A sugar glider, "the world’s most dangerous animal" (because of it's likelihood to be imported and so transmit rare diseases) according to ecologist and TedMed speaker Peter Daszak.

TEDMED is a spinout from TED - events that gather a diverse set of luminaries to discuss ‘technology, entertainment and design’. TEDMED applies the same principles - senior level participation from a range of fields, intimate atmosphere and short engaging talks, in the area of healthcare, innovation and wellness. I participated this year at the event in San Diego which was held October 26-29. This post highlights some broad cross cutting themes, then provides a (non-exhaustive) summary of the key insights from the sessions.

KEY THEMES

Impact of aging populations

Within 40 years there will be 6m centenarians, up from a few hundred thousand today. The proportion of people over 65 is set to triple globally between now and 2050. The key idea here, pushed by Aubrey de Grey and others) is that aging should be considered a disease. His SENS foundation has identified 7 characteristics of pathology - how the cells die - that he thinks should be treatable. In this way not only will people live longer, but more important, their lives will be less ravaged by disease and 'decripitude'. Another points that was made was how there are often different treatment models and drugs for young vs. old people which often is overloooked.

Dramatic need for innovative cost reductions

In 1960 US spent 4% of GDP on healthcare, that number was 18% in 2010, with a value of $2.62trillion. Americans spent $134bn on pharma drugs in 2004, rising to $234bn in 2008. Massive amounts of waste and opportunity for improvements:

1. 1.7m infections in US hospitals causing 99k deaths/year
2. Medical care is the 3rd biggest cause of deah in US!
3. 75% of healthcare spending is on chronic diseases.
4. For every $1 spent on medical research, $400 is spent on care for the patients.

Coupled with aging populations, this is unsustainable. Alzheimer’s will collapse Medicaid and Medicare by 2015 if no new drugs. Need for innovative and cost effective treatments and behavior change.  30% of patients starting a long term course of medications stop taking them after the first month. Mobile healthcare has the potential to deliver massive cost savings - e.g. stated mission of the new West Wireless Institute.

Consumerization of healthcare

Walt Mossberg put it succinctly “the most important electronic device is my glucose monitor, and it’s a piece of crap”. For more info on this, see Section 3 below, including his pleas for change. More generally, the impact of consumer empowerment underlies many of the emerging innovations on display such as the easy to use web accessible genomics tools of Knome and 23andme, and ubiquity of smart phones as human controllers.

Importance of information (re) design

“Healthcare is not a science problem it’s an information problem”. Need to help people make better decisions –relevant (personalized) information at right time will lead to better outcomes. Create change through emotion People change because of what they feel, not what they know. Quest earns $730m profit last year, Labcorp earned $543m profit - the redesign done by the Wired editors cost less than $10k and resulted in much more effective information that can lead to behavior change.

Solving diseases with genomes (and proteomes)

Massive decrease in cost of sequencing a human genome. 2227 genes are highly predictive and medically actionable. 0.004% genetic difference between humans and neanderthals. However, genes are not deterministic – can be turned on and off. Lifestyle / environment has the ability to turn on and off genes - epigenetics.

Holistic health vs. chronic illnesses

81% of Americans take at least one medication a day. Only 3% of Americans lead healthy lives (no smoking, good diet, exercise). 35m deaths globally/year could be prevented through diet, exercise and quitting smoking.

Whole body approach to diagnosis and treatment - body is a system and a process - not static.  Cancer should not be a noun – it’s a verb. A symptom of a problem with the system.  “Unhappiness comes from spending money you don’t have on things you don’t want to impress people you don’t like” - Deepak Chopra.

Non-pharma techniques to improve health focus on diet, exercise, sleep, stress and relationships. Evidence that changing diet and lifestyle reversed disease in cancer and heart disease patients. 62% of an average US citizen’s calories come from processed foods, 20% from animal products. Around 10% from unprocessed fruits and vegetable (should be about 90%).

Going mobile

Everything is moving mobile - which means being untethered from the traditional model and location (e.g. of a hospital). Mobile technology described include mobile ECG readers - reading a patient’s heart rate in real time to lab on a nano-chip technology (Nanobiosym’s Gene Radar) that will be able to determine diseases on the spot. But mobile doesn’t only mean mobile phones - the next generation of bionic machines (prosthetic arms & legs, pace makers) have wireless sensors embedded in them so can be controlled with smart phones.

