 0,0:06:26.31,0:06:28.64,Default,,0000,0000,0000,,worried that they were going to actually lose the arm.
Dialogue: 0,0:06:28.64,0:06:31.58,Default,,0000,0000,0000,,Recovering from the surgery in the hospital, I get bedsores.
Dialogue: 0,0:06:31.58,0:06:33.81,Default,,0000,0000,0000,,Those bedsores become infected,
Dialogue: 0,0:06:33.81,0:06:36.74,Default,,0000,0000,0000,,and they give me an antibiotic which I end up being allergic to,
Dialogue: 0,0:06:36.74,0:06:38.70,Default,,0000,0000,0000,,and now my whole body breaks out,
Dialogue: 0,0:06:38.70,0:06:41.26,Default,,0000,0000,0000,,and now all of those become infected.
Dialogue: 0,0:06:41.26,0:06:43.80,Default,,0000,0000,0000,,The longer I stayed in the hospital, the sicker I became,
Dialogue: 0,0:06:43.80,0:06:45.39,Default,,0000,0000,0000,,and the more expensive it became,
Dialogue: 0,0:06:45.39,0:06:48.73,Default,,0000,0000,0000,,and this happens to millions of people around the world every year.
Dialogue: 0,0:06:48.73,0:06:51.08,Default,,0000,0000,0000,,The future of personal health that I'm talking about
Dialogue: 0,0:06:51.08,0:06:55.53,Default,,0000,0000,0000,,says care must occur at home as the default model,
Dialogue: 0,0:06:55.53,0:06:57.01,Default,,0000,0000,0000,,not in a hospital or clinic.
Dialogue: 0,0:06:57.01,0:06:58.57,Default,,0000,0000,0000,,You have to earn your way into those places
Dialogue: 0,0:06:58.57,0:07:02.14,Default,,0000,0000,0000,,by being sick enough to use that tool for the job.
Dialogue: 0,0:07:02.14,0:07:04.24,Default,,0000,0000,0000,,Now the smartphones that we're already carrying
Dialogue: 0,0:07:04.24,0:07:07.97,Default,,0000,0000,0000,,can clearly have diagnostic devices like ultrasounds plugged into them,
Dialogue: 0,0:07:07.97,0:07:10.14,Default,,0000,0000,0000,,and a whole array of others, today,
Dialogue: 0,0:07:10.14,0:07:11.66,Default,,0000,0000,0000,,and as sensing is built into these,
Dialogue: 0,0:07:11.66,0:07:13.69,Default,,0000,0000,0000,,we'll be able to do vital signs monitor
Dialogue: 0,0:07:13.69,0:07:16.53,Default,,0000,0000,0000,,and behavioral monitoring like we've never had before.
Dialogue: 0,0:07:16.53,0:07:19.08,Default,,0000,0000,0000,,Many of us will have implantables that will actually look
Dialogue: 0,0:07:19.08,0:07:21.82,Default,,0000,0000,0000,,real-time at what's going on with our blood chemistry
Dialogue: 0,0:07:21.82,0:07:24.07,Default,,0000,0000,0000,,and in our proteins right now.
Dialogue: 0,0:07:24.07,0:07:26.76,Default,,0000,0000,0000,,Now the software is also getting smarter, right?
Dialogue: 0,0:07:26.76,0:07:29.86,Default,,0000,0000,0000,,Think about a coach, an agent online,
Dialogue: 0,0:07:29.86,0:07:31.100,Default,,0000,0000,0000,,that's going to help me do safe self-care.
Dialogue: 0,0:07:31.100,0:07:34.30,Default,,0000,0000,0000,,That same interaction that we just did with the ultrasound
Dialogue: 0,0:07:34.30,0:07:36.52,Default,,0000,0000,0000,,will likely have real-time image processing,
Dialogue: 0,0:07:36.52,0:07:38.67,Default,,0000,0000,0000,,and the device will say, "Up, down, left, right,
Dialogue: 0,0:07:38.67,0:07:41.33,Default,,0000,0000,0000,,ah, Eric, that's the perfect spot to send that image
Dialogue: 0,0:07:41.33,0:07:43.18,Default,,0000,0000,0000,,off to your doctor."
