Conference Review: Exponential Medicine 2015

I was fortunate to attend this most unusual event recently. The meeting is intended for physicians, basic science researchers, academics, industry, and anyone interested in what medicine will look like in the next 30 years. The technology world was well represented especially in the area of sensors, mobile health, virtual reality, advanced diagnostics, robotics, artificial intelligence, and of course big data. It was like stepping into the future on steroids. The meetings origins stem from Singularity University, the brainchild of Peter Diamandis (founder of the X prizes) and Ray Kurzweil ( the foremost futurist whose predictions have been over 80% accurate). Both of them spoke.

The chair of the meeting was Daniel Kraft, a Stanford and Harvard trained physician in hematology/oncology who is also on the faculty of UCSF. He delivered several rapid fire presentations coordinated with slides and video that was completely engaging. He will be giving a keynote speech at the upcoming A4M meeting next month that is not to be missed. On day one, I sat next to a medical resident who flew in from South Korea just for this meeting and during the meeting met many people from other countries who all shared an entrepreneurial bias. There was more than enough to fill anyone’s curiosity. I cannot possibly cover everything in this brief review but will highlight some things that caught my attention as a functional medicine practitioner, author and examiner:

1- a recording stethoscope. Think throw away your old model. This is way cool and much better. You do not even need to listen along with it, nor do you need a physician to use it (think robo doc and the deconstruction, democratization, and dematerialization of medicine per Topol’s books). It is placed on the chest and it records the heart sounds, which can be printed out and attached to the chart. You actually get a sound tracing like an EKG. No longer are you dependent on the physician’s memory about how your heart sounded 6 months ago or even yesterday. It transforms auditory unrecorded data into memorialized visual date. Right now it is not paired to a printed interpretation (as ekgs are now) but I think that is coming. The possibilities are endless for this breakthrough device. I want one, now!

2- $99 cancer tests developed in a lab in Spain that claims over 85% sensitivity and specificity via serum. If this pans out, the colonoscopy business will loose big, as will many other cancer screening enterprises. This is a good thing since they largely do more harm than good. Not enough space to go into this contentious topic, but I highly recommend Hadler’s and Welch’s books on this subject.

3- A company called First Derm that allows a patient to take a photo of any skin lesion, submit it online for rapid interpretation by a dermatologist. Compare that to a 30 day wait time, 3 hours in the office, and even after all that, facing a misdiagnosis in many cases. It's surprisingly affordable , fast and accurate - who could want more?

4- A new cardiac CT scanning company called HeartFlow that pairs a low radiation CTscan with state of the art graphics to produce not only a calcium score (which is what is available now), but a 3d image of your entire heart and its vascular tree showing in vivid color that status of every vessel. I have never seen anything like it. It will put a serious dent in the angiography and treadmill business, which are archaic in many ways, not to mention the nuclear scanners which are even worse.

5- A neuro stimulation device called Thync. I have investigated several of these devices and may publish a review of all of them in another post. These include the alpha stim, Fisher Wallace, Tenant Biomodulator, the Muse, Trans Magnetic Stimulation, and Focused ultrasound of the brain. They are all used for slightly different indications and worth looking at individually but I will limit my comments here to the Thync device. It is a small white patch placed on one side of your forehead as well as your neck. It is linked to a mobile device which allows you to control time, intensity, and frequency depending on what effect you desire. It can cause almost instant calm, a zen like state, or high energy depending on the circumstances. When I first saw it advertized, I thought is was another gadget with limited usefulness, but then I tired it. After about 8 minutes I was in an altered state that was very pleasant. It was very noticeable and lasted over 3 hours, even though the session itself was only for 10 minutes. Clearly, each individual must customize the experience in regard to settings, but I think there is real science behind this technology. Although it is still based on the drug model (used for a symptom prn), it is far less invasive and quicker acting. This is probably where neuroscience will go in the future and eventually these devices can be implanted, so they can work behind the scenes to create any mental emotion you want ( think Woody Allen’s orgasmatron from Sleeper, except invisible). Is there anyone who does not want this???

In addition to all this, there were lavish meals, nighttime activities which encouraged networking, and a beach party with a bonfire. This meeting raises the bar for medical events which will be hard to beat.

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