SUMMARY OF KEY TALKS

This review covers the majority of the most interesting - but not all - talks at TedMed 2010.

Shef Keshavjee, Senior Scientist, Toronto General Resarch Institute (link)

He’s developed a technique where for the first time you can keep the donor organ outside the body at room temperature for up to a day. This means that you can then repair it (for example if it has an infection) or even potentially genetically modify it (for example to reduce the cance the the recipients body rejecting it).

Nathan Mhyrvold, Founder, Intellectual Ventures (link)

Talked about a few of their health-focused innovations such as: self-disinfecting surfaces using UV light. Lght-activated nitric oxide bandages that kill bacteria. Back-scatter X-ray to provide a view of 1" below the surface. Talked with great enthusiasm about his new 2400 page cook book Modernist Cuisine.

Dr. Nathan Wolfe, Director, Global Virus Forecasting Initiative (link)

Massive increasing in interconnectivity. Use of social tools e.g. Facebook / Twitter updates can be used to predict and manage viral spread.

Global airline networks facilitate the spread of disease.

Thomas Goetz, Executive Editor, Wired Magazine (link)

Healthcare is not a science problem it’s an information problem. You can dramatically improve healthcare by helping people make better decisions. This will come from providing (personalized) information at the right time that lead to better outcomes. Information’s power to enable behavior change when it’s personalized, has relevance, highlights choices, and prompts action. Redesigned Quest’s lab forms - traditionally unreadable - to a new format that made it clear to extract meaning from the numbers.  Four questions for your doctor: Can I have my data?;  What does it mean?;  What are my options?; What’s next?

Mike Barber, GE HealthyImagination (link)

Talked about new mobile ultrasound VScan - used in Olympics and allowed athletes and supporter not to miss the games, and proving effective at paces like Indonesia with 1000 islands. Spending $6bn on GE Healthymagination programme. GE has just launched a large healthcare initiative with Intel to be launched in 2011.

Jon Mackey, CEO, WholeFoods (link)

Gave a review of the bad food Americans were eating - of the appx 10% of calories in our diet that come from fruit and vegetables, half of that is from potatoes and half of those are fries. He talked about some innovative incentive schemes in the company - greater discounts (20% is standard, up to 33% is possible) for being healthier. They have an optional residency program where the very unhealthy e.g. obese can go - great results impacting morale and lowering insurance costs.

Frances Jensen, The Children’s Hospital (link)

Focused on the adolescent brains. Found that adolescents treated by a pediatrician had higher survival rates than those treated by a regular doctor. Kids and adolescents brains are wired differently - epilepsy drugs for adults are less effective on kids since they have more excitors and less inhibitors, each react differently to these drugs.

Juan Enriquez, Former HBS Professor, MD Excel Venture Management (link)

Presented the concept of “Homo evolutus” - a new human species created by humankind itself. “There have been at least 25 prototype humans. We are but one more model, and there is no evidence evolution has stopped.”

George Church, Professor of Genetics, Harvard Medical School (link)

Worked on the human Genome Project, create synthetic life. Has now created the PersonalGenomes.org project - monitoring the genomes of 16,000 volunteers.

Craig Venter, Chairman, Craig J Venter Institute (link)

Sequenced human genome in 2001, announcement of the 1000th genome sequenced in Apri this year, but ‘what we need is 10million’ . Craig’s institute made the first synthetic life last year - put together bits of DNA to create a new organism. Multiple uses for synthetic life Craig proposed reverse vaccinology - using the synthetic genome to create new vaccines. He also thinks they can create new solutions for food, water and rewnewable fuels.

This is in the DNA of the first synthetic organism - peppered with existential quotes.

Peter Daszak, Founder, Ecohealth Alliance (link)

Most viruses jump from animals to man (HIV: monkeys, SARS: birds). Use of modelling techniques to predict next global outbreak. “Most dangerous animal” in the world according to him - the cute sugar glider, since it is imported direct from disease hotspots around the world direct to people’s homes, and laps.

