Conference Review: Exponential Medicine 2014

Exponential Medicine 2014 took place in San Diego, California USA. As an A4M Board Examiner, Advanced Fellow, student and practitioner of functional medicine I attended this meeting specifically because its content is of particular interest to the A4M community. This report aims to share the meeting highlights from the viewpoint of Anti- Aging and Regenerative Medicine.

This meeting was originated as a spinoff of Singularity University which was co-founded by Ray Kurzweil, the inventor, futurist, and current Director of engineering at Google. Many of you may recall his books (“Fantastic Journey,” “Transcendence,” and “How to Create a Mind”) in which he outlines his prediction that our biology will be fully integrated into the web within a few decades. All 3 books are well worth reading. This will transform Medicine as we know it as well as most other fields. Kurzweil has been highly successful with his predictions. The other founder of Singularity U is Peter Diamandis who is the originator of the X Prizes with which he attempts to motivate private entrepreneurs to make massive societal improvements (like solving hunger, water shortages, and commercial manned space exploration) by offering millions of dollars in prize money. Dr Daniel Kraft was the host of the meeting and is a Harvard trained hematologist who anticipates a transition from fee for service based care to outcome oriented care, a change from sick care to health care, and the rise of the e patient who is the CEO of his health care owning the records and making their own informed choices. There was a great deal of interest in biological sensors which will provide real time feedback via a smartphone. There are already devices like that in play which collectively are referred to as “wearables” like the fit bit wrist band, contact lenses that measure blood glucose, and rfid implantable devices suitable to measure physiologic functions like BP, pulse and many others. There are over 250 sensors placed inside a plane and in other automated devices but almost none designed for the human body yet. The design and implementation of these sensors will eventually lead to nano bots the size of an RBC that can repair tiny defects and even be used to treat cancer. Of course this begs the question of how our current minds will be able to handle all this data from these sensors or if this will be done by computer or even a cell phone app. The effects on our lives that integration into the web as well as increased automation will have is dealt with in Nicholas Carrs books “The Glass Cage and The Shallows” . Not all of these effects are positive. For instance, today’s airline pilots are mostly there to watch the automatic pilot computer work. They rarely take control and this degrades their skills in case of an emergency. The same can be said of a self driving car which is currently in production at Google. Our driving skills will wilt just as our navigation skills have wilted with the invention and dependency on GPS. Will all this automation lead to an earlier onset of dementia? Many people think it will.

Peter Diamandis lecture outlined his 6 “Ds” of exponential thinking: digitized, deceptive, disruptive, demonetizing, democratizing, dematerializing. Think of the cell phone which is the classic example. Think of what happened to Kodak as a result of digital cameras and Peter predicts that because of exponential thinking 40% of the current Fortune 500 companies will no longer exist in 10 years.

There was a great deal of discussion about robotics and its future impact on surgery, home health care, nursing, and even as replacement physicians. Its coming, like it or not. The human physician will be no competition for a robot connected to the worlds medical literature. They will mostly be like today’s pilots- watching the computer and rarely stepping in. We will need fewer of them . Today’s surgical robots made by Intuitive Surgical (which exhibited at the show) require a human operator but that will change. There will also be personalized custom implants made on the fly with 3D printers right in the OR. Just as most people resisted the automobile or the telephone when it first came out, most of the medical community will be unable or unwilling to embrace the future of medicine. They will resist it and will loose. Dr Google is slowly entering every medical office as a second opinion. Its only a matter of time until Dr Google is the primary care physician. Laboratory medicine will be completely dematerialized – gone with the increasing use of sensors. Big data and artificial intelligence will rule. Again, not all of this is good but its coming.

Dr Craig Venter, one of the leading scientists in genomic research, outlined his vision for the newly built institute bearing his name that I drive by almost daily. He also broke the human genome code and has the goal of sequencing 1 million genomes by 2020. If anyone can do it its him. He appears to be the modern day Jonas Salk whose institute is right down the block.

Vinod Khosla predicted “that data science will do more for medicine within the next 10 to 20 years than all the biological sciences combined.” He also thinks that in that timeframe we will see five times fewer errors, five times lower cost of care, five times less work per doctor, five times faster clinical interactions, and five times the number of opportunities for clinicians to take part in research. From that outlook, the clear trend is a reduction in the reliance on the doctor for most healthcare needs. Instead, as Vinod has commented in other talks, patients will become the CEOs of their own health.”

There were many other equally fascinating presentations by leading scientists, physicians, start ups, and established companies. It was a cornucopia of futuristic thinkers in a 4 day meeting which gave all attendees plenty of impactful information relating to the near-term revolution in medicine and healthcare.

Review Prepared by Ira L. Goodman, M.D., FACS, ABIHM, FAARM, ABAARM