Jack Uldrich: Future Trends in Health Care
Filmed at a Health.Inspired Event in Minneapolis
From social networking to robotics, advances in technology are transforming health care. In this thought-provoking talk, acclaimed futurist and author Jack Uldrich explores the implications of 10 trends. He reminds us that keeping up isn't good enough. You need to jump the curve.
In 2009, I wrote a book called Jump the Curve. As I was researching it, I came across a wonderful quote from Albert Einstein. He said to scientists and to technology writers, “If you can’t explain what you’re talking about to an 8-year-old child, you’re a fraud.” I thought that’s a wonderful test. It just so happens, I am blessed with an 8-year-old son. When this picture was taken, he was only 7. He had not lost any of his teeth yet, but I wanted him to see if he could understand what I meant by jump the curve. He had not lost any of his teeth, but he finally lost one. I thought, “Here’s a great opportunity to see if he can grasp what I mean by jump the curve.” I said to him, “What would you rather have from the tooth fairy? Would you rather have $5 per tooth (and all babies have 20 teeth)? Or, would you rather have a penny for the first 2, 2 for the second, 4 for the third – it keeps on doubling?” He looks at me like I’m dense, he does the math, and he says, “I’m taking the $100, Dad.” I go, “No, Shawn, you have to learn how to jump the curve because your 20th tooth is worth $5,242.88.” The reason this is so important is that if you plot out a trend that is growing exponentially, the curve quickly shoots up. The reason this is so important is that there are now nine trends in society that are doubling: computer processing power, data storage, bandwidth, the sequencing of the human genome, advances in brain scanning technology, robotics. All of these things aren’t just increasing linearly; they’re increasing exponentially. If you want to understand the future, you have to similarly jump the curve. One of the really interesting things about technology is that if something is growing exponentially, it can also get better, faster, cheaper, and smaller. Many of you can remember some movies from the early 1990s, and they were showing Wall Street executives. To demonstrate that they were Wall Street tycoons, what device would they show them using back in the early 90s? It was this huge, brick-like cell phone. In the early 1990s, only they could afford it, because it cost $5,000. I now want to fast forward to today. This is an unfortunate sign of the times. It’s an unemployment line out on Wall Street. If you look closely, what does every unemployed person have? Well, it’s a cell phone. But it’s not just a cell phone. You can access the Internet, you can social network, you can store every song you’ve ever purchased on it. If you are so motivated, you can shoot, produce, and edit a movie on it. It is a demonstrably more powerful tool at a fraction of the cost. Trend #1: Smart Devices History reminds us that technology has this curious way of getting better, faster, and cheaper. As it does, it diffuses out. That leads me to my first trend, which is smart devices. This is a picture of Dr. David Alpert, and earlier this year he developed an electrocardiogram that you can attach to your smartphone for less than $100. Today, ECGs typically cost around $35,000, but this is going to allow individuals to begin sending their heart information directly to their providers. Because I’m a futurist, I want to help people understand the future. I’m 47 years old, and as a young man I would go to a lot of concerts. If you were my age, after the artist was done, what would we do to bring them back out on stage? We would hold up a lighter. Woo, come on back out! Just why we had a lighter, that’s none of your business, but we did have it! Well, I got married, and have two young kids and for years I didn’t go to a concert. I finally went to one a couple years ago. What was the big difference? Young people were holding up cell phones. And I go, “That’s a curious difference.” I went to one just a few months ago, and there was a young kid holding a lighter app on it. He would hold it up, and it’s like “Woooo!” The reason I show you this is because, look, we’re still going to do the same things we’ve always done in the future, but how we do them is going to change ever so slightly. Trend #2: Gaming Dynamics That leads me to my second trend, and that is the whole field of gaming dynamics, or “gamification.” We’re still going to exercise, and still going to try to eat healthy, but the way we do this is going to change because of this device. If you’re in the insurance industry, there’s a way to use gaming technology to encourage people to engage in healthier behavior. If you want to eat better, there’s a way to use this technology to work with your friends to eat better. Technology is going to allow us to do things in slightly different ways. Here’s another curious thing about exponential growth. Anything that just doubles 10 times is 1,000 times bigger. So my son’s 10th tooth would have been worth $5.12; his 20th tooth, over $5,000. A lot of people say to me, “Well, Jack, we’re not going to see a thousand-fold increase in the future.” I go, “You know what? Before I even walk you into the future, let’s just look back a decade in time.” I did this as I was writing my book, and I put the idea of exponential growth into a search engine, which has grown a thousand-fold in the last decade. The very first entry that pops up is an entry from an online encyclopedia, which didn’t even exist eight years ago, but which has grown a thousand-fold. There was this bizarre word in there called “zenzizenzizenzic.” I go, “What does that mean?” Does anyone here know what zenzizenzizenzic means? I figured not. It means two to the eighth power – anything that doubles eight times. I’m a fairly conservative guy, so I said, “Maybe some of the technologies I’m telling you about aren’t going to double 10 times in the next decade. They’re just going to double eight.” Just last week, a major telecommunication company came out and said, in the next four years, by 2015, mobile Web video conferencing is going to grow 250-fold in the next four years. A zenzizenzizenzic-like transformation. Trend #3: Mobile Web Video That leads us to our third trend, which is, not surprisingly, mobile Web video. The way that you communicate with your health care providers is going to change radically in the next few years. You’re not going to be doing everything via video. A lot of your consultations and a lot of your meetings can and will be done this way. I have another question for you. What is the relationship between all of these numbers? A. 1,000 B. 1 million C. 1 billion D. 1 trillion E. 1 quadrillion Each one is a 1,000 times bigger. This really leads us to our next four trends, and I’m going to walk you through why all of these numbers matter. Trend #4: Robotics Today, in the health care industry, there are thousands