Walt Mossberg, Wall Street Journal (link)

Walt has been a life long lover of technology - and a diabetic. He railed against the state of medical devices today compared to his beloved iPhone and iPad, and called out his own glucose monitor - the Accu-Check Aviva, and said ‘it’s a piece of crap’.  In a follow up interview, I asked Walt to provide more info and he made three clarifying points - that he was pessimistic about innovation from within due to the industry's revenue model ($1 per test strip); that the holy grail is to detect glucose levels non-invasively (and non wearable for type II patients who don't need continuous readings) and third, to make devices as "sophisticated, accurate, and connected to the computer, smartphone, tablet and -- importantly -- the web (securely) so that both patients and doctors have easy access to the data". I'd suggested that Apple should be the benchmark that pharma companies (e.g. the one that's currently my client) use, and he thought that was right.

Walt Mossberg expressing his frustration with the poor quality user experience on his glucose monitor.

Alex Berenstein, Director,  Center for Endovascular Surgery, Beth Israel (link)

He is a pioneer in the emerging field of interventional neuroradiology, a specialty that utilizes minimally invasive procedures to treat conditions related to the vascular system of the brain, head, face, spine and spinal cord. He reviewed state of play of catheter’s etc, how technologies have evolved.

Henry McCance, Greylock Partners, Founder Cure Alzheimer’s Fund (link)

Henry is using a VC-approach to accelerate research in Alzheimer’s at the Cure Alzheimer’s Fund, and he coined the term “Venture Research”. Current research is inefficient (30% of time filling out forms), ineffective ($1 on research for every $400 on care) and incremental (risk averse studies, moving one stage at a time.)  The approach at the CAF is based on the following principles: Proactive, Frugal, Collaborative, Outsize ambition.  Other business people creating innovative organizations include Steve case (ABC2) & Jamie Heyward (ALS-TDI). Rudi Tanzi from Harvard talked about the Alzheimer's genome project.

Danny Hillis, Founder, Applied Minds (link)

Looking at cancer research and treatment from a different perspective. Traditional genome approach is static, whereas proteomics is dynamic, and more able to help you understand what is actually happening in the disease. Analogy of the body as restaurant, the list of ingredients are the genes and the meals actually being created and served are the proteins. Created Applied Proteomics company and partnereed with David Agus for a new department at USC. He estimates it will take 5 years – to get to a predictive model of what happens, that will include neurodegenerative diseases.

Hugh Herr, Professor, MIT (link)

Skilled rockclimber who was caught in a mountain got frostbite and had to have both legs amputed above the knee. “I wouldn’t have it any other way - before the accident i was a below average student, with my new bionic legs i’m now a professor at MIT” (who has the cool title Director of Biomechatronics)

Dean Kamen, Founder, Deka (link)

Updated the crowd with his innovative prosthetic limb robots - displaying a complex model ship that someone with no arms had built using the Deka prosthesis. He described an innovative water filter that creates perfectly clear water from any type of water however dirty. He’s in negotiations with Coca Cola to have it distributed with their soft drink machines globally. He’s also passionate about his FIRST training kids to build robots and enjoy science. Funded with a $3m grant from Google, getting kids to sell energy efficient light bulbs door to door, (similar to the girl scouts selling cookies).

Stephen Oesterle, MD, SVP, Medtronic (link)

Stephen talked about next generation pacemakers - tiny, no wires. Allow for wireless monitoring and direct interrogation by cellphone from anywhere. He noted that electronic signalling could be useful for other diseases - e.g. Parkinsons - and potentially controllable with machines.

Craig Fugate, Administrator, FEMA (link)

Emergency management should be more of a public-private partnership rather than the government coming and and doing everything. Use of social media e.g. Twitter by FEMA to assess situation and whether it should be attended to. Urged disaster management to be more integrated into society - to improve the ‘immune’ system.

Marc Koska, Inventor (link)

Described his 20+ year journey since hearing a story about unsafe reuse of syringes to creating a safety syringe (it automatically disables itself after one injection) and selling to globally to developing nations, who tend to reuse the same syringe and spread disease. It is credited with saving over nine million lives.

Scott Parazynski, Astronaut and mountaineer (link)

Scott is the only person to have flown in space and summitted Everest. He talked about the coming commoditization of space travel and urged everyone to do it if they can.

Greg Lucier, CEO of Life Technologies (link)

Greg unveiled a new gadget that can sequence a genome in a few hours (rather than days as currently the case).

Ozzy and Sharon Osbourne, Entertainers (link)

Discussing the results of the sequenced DNA - he has higher tolerance than the norm for alcohol, and has many traits that would make him a good mother (not sure what that means). Their family disagreements mirror societal angst - Sharon wants to know if she carries the genes for Parkinson’s and Alzheimer’s etc (it’s in her family), whereas Ozzy doesn’t.

