From HEALTHCARE to HEALTH and from CONTINUOUS CARE to PROACTIVE CARE anywhere and anytime

Michael Friebe
Nov 8 · 9 min read

EXPONENTIAL MEDICINE CONFERENCE 2019 – Personal Learnings

(http://ExponentialMedicine.com – #xMED)

Keywords: xMED, xMED2019, Exponential Medicine, healthcare innovation, digital medicine, singularity university, healthcare ai, exponential technology, food is health, virtual care, future of health, hippocratic oath, planetary health

I start this personal “conference learning report” by saying that if you are interested and want to be an active part of healthcares future, then you definitely need to come at least every two to three years to the Exponential Medicine Conference, organized by Singularity University (SU) and Dr. Daniel Kraft. It is fascinating, even for an involved and innovative healthcare engineer and entrepreneur as me, to hear about the major developments in the healthcare domain. And yes, it is expensive and a commercial conference, but that does not make it less valuable … on the contrary, that ensures high calibre input and speakers.

This is a conference covering many aspects and with that provide innovation stimuli for every attendee (Program – see (1)).

The conference is also accompanied by a small, but excellent exhibition on new healthtec devices and applications offered by start-ups. Also quite stimulating for a start-up geek like me. I may ask one of my new ventures to apply for a slot next year … which means I need to come as well 🤓.

For the report I occasionally did some word for word copying from the presentations and slides, but did not always mention the source and apologize for that. This is not very good scientific practice, but I felt it was Ok as this is a summary and as I am not claiming that the content was developed by myself. All numbers mentioned are backed up by credible scientific sources that also are not part of the summary.

The highlights of the conference (600 attendees with all possible healthcare backgrounds from 34 countries) are the wonderful location (a little disturbed by ongoing construction and because of that the lack of a decent swimming pool), the evening and break-out events, but most of all seeing old friends, finding new ones and connecting with like-minded.

A major bumper this year was the flight attendance strike of Lufthansa (🤯), which forced me to go rebook on an earlier flight and made me miss the lectures on Thursday.

Lets start with some necessary bad news.

At the moment we are practicing “reimbursement” based medicine just about anywhere in the world.

Or in other words, since healthcare has a commercial component a lot of things are done because it provides an economic benefit, but is not always beneficial for the individual. Because of that we have a focus on fixing things, but much lower incentives on preventing sickness. That is also why many call the current Healthcare system rightfully Sickcare system. While we know that diet, lack of exercise, the environment are the main responsible factors for why we are getting sicker we are apparently not providing enough motivations to aggressively tackle that. We need to rethink incentives!

For a future HEALTHCARE system that leads to and maintains personal HEALTH we need to also converge many (exponential) technologies with the human biology, and we also need professional clinical education to converge and adapt to these new technologies and a digitally empowered patient – see (2, 3).

The future of health should be affordable, accessible, personalized and healthcare should be SIMPLE providing care only in select instances.

Since 1950 population and Carbon Emissions increased by a factor of 4, Fossil Fuel Consumption by a factor of 5.5, 50% of the livable earth surface is used for food production that consumes 50% of the annual fresh water supply, 60% of the worlds rivers are dammed, we have build huge cities and altered our coastlines. That led to changed climate conditions with extreme temperatures, loss of tropical forests, and destruction of coral reefs – these are called environmental crisis, but they are also public health crisis.

Asthma, allergies, and vector borne diseases have significantly increased clearly showing that the human and the earth health are connected! That may sound very esoteric to many of you, but as a scientist I am convinced that this is absolutely true.

Yes, we need to work on improving health, healthcare, longevity … but we also need to dramatically increase the efforts to save our own habitat.

If we do not do anything then the worsening accelerates due to population- / energy use – /ozone- / meat consumption- / fertilizer use- / Transportation- / Paper production- increase, CO2 emission, Methane/NO and Sulfur oxides in the atmosphere, global warming and sea level rise. If we continue then by 2050 plastic will exceed fish biomass in the oceans. Shocking!

Pollution is the largest environmental cause of disease and premature death (7–9 Mio person per year). We need changed policies, climate prevention, and public health systems – globally! Isolated developments are not solving these issues.

Other selected bad news (US numbers):

  • Diabetes: cost of diagnosed diabetes went up from USD 245 Bio. (2012) to USD 327 Bio (2017)
  • Cancer: 659k (of 1.570k) cases, and 265k (of 587k) deaths are preventable in US alone every year
  • Suicide: age adjusted suicide rate increased 33% from 1999 to 2017 (now 14 per 100.000 or 47k deaths p.a.)
  • Life Expectancy (US): dropped for 3 consecutive years
  • Food Waste: 30–40% of the food supply (value USD 161 Bio), but 11% of the US households have a food insecurity

Exponential technologies can for sure provide solutions to some of these problems short- to midterm highlighted by some fantastic talks on digital surgery, surgical robots, health related AI and deep learning applications (was voted the exponential technology with the greatest future impact), blockchains, virtual health, 3D printing, monitoring and sensing devices and methods, training and education using virtual/mixed/augmented realities, CRISPR gene editing (which is my favorite and most impactful exponential technology ahead of AI/DL/ML) and other great technologies.

Exponential technologies are typically described by 6 D‘s (based on the works of Ray Kurzweil and Peter Diamandis): they need to be digital based, they initially are rather disappointing, eventually get better and better leading to a disruption of incremental / linear technologies, are then further dematerialized and demonetized, which leads to democratic availability globally (abundance).

