Digital Doctors: The Future of Medicine | Derek O'Keefe | TEDxGalway
Summary
TLDRDr. Derrick, a physician-engineer, discusses the convergence of medicine and engineering for healthcare innovation. He shares his experience with NASA's NEEMO mission, where he used physiological data to make mission decisions. Derrick also explores the future of medicine with wearable tech, AI, and telemedicine, emphasizing how these technologies can transform chronic disease management and deliver personalized healthcare.
Takeaways
- 👨⚕️ Derrick is a physician-engineer with a background in biomedical engineering and endocrinology, focusing on the intersection of medicine and engineering for innovative solutions.
- 🚀 In 2007, Derrick worked with NASA to develop a bio vest for monitoring astronaut sleep in space, using ECG and heart rate variability to deduce sleep stages and quality.
- 🦾 He has been involved in creating exoskeletons with electrical stimulation to help stroke patients with paralysis walk more efficiently.
- 🩺 Derrick has been developing technologies for people with type 1 diabetes to deliver insulin automatically, aiming to improve treatment and quality of life.
- 📊 The talk emphasizes the importance of using data and technology to make informed decisions in healthcare, rather than relying solely on subjective feelings.
- 🧠 Artificial intelligence (AI) is becoming more integrated into healthcare, with the potential to predict health outcomes and personalize treatment plans.
- 🏥 The future of medicine involves telemedicine and remote monitoring, which can reduce the need for physical hospital visits and improve patient care.
- 🤖 AI can analyze wearable technology data to provide personalized health insights and potentially influence insurance premiums based on health behaviors.
- 👕 Smart fabrics are an upcoming technology that will allow clothing to monitor physiological signals, leading to a more integrated approach to health monitoring.
- 🌐 The talk concludes with a vision where the patient is at the center of healthcare, empowered by technology to manage their health more effectively.
Q & A
What does the term 'physician engineer' mean?
-A physician engineer is someone who has training in both engineering and medicine, allowing them to approach problems analytically and logically while also understanding the complexities and nuances of clinical practice.
How does the speaker describe the difference between engineering and medicine?
-Engineering is described as black and white, analytical, and problem-solving, while medicine is seen as a spectrum of color where nothing is ever black and white, indicating its complexity and variability.
What was the challenge NASA faced in 2007 regarding astronaut sleep?
-NASA needed to monitor how astronauts sleep in space due to the rapid succession of sunrises and sunsets causing severe jet lag, which affected their sleep quality.
How did the speaker's team address the sleep monitoring issue for astronauts?
-They developed a bio vest that astronauts could wear to monitor their ECG and heart rate variability, allowing them to deduce sleep stages and assess sleep quality.
What is the significance of the NEEMO mission mentioned in the script?
-The NEEMO (NASA Extreme Environment Mission Operations) mission is significant as it simulates space exploration conditions on Earth, allowing for the development of protocols and technology that can be used in actual space missions.
Why was the speaker invited to participate in the NEEMO mission?
-The speaker was invited due to his experience with telemedicine and the mission's focus on making decisions based on physiological data.
How does the speaker envision the future of wearable technology in sports?
-The speaker sees wearable technology being used not just during training but also during games and potentially being worn all the time to monitor and improve athlete performance.
What is the potential impact of AI on health insurance policies?
-AI could analyze data from wearable technology to predict health risks and adjust insurance premiums accordingly, rewarding those with healthier lifestyles and penalizing those with unhealthy behaviors.
What is the concept of 'predictive purchasing' as mentioned in the script?
-Predictive purchasing is an AI-driven service where online shopping platforms predict and deliver products that customers are likely to want before they even realize it, based on their past purchasing patterns and behaviors.
How does the speaker propose to improve the delivery of healthcare for chronic diseases?
-The speaker suggests using remote monitoring and AI to manage chronic diseases, allowing for virtual clinics and reducing the need for physical hospital visits, thus improving efficiency and patient care.
