Exponential Medicine

I spent last week at the Exponential Medicine Conference (xMed) in San Diego, put on by the Singularity University (SU). SU is a group dedicated to the notion that Moore’s Law (number of transistors in a dense integrated circuit doubles approximately every two years) will soon result in computing capacity that eclipses the computational capacity of the collective human brains on the planet. This is referred to as the singularity; a concept advanced by Ray Kurzweil. It will change the way we do everything including healthcare.

In the course of the conference I had a couple of ah-hah moments.

1) Physics is science built on first principles while medicine is an observational art

This first “ah-hah” came in a conversation with Dr. Catherine Mohr who trained as an engineer before going to Med School. When I asked her the biggest difference between engineering and medicine, she observed that engineering is built upon first principals. We know definitively how materials behave and have a complete understanding of physical dynamics (at least at the human scale). Medicine on the other hand is essentially observational. We don’t yet have first principals for biological systems.

2) Health sensing and health data will be ubiquitous and zero cost

The second “ah-hah” came from pattern recognition; today’s healthcare looks a lot like the early commercial Internet. I started an Internet email company in 1993 when the Internet was first becoming commercialized. The Internet was born from telecom and institutional computer centers. In those environments bandwidth and computing power was scarce and precious. But the models and companies that won on the Internet assumed that bandwidth and computing were ubiquitous and zero cost. That’s why we have Instigram, and Kodak is dead. The winning models of Health Care will assume sensing and health data are free.

Combine 1 and 2 and you get the real ah-hah – medicine is experiencing exponential advances emerging from observations, correlations and analysis of ubiquitously available data. The pace of change will only increase. As Vinod Khosla put it: technology will replace 80% of what doctors do.

Our experience at SweetSpot Diabetes Care reflected this trend. Standards of care for diabetes are moving from measuring HbA1c three times a year, to measuring blood glucose levels every minute and combining it with blood pressure, caloric intake, pulse rate, activity, etc. Smart analytics turn thousands of data points into actionable insights and visual indications reflecting the specific metabolic dynamics of each individual. This informs medications, behaviors and potential interventions.

We don’t yet have the first principles of what causes diabetes, but the art of care is rapidly transforming. It’s getting easier to live well and long with diabetes, as with most other diseases. That’s what xMed is all about.

The Mother of Invention

Our future is Urban. Urban centers are growing and rural areas are shrinking. It‘s an amazing opportunity to reinvent how we live when we add 2.5 billion people to cities in the next 25 years.

It’s mind boggling how fast China is urbanizing – 21 million people per year are moving to cities. That’s the population of the 9 largest US cities. Imagine creating the equivalent housing, infrastructure and services that exist in New York, Los Angeles, Chicago, Houston, Philadelphia, Phoenix, San Antonio, San Diego and Dallas every year for the next ten years.

If necessity is the mother of invention, China is faced with the mother-of-all invention. I doubt their future cities will be developed on historic western models. I suspect we’ll see very interesting invention coming out China in the next few years.