of robots, and they are performing prostectomies and hysterectomies. The number of robots is doubling every year. What that means is, we’re going to see a thousand-fold increase. We’re going to go from thousands of robots to millions of robots, and they’re going to start performing knee surgery, heart surgery, and potentially even brain surgery. The reason this matters to you is that the incisions are now so precise, that you can get in and out of the hospital sometimes up to a week quicker because of this technology. A lot of people will tend to dismiss some of my technologies. You know what? Some of the technologies I’m telling you about aren’t going to be perfect today, but here’s an analogy from history. Ten years ago, e-books were big, fat, and clunky – and didn’t work. Seven years ago, they were slightly less big but they still didn’t work. It was only three years ago that a number of providers finally got it right. Today, less than three years later, we now sell more books electronically than we do real books. Change happens, and change can happen very fast when a technology is growing exponentially. Trend #5: RFID/Sensors This leads us to trend number 5, and there’s something called Radio-Frequency Identification Device (RFID) or sensor technology. Today, hospitals are employing millions of these sensors with the number doubling every year. We’re going to go from millions of these sensors to billions of them. Today, we’re using them in hospitals to track inventory, and to track biopsies, and other things like that. The technology is getting better, faster, cheaper, and they’re starting to go on the caps of pill bottles. We know in the health care industry that because people don’t take their medication properly, that’s costing the U.S. health care system $290 billion. As this technology continues to get better, we have an opportunity to significantly address that issue. Trend #6: Genomics This trend, number 6, is another thousand-fold increase, and it’s the whole field of genomics. Today, we’re sequencing billions of genes in a couple of minutes. Well, this technology is doubling every four years, and we’re soon going to be sequencing trillions of genes in the blink of an eye. Here’s how I want you to think about this. If you had wanted to have your genome sequenced just three years ago, it would have cost you $70 million. Not very practical. In 2009, it dropped to $1 million. Still not practical. 2010, $60,000. Today, $10,000. Next year, $1,000 and then below that. What this means is we’re going to know so much about your individual genome that it is going to profoundly change health care because it’s going to allow for personalized medicine. We now know that there are over 1,000 genetic tests. If you have a particular gene, we know a significantly better way to treat you. This revolution is steamrolling down upon us, and it’s incumbent upon all of us to understand its implications. Trend #7: Artificial Intelligence The last trend that’s going to undergo a thousand-fold increase is the whole field of computers. We now have computers that can perform 1 quadrillion calculations per second. This is a mind-boggling number, but here’s what you need to know. These computers can now access 200 million pages of medical information in 3 seconds. And just a month ago, a health insurer has now hired this computer to do what? To help doctors and insurance companies and hospitals better diagnose disease. I don’t want to mislead anyone to say these devices are going to put doctors and nurses out of work. That’s not going to happen. If this equipment can better and more quickly and more accurately diagnose disease, let’s allow the machine to do it. That then gives the health care provider more time to spend with the patient. Trend #8: Business Analytics So we have all of these sensors, we have all of this genomic information, and we have all of these powerful computers. That’s going to lead us into this whole field of data mining and business analytics. Here’s how I want you to think about this. In World War II, Allied bombers were getting shot down at a staggering rate. The military high command said to a group of scientists, “Figure out how to protect our planes.” The planes came back, and they were primarily shot up in the wings and the tails. Eighteen of the 19 scientists said, let’s reinforce the wings and the tails. Makes sense, right? Wrong! The lone standout said, “That’s wrong.” Here’s what we’re not seeing. We’re not seeing the planes that don’t come back, and those are the ones we really want to protect. Counterintuitively, if a plane can land with its wings and its tail shot up, we don’t have to address that area. We do have to protect the area that doesn’t have any bullet holes. Once it’s explained that way, it makes sense. Well, the analogy to health care data mining is, we now have so much data, but often individuals and their health care providers are looking at the wrong symptom. Data mining is going to lead to new insights and they’re going to challenge our intuition. We have to be open to what the field says because it’s going to lead to better health care. Trend #9: Social Networking The ninth trend is one that we are already living through. As great as this data mining technology is going to be, we’re still going to learn more from who? From our friends, from our neighbors. We’re now using social networking tools to find out a lot more about our health and how to treat ourselves. This is a trend that is only going to continue to grow in the future. Now, I want to close with one last analogy of exponential growth. If I had a piece of paper and if I could fold it 50 times, each time it would get smaller. Remember, things get better, faster, smaller, cheaper. But it would also get higher and thicker, right? The question is, after 50 folds, how high do you think that would be? The answer is likely to astound you. The answer is 62 million miles. That is a mathematical fact – that if a piece of paper could double. Doesn’t that sound impossible? To many people it does, but it is a mathematical fact. The reason I tell you this is, remember, the trends I have been telling you about are in fact doubling. Computer processing technology has already doubled 40 times and it’s going to double 50 times. Gene sequencing technology has already doubled 40 times and it’s going to double another 10. This is going to take us into a future that to many people sounds absolutely impossible but it’s going to be eminently possible. Trend #10: Tissue Engineering The final trend is the whole field of tissue engineering or regenerative medicine. Advances in nanotechnology, biotechnology, stem cell technology. We are already growing skin, we are growing kidneys, and bladders. Just a mile from here, the University of Minnesota has already grown a beating human heart. I’m telling you, in the very near future, things that sound impossible today are going to be eminently possible tomorrow, and that’s what you have to keep in mind.