What is the potential benefit of telemedicine in managing chronic diseases?
-Telemedicine can reduce the need for patients to travel to clinics, provide more frequent check-ins, and allow healthcare providers to monitor patient data remotely, leading to more effective management of chronic conditions.
Outlines
👨⚕️ The Fusion of Medicine and Engineering
Derrick, a physician with a background in biomedical engineering, discusses the synergy between clinical medicine and engineering. He highlights his involvement in innovative projects, such as developing a bio vest for NASA to monitor astronauts' sleep in space, creating exoskeletons for stroke patients, and working on technologies for type 1 diabetes. He emphasizes the importance of combining clinical problems with engineering solutions for innovation and shares his experience of being invited by NASA for a mission involving telemedicine.
🚀 Advancing Medicine with Space Exploration
In this section, Derrick talks about his collaboration with NASA on the NEEMO mission, where he was involved in making mission decisions based on physiological data from astronauts living underwater in the Aquarius habitat. He describes how this technology is being adapted for elite sports to monitor player health and performance, and how it will soon be integrated into consumer wearable technology, leading to a future where smart fabrics in our clothing monitor our health and make decisions about our well-being.
🤖 The Role of Artificial Intelligence in Predicting Behavior
Derrick explores the potential of artificial intelligence in recognizing patterns in human behavior and predicting future actions. He gives examples of how AI is used in car insurance to reward good driving behavior and how it could be applied to health insurance. He also discusses the concept of predictive purchasing, where AI algorithms predict consumer needs before they realize them, and how this technology could be used to analyze health data to predict and prevent chronic diseases.
🏥 The Future of Telemedicine and Chronic Disease Management
In the final paragraph, Derrick envisions a future where telemedicine and remote monitoring play a significant role in managing chronic diseases. He criticizes the inefficiency of traditional healthcare systems and suggests that virtual clinics could reduce the need for physical hospital visits. He describes how AI could help schedule virtual appointments based on patients' health data, allowing healthcare providers to monitor and adjust treatment plans remotely, thus improving the delivery of healthcare.
Mindmap
Keywords
💡Physician Ear
💡Endocrinology
💡Heart Rate Variability (HRV)
💡Exoskeletons
💡Telemedicine
💡Aquarius Habitat
💡Artificial Intelligence (AI)
💡Smart Fabrics
💡Chronic Diseases
💡Telehealth
💡Wearable Technology
Highlights
Introduction to Derrick, a physician-engineer with expertise in biomedical engineering and endocrinology.
The potential for innovation by combining clinical problems faced by doctors with engineering solutions.
In 2007, NASA faced challenges monitoring astronaut sleep patterns in space due to rapid day-night cycles.
Development of a bio vest to monitor astronauts' ECG and heart rate variability for sleep quality assessment.
Collaboration on projects involving exoskeletons and electrical stimulation for stroke patients with paralysis.
Recent work on technologies for type 1 diabetes management, including insulin delivery systems.
The importance of data in making mission-critical decisions, illustrated by NASA's telemedicine practices.
Involvement in NASA's NEEMO mission, which focuses on extreme environment simulations for space exploration.
The Aquarius habitat, an underwater laboratory used to simulate space mission conditions.
Use of physiological data to make mission decisions, a concept being adopted in elite sports.
The rise of wearable technology and its potential impact on consumer health and wellness.
The future of smart fabrics that can monitor physiological signals and interact with users.
The role of artificial intelligence in analyzing data from wearable tech and making health predictions.
The potential for AI to personalize health insurance premiums based on individual health data.
The ethical considerations of AI and data in healthcare, including privacy and decision-making autonomy.
The transformation of healthcare delivery through telemedicine and remote patient monitoring.
The vision for a future where patients are at the center of healthcare, empowered by technology.
Encouragement to embrace technology's potential to improve healthcare delivery and patient outcomes.