Dialogue: 0,0:07:43.18,0:07:45.38,Default,,0000,0000,0000,,Now, if we've got all these networked devices
Dialogue: 0,0:07:45.38,0:07:47.76,Default,,0000,0000,0000,,that are helping us to do care anywhere,
Dialogue: 0,0:07:47.76,0:07:49.56,Default,,0000,0000,0000,,it stands to reason that we also need a team
Dialogue: 0,0:07:49.56,0:07:51.54,Default,,0000,0000,0000,,to be able to interact with all of that stuff,
Dialogue: 0,0:07:51.54,0:07:54.16,Default,,0000,0000,0000,,and that leads to the second pillar I want to talk about,
Dialogue: 0,0:07:54.16,0:07:55.74,Default,,0000,0000,0000,,care networking.
Dialogue: 0,0:07:55.74,0:07:58.88,Default,,0000,0000,0000,,We have got to go beyond this paradigm
Dialogue: 0,0:07:58.88,0:08:02.53,Default,,0000,0000,0000,,of isolated specialists doing parts care
Dialogue: 0,0:08:02.53,0:08:06.75,Default,,0000,0000,0000,,to multidisciplinary teams doing person care.
Dialogue: 0,0:08:06.75,0:08:10.15,Default,,0000,0000,0000,,Uncoordinated care today is expensive at best,
Dialogue: 0,0:08:10.15,0:08:12.24,Default,,0000,0000,0000,,and it is deadly at worst.
Dialogue: 0,0:08:12.24,0:08:14.65,Default,,0000,0000,0000,,Eighty percent of medical errors are actually caused
Dialogue: 0,0:08:14.65,0:08:16.60,Default,,0000,0000,0000,,by communication and coordination problems
Dialogue: 0,0:08:16.60,0:08:18.92,Default,,0000,0000,0000,,amongst medical team members.
Dialogue: 0,0:08:18.92,0:08:21.16,Default,,0000,0000,0000,,I had my own heart scare years ago in graduate school,
Dialogue: 0,0:08:21.16,0:08:23.27,Default,,0000,0000,0000,,when we're under treatment for the kidney,
Dialogue: 0,0:08:23.27,0:08:25.88,Default,,0000,0000,0000,,and suddenly, they're like, "Oh, we think you have a heart problem."
Dialogue: 0,0:08:25.88,0:08:27.77,Default,,0000,0000,0000,,And I have these palpitations that are showing up.
Dialogue: 0,0:08:27.77,0:08:30.27,Default,,0000,0000,0000,,They put me through five weeks of tests --
Dialogue: 0,0:08:30.27,0:08:33.77,Default,,0000,0000,0000,,very expensive, very scary -- before the nurse finally notices
Dialogue: 0,0:08:33.77,0:08:35.87,Default,,0000,0000,0000,,the piece of the paper, my meds list
Dialogue: 0,0:08:35.87,0:08:37.39,Default,,0000,0000,0000,,that I've been carrying to every single appointment,
Dialogue: 0,0:08:37.39,0:08:39.58,Default,,0000,0000,0000,,and says, "Oh my gosh."
Dialogue: 0,0:08:39.58,0:08:41.55,Default,,0000,0000,0000,,Three different specialists had prescribed
Dialogue: 0,0:08:41.55,0:08:43.58,Default,,0000,0000,0000,,three different versions of the same drug to me.
Dialogue: 0,0:08:43.58,0:08:47.86,Default,,0000,0000,0000,,I did not have a heart problem. I had an overdose problem.
Dialogue: 0,0:08:47.86,0:08:50.67,Default,,0000,0000,0000,,I had a care coordination problem.