Conclusion: Outstanding.

I highly recommend making the trip to TedMed 2011 if you want to hear - and meet - fascinating  leaders in the healthcare field who are passionate about innovation.

A parting comment - the ticket is not cheap - $4k, and if you only go and listen to the lectures you're wasting your money. It's about being part of the community - the real value is in the gaps, not the talks. The founder Richard and his business partner Mark really make a sterling effort with excellent dinners (the lobster bake on the beach was fantastic), generous munchies at the breaks and a warm, inviting ambience at the Hotel Del Coronado (especially valued for an East Coaster settling in for a cold winter). I'd recently read Never Eat Alone, and his main takeaway is to think of networking not as what they're doing for you but as what you can do for them. It  changed how I thought about networking from a rather unappetizing - and unBritish - quest to being about helping people. Spread the love, man.

Anyway, well worth it, and if you're interested, get your skates on. Rumor has it that tickets for next year's jamboree - which are non refundable or transferable - will probably sell out by end of Q1.

There are no shortage of predictions about what this year will bring for mobile, so at the risk of piling on a bolted bandwagon here are a few more. Not exhaustive by any means, more of a selection of some of my favorites.

1. Celebrities figure out how to monetize social media, even if social media doesn't.

If Kim Kardashian can get $10k for a single Twit, how much could someone with a broader following and even greater respect coin? Lots of outrage and fuss predicted (can you trust anyone?), but the market will reward credible endorsements, and affiliate technology will enable both transparency and revenue.

Location-based posts and pics/ videos submitted via mobile will be a big part of this, as the mundanities of daily life are manna from heaven to the celebrity obsessed.

2. Developers expand focus from the device to the hardware ecosystem

A big challenge until now has been making it easy and reliable for phones to make calls, send texts, browse the web and download apps. Thankfully this is more or less a solved problem, so I suspect part of the battle will shift to the hardware ecosystem. People will start to integrate mobility into their physical environment - TVs, thermometers, speed cameras and sensors will become part of the extended operating system. Creative developers for Apple are already straining at the leash; first flashlights, spirit levels and compasses, and now blowers and handwarmers take us beyond the digital to the physical environment.

Look for big growth in the m2m market and intriguing modular hardware initiatives like Nokia's NOTA, Aduino and BugLabs and a fun new concept out of Portland, Green Goose (thanks Rob!).

In addition, companies like Nokia and RIM/Blackberry who are overdue for an operating system upgrade could take this opportunity to leapfrog even even Palm's fabulously slick WebOS and ensure their next OS is integrated more tightly into the physical environment.

3. Mobile augmented reality as a new search interface

Continuing the theme of moving beyond the phone, here we'll see the the overlay of digital intelligence with the real world. Google Goggles is an important validation - and gives them the advantage of having an alternative search trigger (their location algorithms deliver the search term, rather than the keyboard). This is a new enabler for many services that can overlay digital with physical, and there are some intriguing proof of concepts popping up like mushrooms, subway finders, interior design and ski slopes.

Bruce Sterling's speech at Layar's launch provides a good summary of the state of play and potential here.

Video: Bruce Sterling's Keynote - At the Dawn of the Augmented Reality Industry from Maarten Lens-FitzGerald on Vimeo.

4. Health goes online and mobile at the same time

Healthcare eats up massive amounts of consumers' attention,' powerpoint ink and investment dollars (the second quarter of 09 saw more VC investment in healthcare than in IT). Professional-grade startups such as AmericanWell are quickly dismantling barriers to online health such as onerous insurance liability, online doctor-patient relationships and restrictions on cross-border medicine. At the same time Congress is on the verge of throwing another 30m uninsured Americans into the system who will need cheap yet effective treatment, and the shortage of primary care physicians is set to increase. I predict mobile as platform of choice here - more secure and personal than a computer and able to take, send and store pictures, sounds and videos of questionable body parts, and deliver location-based services that will help patients find services easier.

Every year for the past few years has been billed as the year that mobile will break through. As AdMob and Quattro proved late last year - 2009 was actually the year for mobile, but it came and went. Mobile is no longer another place, it is all around us, like the Internet now is. I think 2010 will be the year that mobile starts to integrate with the physical world to deliver genuine user benefits (such as saving lives) as well as more trivial ones (such as Kim K painting her nails). Either way, a busy time for innovation ahead.