Transcripts
[Music]
[Music]
my name is Derrick you've heard a bit
about me from the intro and I'm a
physician ear so what that term means is
is that I've trained as an engineer so
I've done an electronic computer
electronic computer biomedical
engineering and I've also trained as a
physician or a doctor so I've done my
medical training and my clinical
training in general medicine and an
endocrinology and in diabetes and as an
engineer half my brain is in black and
white so it's analytical problem-solving
very logical and as a clinician well
anyone who knows medicine knows it's a
spectrum of color nothing's ever black
and white in medicine and the
interesting thing is is that doctors
have a lot of clinical problems and
engineers have lots of solutions so if
you put the two of them together you
have great opportunity for innovation
and I've been lucky in the last 20 years
or so to be involved with some of some
very innovative projects so back in 2007
and NASA had a problem with monitoring
how astronauts sleep in space because if
you're in orbit and you're going around
the earth 16 times a day that's 16
sunrises and sunsets that's really bad
jet lag so they had to figure out how
they're sleeping rather than just saying
are you sleeping okay subjectively
so we came up with an idea where we put
a bio vest on the astronauts and we
looked at their ECG and what's called
our heart rate variability and from that
we could deduce their sleep stage and
see the quality of sleep they were
getting so when you do an intervention
then you can see if it's effective or
not we've done projects where we've
worked with patients who have had
strokes and I've had paralysis
afterwards we've built exoskeletons with
electrical stimulation to allow them to
walk more efficiently
and more recently we've done work with
people with type 1 diabetes developing
technologies to deliver instant
automatically so the idea of a clinical
problem and an engineer being at the
table and being involved with the
solution is a very very innovative mix
and tonight I'm going to hopefully talk
to you about that where that mix of
engineering and medicine is going in the
future with the talk about digital
doctors the future of medicine so this
story starts actually here in Galway
about four years ago I was a doctor on a
ward round in the hospital and when
you're on a ward round you go out to see
all your patients in the morning so you
see the patient and you ask them how
their how their
how the treatment is working you check
their vital signs you look at the Bloods
you look at the radiology and then
during the ward round I get a phone call
and I answered the phone because it
could be radiology ringing me with an
updated report and the patient or it
could be the labs ringing me about an
updated blood result so I took the phone
call and somebody said hi is this dr.
O'Keefe and I said yes
is this you dad and they said oh this is
actually NASA we have a Nemo mission
next summer and we're wondering if you'd
like to be part of it because part of
the mission brief is telemedicine and
you did things with telemedicine with as
few years ago and I was like okay I'm in
the middle of something at the moment
can I ring you back later and they were
like yeah sure no problem so I hung up
the phone and I turned back to the team
and they were like who was on the phone
I was like it was NASA they were like
yeah sure was yeah but it actually was
NASA and and for those who don't know
who NASA is if you haven't watched any
movies or being involved with society in
the last 50 years NASA is the u.s.