Dialogue: 0,0:08:50.67,0:08:53.44,Default,,0000,0000,0000,,And this happens to millions of people every year.
Dialogue: 0,0:08:53.44,0:08:57.07,Default,,0000,0000,0000,,I want to use technology that we're all working on and making happen
Dialogue: 0,0:08:57.07,0:09:00.80,Default,,0000,0000,0000,,to make health care a coordinated team sport.
Dialogue: 0,0:09:00.80,0:09:03.11,Default,,0000,0000,0000,,Now this is the most frightening thing to me.
Dialogue: 0,0:09:03.11,0:09:07.36,Default,,0000,0000,0000,,Out of all the care I've had in hospitals and clinics around the world,
Dialogue: 0,0:09:07.36,0:09:10.71,Default,,0000,0000,0000,,the first time I've ever had a true team-based care experience
Dialogue: 0,0:09:10.71,0:09:13.48,Default,,0000,0000,0000,,was at Legacy Good Sam these last six months
Dialogue: 0,0:09:13.48,0:09:14.54,Default,,0000,0000,0000,,for me to go get this.
Dialogue: 0,0:09:14.54,0:09:17.51,Default,,0000,0000,0000,,And this is a picture of my graduation team from Legacy.
Dialogue: 0,0:09:17.51,0:09:20.02,Default,,0000,0000,0000,,There's a couple of the folks here. You'll recognize Dr. Batiuk.
Dialogue: 0,0:09:20.02,0:09:22.64,Default,,0000,0000,0000,,We just talked to him. Here's Jenny, one of the nurses,
Dialogue: 0,0:09:22.64,0:09:24.95,Default,,0000,0000,0000,,Allison, who helped manage the transplant list,
Dialogue: 0,0:09:24.95,0:09:27.09,Default,,0000,0000,0000,,and a dozen other people who aren't pictured,
Dialogue: 0,0:09:27.09,0:09:29.63,Default,,0000,0000,0000,,a pharmacist, a psychologist, a nutritionist,
Dialogue: 0,0:09:29.63,0:09:31.87,Default,,0000,0000,0000,,even a financial counselor, Lisa,
Dialogue: 0,0:09:31.87,0:09:34.60,Default,,0000,0000,0000,,who helped us deal with all the insurance hassles.
Dialogue: 0,0:09:34.60,0:09:37.20,Default,,0000,0000,0000,,I wept the day I graduated.
Dialogue: 0,0:09:37.20,0:09:38.82,Default,,0000,0000,0000,,I should have been happy, because I was so well
Dialogue: 0,0:09:38.82,0:09:40.48,Default,,0000,0000,0000,,that I could go back to my normal doctors,
Dialogue: 0,0:09:40.48,0:09:43.77,Default,,0000,0000,0000,,but I wept because I was so actually connected to this team.
Dialogue: 0,0:09:43.77,0:09:45.37,Default,,0000,0000,0000,,And here's the most important part.
Dialogue: 0,0:09:45.37,0:09:48.41,Default,,0000,0000,0000,,The other people in this picture are me and my wife, Ashley.
Dialogue: 0,0:09:48.41,0:09:52.51,Default,,0000,0000,0000,,Legacy trained us on how to do care for me at home
Dialogue: 0,0:09:52.51,0:09:55.25,Default,,0000,0000,0000,,so that they could offload the hospitals and clinics.
Dialogue: 0,0:09:55.25,0:09:57.72,Default,,0000,0000,0000,,That's the only way that the model works.
Dialogue: 0,0:09:57.72,0:09:59.53,Default,,0000,0000,0000,,My team is actually working in China
Dialogue: 0,0:09:59.53,0:10:01.27,Default,,0000,0000,0000,,on one of these self-care models
Dialogue: 0,0:10:01.27,0:10:03.64,Default,,0000,0000,0000,,for a project we called Age-Friendly Cities.