So health and healthcare needs to become rapidly digital because – see (4):

  • Globally, healthcare systems are struggling (over 60‘s will more than double from 2017 to 2050 – 962 Mio to 2.1 Bio; estimated 630 Mio people – +48% – will live with Diabetes in 2045)
  • Empowered patient Revolution through Technology is already on its way.
  • Digital Health is fostering tech-enabled physicians (Telehealth, digital Biomarkers, …) and will change Medical practice (Uber Health, Walmart Health, …)
  • Drug treatment alone is not enough and will need to be filled by technology (Fitbit, Better Me, dusbeo, Dr, …)
  • Technology enabled virtual HC is growing and proven to improve clinical outcomes (Monitoring – Guidance – Cause + Effect – Access to Care)
  • Regulators (FDA) are supporting the adoption of Digital Health – new players are emerging (facebook, amazon, Apple, Google health) – see (5)
  • Technology acceleration and focus on health is unprecedented … AI is already changing the potential of science discovery … and Big Data and advanced analytics has already disrupted some elements of R&D (drug discovery, digital biomarkers, …)

With all the exponentials, FOOD is probably the best MEDICINE and also one of the most important factors for staying healthy and preventing diseases – see (6).

But food is also a major problem factor for the future of earth. The Lancet Commission of the UN has therefore defined some sustainability requirements related to food. Global consumption of fruits, vegetables, nuts and legumes will need to double by 2100 and at the same time red meat and sugar reduced by 50%.

Fruits and vegetables have a significant positive effect on cancer prevention and we will need more plant-based meats, 3D food printing, precision nutrition based on microbiomics and personal situations, and biosensors that monitor the nutritional status … so here are some exponential technologies again.

Food can increase or decrease angiogenesis, strengthen the immune system, positively change the microbiome, and support cell regeneration. Foods can reduce occurrence of cancer (soy: significant reduction of breast cancer, tomato: reduction of prostate cancer), have antiangiogenic effects (most berry and citrus fruits, nuts, dark chocolate, …), a positive effect on cardiohealth (barley), increase the circulation of adult stem cells in the bloodstream (Cocoa), inhibit cancer stem cells (green tea, walnuts, capers, purple potato, thyme), or are good for digestion (eg Kiwi increases lactobacillus and bifidobacteria in just 1 day). Food can also work as a form of immunotherapy.

The human-immunology topics defining the 21st century as the century of biology had the biggest impact on me. Our lifespan has outpaced our healthspan and dramatically outpaced evolutionary changes, making cancer, cardiovascular, and neurologic diseases so much more prevalent. A healthy longevity requires more than finding a fix for cancer (not that we should not find that) or to find a cure for Alzheimer. It requires a change in habits and an understanding of earth and human health connection.

I was fascinated by the intro on

planetary health, explaining the impact of human contribution to climate change, decline in biodiversity and increased pollution leading to massive disruptions for the human race.

We need to work on health advancements, individualized/personalized health approaches, but we also need to urgently fix our habitat on earth and rethink the economics – see (7).

Another personal highlight was the presentation about the need for an adapted Hippocratic oath (Dr. Jordan Slaith) – see (8).

So my conclusion and formulated action steps are:

  • We need more collaborative Network Approaches to research (expanded community, result dissemination, leverage community including patients, …) rather then the traditional research (few researcher apply for grant … research is performed … hope that research is translated)
  • There are many „undiscovered“ or underfunded areas that could have a significant positive effect on health (e.g. Audio as a pathway to health, healing, and happiness … HEARABLES)
  • The Hippocratic Oath needs to be adapted to the changed digital environment, keeping the main points: do no harm, alleviate suffering, bring dignity & integrity to illness, respect privacy and confidentiality (Dr. Jordan Shlain)
  • We need a different type of physician (and biomedical engineer for that matter) – education needs to be adjusted (see figure below)
  • The future of Health should focus on sustaining well-being, providing care only in select instances.
  • Virtual Care (VC) needs to be globally introduced – has already proven to be better than regular healthcare in certain situations and will improve further. VC is infinitely scalable, personal, compassionate healthcare for people suffering from or are at risk of chronic disease.
  • AI driven Emergency rooms need to be introduced with a potential to reduce emergency visit cost by 90% (see Diagnostic Robotics, Israel – https://www.diagnosticrobotics.com)
  • Personal Health Data needs to be interoperable and shareable and owned by the individual.
  • And, we need to be dirtier (! – see (9)), eat more conscious and personalized, move more, and continuously learn and be curious.

Early November 2020 is reserved already for the EXPONENTIAL MEDICINE 2020.

References and books:

  1. Exponential Medicine Conference 2019 – Program. https://exponential.singularityu.org/medicine/wp-content/uploads/sites/5/2019/11/Exponential-Medicine-2019-Agenda-v9.pdf
  2. Jane Metcalfe, Brian Bergstein. Neo.Life 25 Visions for the Future of our Species.
  3. Deepak Chopra, Rudolph Tanzi. (3Books) 1. Superbrain 2. Supergenes 3. The Healing Self
  4. A Coravos, J Goldsack, et al. Digital Medicine: A primer on Measurements.
  5. FDA. Digital Health Innovation Plan https://www.fda.gov/media/106331/download
  6. William Li. Eat to Beat Disease.
  7. Jay Lemery, Paul Auerbach. Enviromedics.
  8. Why Medicine needs a New Hippocratic Oath – and What it should be. https://singularityhub.com/2019/11/07/why-medicine-needs-a-new-hippocratic-oath-and-what-it-should-be/
  9. Jack Gilbert, Rob Knight. Dirt is Good.

About the Author:

Michael Friebe, PHD is a German biomedical engineer and university professor (Image Guided Therapies) with a 25+ year experience as Inventor, Entrepreneur, Researcher, Start-Up Geek, and Business Angel.

Please connect via

LINKEDIN – http://linkedin.com/in/michaelfriebe

and/or

Twitter – Friebe_Michael

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