federal agency that's kind of tasked
with manned spaceflight and they have a
big year this year this year is the 50th
anniversary of putting a man on the moon
this July so you're gonna hear a lot
about NASA and their achievements this
year and they've done some phenomenal
stuff over the last 50 years of manned
spaceflight you're aware of see of the
of the shuttle program and the robotic
missions and so on but what NASA really
have done for us as society is develop
new technologies and new protocols for
us as as humans and push the boundaries
of science and one thing they do really
well at NASA and the one of the reasons
of their success is what's called the
three P's so that's practice practice
practice
very good so what they asked me to do
with NASA is they asked me to get
involved with one of their practice
sessions so they have these facilities
around planet Earth whereby they take a
habitat which we're going to hopefully
put on the lunar surface of the Martian
surface and they take this habitat and
they put it in what's called an extreme
environment and those extreme
environments are in the High Arctic
where there's snow and you know for high
winds they're on the lava fields of
Hawaii they're in the deserts of the
Mojave and the one that I was invited to
be involved with was underwater off the
coast of Florida it's called the
Aquarius habitat it's about 60 feet down
which is double the height of a
two-story house it's about 10 kilometers
off the coast of Florida and this pretty
much both sized sunken laboratory is
where four astronauts live for a month
every year in what's called Nemo the
NASA extreme environment mission
operation and the idea of these four
astronauts living there are aquanauts as
they're called underwater for the month
is that during that month they can do
science and engineering experiments and
they can develop the protocols here on
earth before we put that base on the
moon and Mars and you might say well why
do they want to put in such an
inhospitable environment but that's the
key that makes the simulation high
fidelity because if something is wrong
you can't just pop outside and leave the
habitat if you forget something you
can't just pop outside
historian get it you really have to plan
the mission and you have to be in the
moment in the mission so it allows us to
test protocols and techniques and
technology in a high fidelity scenario
so why did they want me that was the
question I guess so I rang them back and
I said yeah I'm actually available next
summer what's the what's the mission and
they said we have this idea you know
we've been doing telemedicine and remote
monitoring for a while at NASA but the
NEEMO mission this year we have an
interesting idea we want to make mission
decisions based on physiological data
and I was like all right that sounds
interesting so usually there's a flight
surgeon which is the physician that
looks after the health of the astronauts
or aquanauts but this was the flight
surgeon actually inputting into Mission
decisions so the idea would be is that
the aquanauts under water would wear
something like a bio vest that would
measure their heart rate their ECG their
respire to rate their movement and so on
and then with that activity then we
could actually make decisions so for
example I was able to talk to one of the
the crew dr. Marc or Eva and I'd say to
me you know you're planning today on the
mission schedule to go outside the
habitat today to do extra vehicular
activity and there's a choice of four
people that you can pick but I've been
looking at the physiological data for
the last 24 hours and I think you should
pick Aquanaut number two because
Aquanaut number one they haven't slept
so well the last three nights an
Aquanaut number three they're developing
a temperature so they're probably gonna
get a flu so we made a mission decision
based on physiological objective data
and that's a very interesting concept
and it's kind of a tease of where we're
going to go in medicine so as I said
when you're outside their habitat you
have to be at your physical and mental
best and that's why it's really
important that you use data to make the
decisions and not just ask somebody how
they feel and this technology was 2015
this kind of concept and it's starting
to creep in now to what we call elite
sports so elite you know soccer in the
Premiership or football basketball all
the top sports of the world what you're
starting to see now is a lot of the
players in the training ground wearing
this kind of technology both to assess
how they're performing and then also on
the day when they're playing sports the
next level of course which is going to
become more common if it's not there
already is that a lot of these elite
athletes will be expected to wear this
equipment all the time not just where
they're in training not just one
they're playing the game so now on a
Friday night when a coach makes a
decision about a big international the
next day he says okay not only is this
player playing well during the week in
training I can see that they've been in
bed every night at ten o'clock they've
got the radar asleep they haven't gone
to too many night clubs so that's what's
going to be expected of the elite sports
person because what's going to happen is
on the Friday night when you're picking
your team you want to pick the best at
the best eleven does that make sense
yeah so let's just take that idea and go