Dialogue: 0,0:10:03.64,0:10:05.44,Default,,0000,0000,0000,,We're trying to help build a social network
Dialogue: 0,0:10:05.44,0:10:07.92,Default,,0000,0000,0000,,that can help track and train the care of seniors
Dialogue: 0,0:10:07.92,0:10:09.43,Default,,0000,0000,0000,,caring for themselves
Dialogue: 0,0:10:09.43,0:10:11.83,Default,,0000,0000,0000,,as well as the care provided by their family members
Dialogue: 0,0:10:11.83,0:10:14.32,Default,,0000,0000,0000,,or volunteer community health workers,
Dialogue: 0,0:10:14.32,0:10:16.57,Default,,0000,0000,0000,,as well as have an exchange network online,
Dialogue: 0,0:10:16.57,0:10:19.90,Default,,0000,0000,0000,,where, for example, I can donate three hours of care a day to your mom,
Dialogue: 0,0:10:19.90,0:10:22.77,Default,,0000,0000,0000,,if somebody else can help me with transportation to meals,
Dialogue: 0,0:10:22.77,0:10:25.43,Default,,0000,0000,0000,,and we exchange all of that online.
Dialogue: 0,0:10:25.43,0:10:27.82,Default,,0000,0000,0000,,The most important point I want to make to you about this
Dialogue: 0,0:10:27.82,0:10:31.13,Default,,0000,0000,0000,,is the sacred and somewhat over-romanticized
Dialogue: 0,0:10:31.13,0:10:33.91,Default,,0000,0000,0000,,doctor-patient one-on-one
Dialogue: 0,0:10:33.91,0:10:36.02,Default,,0000,0000,0000,,is a relic of the past.
Dialogue: 0,0:10:36.02,0:10:38.47,Default,,0000,0000,0000,,The future of health care is smart teams,
Dialogue: 0,0:10:38.47,0:10:42.04,Default,,0000,0000,0000,,and you'd better be on that team for yourself.
Dialogue: 0,0:10:42.04,0:10:44.34,Default,,0000,0000,0000,,Now, the last thing that I want to talk to you about
Dialogue: 0,0:10:44.34,0:10:45.58,Default,,0000,0000,0000,,is care customization,
Dialogue: 0,0:10:45.58,0:10:48.50,Default,,0000,0000,0000,,because if you've got care anywhere and you've got care networking,
Dialogue: 0,0:10:48.50,0:10:51.31,Default,,0000,0000,0000,,those are going to go a long way towards improving our health care system,
Dialogue: 0,0:10:51.31,0:10:54.34,Default,,0000,0000,0000,,but there's still too much guesswork.
Dialogue: 0,0:10:54.34,0:10:58.43,Default,,0000,0000,0000,,Randomized clinical trials were actually invented in 1948
Dialogue: 0,0:10:58.43,0:11:01.81,Default,,0000,0000,0000,,to help invent the drugs that cured tuberculosis,
Dialogue: 0,0:11:01.81,0:11:04.11,Default,,0000,0000,0000,,and those are important things, don't get me wrong.
Dialogue: 0,0:11:04.11,0:11:05.97,Default,,0000,0000,0000,,These population studies that we've done have created
Dialogue: 0,0:11:05.97,0:11:08.55,Default,,0000,0000,0000,,tons of miracle drugs that have saved millions of lives,
Dialogue: 0,0:11:08.55,0:11:10.99,Default,,0000,0000,0000,,but the problem is that health care
Dialogue: 0,0:11:10.99,0:11:15.07,Default,,0000,0000,0000,,is treating us as averages, not unique individuals,
Dialogue: 0,0:11:15.07,0:11:16.61,Default,,0000,0000,0000,,because at the end of the day,
Dialogue: 0,0:11:16.61,0:11:19.87,Default,,0000,0000,0000,,the patient is not the same thing as the population
Dialogue: 0,0:11:19.87,0:11:23.15,Default,,0000,0000,0000,,who are studied. That's what's leading to the guesswork.
Dialogue: 0,0:11:23.15,0:11:24.98,Default,,0000,0000,0000,,The technologies that are coming,
Dialogue: 0,0:11:24.98,0:11:27.07,Default,,0000,0000,0000,,high-performance computing, analytics,
Dialogue: 0,0:11:27.07,0:11:28.99,Default,,0000,0000,0000,,big data that everyone's talking about,
Dialogue: 0,0:11:28.99,0:11:31.91,Default,,0000,0000,0000,,will allow us to build predictive models for each of us
Dialogue: 0,0:11:31.91,0:11:33.86,Default,,0000,0000,0000,,as individual patients.
Dialogue: 0,0:11:33.86,0:11:38.32,Default,,0000,0000,0000,,And the magic here is, experiment on my avatar
Dialogue: 0,0:11:38.32,0:11:43.12,Default,,0000,0000,0000,,in software, not my body in suffering.
Dialogue: 0,0:11:43.12,0:11:45.61,Default,,0000,0000,0000,,Now, I've had two examples I want to quickly share with you
Dialogue: 0,0:11:45.61,0:11:48.17,Default,,0000,0000,0000,,of this kind of care customization on my own journey.
Dialogue: 0,0:11:48.17,0:11:51.34,Default,,0000,0000,0000,,The first was quite simple. I finally realized some years ago
Dialogue: 0,0:11:51.34,0:11:55.22,Default,,0000,0000,0000,,that all my medical teams were optimizing my treatment for longevity.
Dialogue: 0,0:11:55.22,0:11:57.97,Default,,0000,0000,0000,,It's like a badge of honor to see how long they can get the patient to live.
Dialogue: 0,0:11:57.97,0:12:01.04,Default,,0000,0000,0000,,I was optimizing my life for quality of life,
Dialogue: 0,0:12:01.04,0:12:05.42,Default,,0000,0000,0000,,and quality of life for me means time in snow.
Dialogue: 0,0:12:05.42,0:12:08.25,Default,,0000,0000,0000,,So on my chart, I forced them to put, "Patient goal:
Dialogue: 0,0:12:08.25,0:12:12.02,Default,,0000,0000,0000,,low doses of drugs over longer periods of time,
Dialogue: 0,0:12:12.02,0:12:15.26,Default,,0000,0000,0000,,side effects friendly to skiing."
Dialogue: 0,0:12:15.26,0:12:17.92,Default,,0000,0000,0000,,And I think that's why I achieved longevity.
Dialogue: 0,0:12:17.92,0:12:20.15,Default,,0000,0000,0000,,I think that time-in-snow therapy was as important
Dialogue: 0,0:12:20.15,0:12:22.28,Default,,0000,0000,0000,,as the pharmaceuticals that I had.
Dialogue: 0,0:12:22.28,0:12:24.60,Default,,0000,0000,0000,,Now the second example of customization -- and by the way,
Dialogue: 0,0:12:24.60,0:12:26.49,Default,,0000,0000,0000,,you can't customize care if you don't know your own goals,
Dialogue: 0,0:12:26.49,0:12:29.86,Default,,0000,0000,0000,,so health care can't know those until you know your own health care goals.
Dialogue: 0,0:12:29.86,0:12:31.57,Default,,0000,0000,0000,,But the second example I want to give you is,
Dialogue: 0,0:12:31.57,0:12:33.36,Default,,0000,0000,0000,,I happened to be an early guinea pig,
Dialogue: 0,0:12:33.36,0:12:36.96,Default,,0000,0000,0000,,and I got very lucky to have my whole genome sequenced.