forward it again another five years and
then you're coming into the world of us
to consumers so you're all familiar with
wearable technology most of us here
probably have some intelligent band on
our wrist that measures our step counter
tells us our calories we have
smartwatches we have phones in our
pockets that are computers a thousand
times more powerful than that Apollo
mission in 1969 but the big game changer
in the next few years is going to be
smart fabrics this has already been
developed in some research labs but it
just hasn't hit widespread consumer
market yet and what that basically means
is your t-shirt will have fibers in it
that will be measuring your
physiological signals so you'll be
sitting there and you'll get a text
message from your t-shirt
and it'll say hey John you're getting
your temperature I see you've got
tickets booked tomorrow night for the
cinema I'd probably pass in it so this
is this is interesting this is where the
technology is going the idea of wearable
tech ultimately making decisions with
our lives and then the important thing
and all of that discussion is the engine
behind those decisions because all this
variable technology is just data that
doesn't do anything what you need is
information and from the information
then you get knowledge and that's the
second part of the talk so the first
part is remote monitoring which I hope
you've followed me on the journey the
next part is the artificial intelligence
so we've all heard this term artificial
intelligence we're familiar with that I
hope in our lives whereby you're
watching a music video on the internet
and maybe it makes a suggestion of what
video you should watch next and then you
watch it you kind of go oh that was
pretty cool I didn't know that artist so
it's kept you in the same steam attic
area but it's going to get stronger and
it's going to make our lives more
interesting so for example in the United
States at the moment and indeed in
Ireland more recently if you imagine
young drivers they get penalized a lot
with insurance policies because
typically young drivers you know they
tend to have more accidents because they
may not understand the risks involved
with their behaviors but now you can get
an electronic device that you can plug
into your actual car so any car built
since the mid 90s has a diagnostic port
for mechanics this device plugs into it
and it monitors your behavior as a
driver so if you turn rice and you
indicate rice that's a good thing
if you drive between the hours of 8:00
and 8:00 and it's daylight that's good
if you obey the speed limits that's good
so if you have good behaviors you get
10% off your premium brilliant so
rewards people who have good driving
behaviors and therefore have a lower
chance of accidents now imagine the flip
of that so all that wearable technology
I've just told you about that we'll all
be wearing in five years time or so
imagine if all that technology is
harnessed and now it's a life insurance
company or a health insurance companies
looking at it and it says you know what
Jack you're doing a fantastic job you're
going to bed every night at 10:00 you're
getting up every morning at 8:00 you're
getting a great sleep
you're not going to the pub you're going
to salad bars you are living your best
life 10% off your health insurance
policy
now Mary you're going to bed every night
at 10 o'clock but you're watching Game
of Thrones for three hours you're
falling asleep at one o'clock you're
waking up at 6:00 and then you're
wondering why you're tired the next day
and you don't have time to prepare the
food so you're going to a fast-food
joint and then you're so tired you can't
go to the gym you're going to get a 10%
loading on your premium so do we really
want that as a society because these are
the kind of questions were going to have
to ask
it's creeping in already with the car
insurance but as society do we want to
give that kind of access I guess to
artificial intelligence now we are
creatures of habit we know this it's
part of probably an evolutionary biology
mechanism whereby we do things in
patterns and that's where artificial
intelligence is really powerful is when
pattern recognition it sees behaviors
and it predicts the future based on
patterns so a payton was taken out last
year by one of the large online shopping
companies called predictive purchasing
and the idea is you can say $10 $20 or
$50 and you can select once a week once
a month or once a year so we'll just say
you say $50 once a month and they're so
confident with their artificial
intelligence algorithms that they know
what you want before you've even thought
of it that they'll give you free
shipping if you don't want it and I know
what everyone's saying here in their
brain they're saying there's no way a
computer knows what I want I am a
multi-faceted special sentient human
being
we are all creatures of passions and as
I said it's probably something to do
with with our evolution whereby if we
used to walk a certain way back to the
cave every night and we didn't get
killed or attacked
we probably kept walking to the cave the
same way every day most of us here
probably drive the same way to work
every day we go to the same supermarket
we buy the same twenty things so this
new predictive purchasing software
that's gonna come online pretty soon
you've selected $50 you've selected once
a month you look at the calendar and you