Dialogue: 0,0:12:36.96,0:12:39.28,Default,,0000,0000,0000,,Now it took about two weeks of processing
Dialogue: 0,0:12:39.28,0:12:41.41,Default,,0000,0000,0000,,on Intel's highest-end servers to make this happen,
Dialogue: 0,0:12:41.41,0:12:44.44,Default,,0000,0000,0000,,and another six months of human and computing labor
Dialogue: 0,0:12:44.44,0:12:47.00,Default,,0000,0000,0000,,to make sense of all of that data.
Dialogue: 0,0:12:47.00,0:12:50.05,Default,,0000,0000,0000,,And at the end of all of that, they said, "Yes,
Dialogue: 0,0:12:50.05,0:12:52.49,Default,,0000,0000,0000,,those diagnoses of that clash of medical titans
Dialogue: 0,0:12:52.49,0:12:54.88,Default,,0000,0000,0000,,all of those years ago were wrong,
Dialogue: 0,0:12:54.88,0:12:57.15,Default,,0000,0000,0000,,and we have a better path forward."
Dialogue: 0,0:12:57.15,0:12:59.53,Default,,0000,0000,0000,,The future that Intel's working on now is to figure out
Dialogue: 0,0:12:59.53,0:13:01.73,Default,,0000,0000,0000,,how to make that computing for personalized medicine
Dialogue: 0,0:13:01.73,0:13:05.48,Default,,0000,0000,0000,,go from months and weeks to even hours,
Dialogue: 0,0:13:05.48,0:13:07.16,Default,,0000,0000,0000,,and make this kind of tool available,
Dialogue: 0,0:13:07.16,0:13:10.97,Default,,0000,0000,0000,,not just in the mainframes of tier-one research hospitals around the world,
Dialogue: 0,0:13:10.97,0:13:13.78,Default,,0000,0000,0000,,but in the mainstream -- every patient, every clinic
Dialogue: 0,0:13:13.78,0:13:15.93,Default,,0000,0000,0000,,with access to whole genome sequencing.
Dialogue: 0,0:13:15.93,0:13:18.27,Default,,0000,0000,0000,,And I tell you, this kind of care customization
Dialogue: 0,0:13:18.27,0:13:21.10,Default,,0000,0000,0000,,for everything from your goals to your genetics
Dialogue: 0,0:13:21.10,0:13:22.86,Default,,0000,0000,0000,,will be the most game-changing transformation
Dialogue: 0,0:13:22.86,0:13:26.44,Default,,0000,0000,0000,,that we witness in health care during our lifetime.
Dialogue: 0,0:13:26.44,0:13:29.38,Default,,0000,0000,0000,,So these three pillars of personal health,
Dialogue: 0,0:13:29.38,0:13:32.24,Default,,0000,0000,0000,,care anywhere, care networking, care customization,
Dialogue: 0,0:13:32.24,0:13:33.48,Default,,0000,0000,0000,,are happening in pieces now,
Dialogue: 0,0:13:33.48,0:13:37.27,Default,,0000,0000,0000,,but this vision will completely fail if we don't step up
Dialogue: 0,0:13:37.27,0:13:41.27,Default,,0000,0000,0000,,as caregivers and as patients to take on new roles.
Dialogue: 0,0:13:41.27,0:13:42.92,Default,,0000,0000,0000,,It's what my friend Verna said:
Dialogue: 0,0:13:42.92,0:13:45.04,Default,,0000,0000,0000,,Wake up and take control of your health.
Dialogue: 0,0:13:45.04,0:13:46.63,Default,,0000,0000,0000,,Because at the end of the day these technologies
Dialogue: 0,0:13:46.63,0:13:50.53,Default,,0000,0000,0000,,are simply about people caring for other people
Dialogue: 0,0:13:50.53,0:13:53.94,Default,,0000,0000,0000,,and ourselves in some powerful new ways.
Dialogue: 0,0:13:53.94,0:13:55.50,Default,,0000,0000,0000,,And it's in that spirit that I want to introduce you
Dialogue: 0,0:13:55.50,0:13:58.05,Default,,0000,0000,0000,,to one last friend, very quickly.
Dialogue: 0,0:13:58.05,0:14:01.92,Default,,0000,0000,0000,,Tracey Gamley stepped up to give me the impossible kidney
Dialogue: 0,0:14:01.92,0:14:06.60,Default,,0000,0000,0000,,that I was never supposed to have.
Dialogue: 0,0:14:06.60,0:14:22.28,Default,,0000,0000,0000,,(Applause)
Dialogue: 0,0:14:22.99,0:14:27.35,Default,,0000,0000,0000,,So Tracey, just tell us a little bit quickly about what the donor experience was like with you.
Dialogue: 0,0:14:27.35,0:14:29.23,Default,,0000,0000,0000,,Tracey Gamley: For me, it was really easy.
Dialogue: 0,0:14:29.23,0:14:31.18,Default,,0000,0000,0000,,I only had one night in the hospital.
Dialogue: 0,0:14:31.18,0:14:32.89,Default,,0000,0000,0000,,The surgery was done laparoscopically,
Dialogue: 0,0:14:32.89,0:14:36.09,Default,,0000,0000,0000,,so I have just five very small scars on my abdomen,
Dialogue: 0,0:14:36.09,0:14:38.13,Default,,0000,0000,0000,,and I had four weeks away from work
Dialogue: 0,0:14:38.13,0:14:40.02,Default,,0000,0000,0000,,and went back to doing everything I'd done before
Dialogue: 0,0:14:40.02,0:14:41.53,Default,,0000,0000,0000,,without any changes.
Dialogue: 0,0:14:41.53,0:14:44.52,Default,,0000,0000,0000,,ED: Well, I probably will never get a chance to say this to you
Dialogue: 0,0:14:44.52,0:14:46.98,Default,,0000,0000,0000,,in such a large audience ever again.
Dialogue: 0,0:14:46.98,0:14:49.76,Default,,0000,0000,0000,,So "thank you" feel likes a really trite word,
Dialogue: 0,0:14:49.76,0:14:52.23,Default,,0000,0000,0000,,but thank you from the bottom of my heart for saving my life.
Dialogue: 0,0:14:52.23,0:14:58.11,Default,,0000,0000,0000,,(Applause)
Dialogue: 0,0:14:58.11,0:15:00.56,Default,,0000,0000,0000,,This TED stage and all of the TED stages
Dialogue: 0,0:15:00.56,0:15:03.28,Default,,0000,0000,0000,,are often about celebrating innovation
Dialogue: 0,0:15:03.28,0:15:04.39,Default,,0000,0000,0000,,and celebrating new technologies,
Dialogue: 0,0:15:04.39,0:15:06.68,Default,,0000,0000,0000,,and I've done that here today,
Dialogue: 0,0:15:06.68,0:15:09.01,Default,,0000,0000,0000,,and I've seen amazing things coming from TED speakers,
Dialogue: 0,0:15:09.01,0:15:13.04,Default,,0000,0000,0000,,I mean, my gosh, artificial kidneys, even printable kidneys, that are coming.
Dialogue: 0,0:15:13.04,0:15:16.22,Default,,0000,0000,0000,,But until such time that these amazing technologies
Dialogue: 0,0:15:16.22,0:15:19.26,Default,,0000,0000,0000,,are available to all of us, and even when they are,
Dialogue: 0,0:15:19.26,0:15:23.69,Default,,0000,0000,0000,,it's up to us to care for, and even save, one another.
Dialogue: 0,0:15:23.69,0:15:26.12,Default,,0000,0000,0000,,I hope you will go out and make personal health happen
Dialogue: 0,0:15:26.12,0:15:30.05,Default,,0000,0000,0000,,for yourselves and for everyone. Thanks so much.
Dialogue: 0,0:15:30.05,0:15:34.70,Default,,0000,0000,0000,,(Applause)