see it's the first of the month and
you're gonna go home and you're gonna
see this package on the table and you're
gonna think to yourself oh yeah this is
brilliant now I'm going to show that
artificial intelligence how special I am
and you're gonna walk over to the table
you're gonna pick up the box open it and
say there's no way a computer oh my
goodness this is amazing this is exactly
what I wanted how did it know so it knew
because it got you a guidebook for
France on the holidays and it's all in
your calendar that you're going to
France this summer and it also saw in
your calendar that last year you were in
Spain and you bought a guidebook in the
same thematic style and you gave it a
five-star rating so it predicted that
you'd want a guidebook for this year's
holiday Wow maybe computers do know us
better than we know ourselves so this is
the kind of artificial intelligence
that's going to be making big decisions
not only about our purchases but also
about our health so imagine all that
wearable technology I spoke to you about
and the computer is analyzing it and
it's saying you know what Jack you have
a 50% of getting diabetes based on your
current health patterns and then you go
when you change your behavior and maybe
you can drop it to 30% because the
artificial intelligence is able to look
at the patterns and given your level of
activity and your dietary input and so
on it's able to make an accurate
prediction of your chance of developing
different chronic diseases and that can
change behaviors but data gives us the
chance to make better decisions and
ultimately what we want to do is change
the way we deliver health care that's
going to be the future of medicine or by
the patient is at the center of the
health care equation not the institution
or the healthcare network so is there a
way to take that remote monitoring mix
it with the artificial intelligence and
deliver health care and
way especially for chronic diseases
because as we know we're all getting
older and medicine is doing a really
great job of keeping everyone alive so
there's far more people alive now and
living longer and healthier into their
older age and so we have this plethora
of chronic diseases that now need
management which is a good thing
we just need to change the way we're
managing it so hospitals as you know
that might have been built 50 years ago
which had 30 seats in the waiting room
which was enough for that population
that's completely redundant now where
you have people standing because you
need double the amount of seats so there
must be better way of doing it and there
is traditionally centralized things like
shopping go to a department store that's
been changed to online banking going to
a bank that's been changed to online
health has been a bit slower to catch up
with the idea of ICT information
communication technology because we're
afraid about our data being shared and
being been leaked but as we know if we
can trust the internet for our banking
and so on that there's some really good
encryption methods there so is there a
way to take the remote monitoring the
artificial intelligence and to actually
deliver better health care and there is
this is telemedicine and it's already
being used around the world and being
used for a long time but not really in
the area of chronic diseases so why is a
patient coming from Clifton or from the
Aran Islands or even from across Galway
and spending an hour and a half coming
to the clinic 20 minutes parking where
he to hours in a waiting room to see me
for 10 minutes that's a waste of
everyone's resources and you don't need
to be an engineer to figure out that's a
pretty wasteful process for the
environment for the person's time it's
much better if for example the
artificial intelligence can figure out
which patients need to be seen maybe
they're having a lot of low blood
Sugar's if they're diabetic and it
schedules them to have a virtual clinic
with me so at 2 p.m. in the afternoon
they get a link to log on to the clinic
I said in your pockets you have phones
that have audio-visual equipment like
FaceTime and Skype that are encrypted
so I can see you on the computer and
then I can see all your data because all
these meters these glucose meters now
when you take a value it goes to the
cloud so I can see your sugar data I can
see your activity data and I can see
your your your medication administration
and then we can have a very rich
conversation and I can say as you would
if you were beside me I see every
Tuesday afternoon you're going low
but also I noticed on Tuesday afternoon
your activity goes up what's going on
and then you might say I've joined a way
of walking Club every Tuesday and I say
oh that makes sense you better pull back
on your your mealtime insulin so we can
have rich conversations remotely and it
prevents people having to come in to a
physical hospital now you'll still have
to come in at least once a year for a
chronic disease to get you know the
general medical exam but a lot of the
care can be delivered remotely and if
these visits throughout here which will
keep people on track with their targets
for chronic diseases
so in summary two things I hope you
learned tonight from my talk one if your
phone rings always answer it it could be
NASA and to the power of technology to
improve the way that we deliver health
care that's the future of Medicine thank
you
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