Exponential Medicine with Daniel Kraft

October 11, 2018by Reena0

Exponential Medicine with Daniel Kraft

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Read the Transcript Below the Bio

Daniel Kraft is a Stanford and Harvard trained physician-scientist, inventor, entrepreneur, and innovator. With over 25 years of experience in clinical practice, biomedical research and healthcare innovation, Kraft has served as Faculty Chair for Medicine at Singularity University since SU’s inception, and founded and is chair of Exponential Medicine, a program that explores convergent, rapidly developing technologies and their potential in biomedicine and healthcare. Following undergraduate degrees from Brown University and medical school at Stanford, Daniel was Board Certified in both Internal Medicine & Pediatrics after completing a Harvard residency at the Massachusetts General Hospital & Boston Children’s Hospital, and fellowships in hematology, oncology and bone marrow transplantation at Stanford. He has multiple patents on medical device, immunology and stem cell related patents through faculty positions with Stanford University School of Medicine and as clinical faculty for the pediatric bone marrow transplantation service at University of California, San Francisco.

Daniel was selected as a fellow of the inaugural 2016 class of the Aspen Institute Health Innovators Fellowship and is a member of the Aspen Global Leadership Network.

Daniel’s academic research has focused on: stem cell biology and regenerative medicine, stem cell derived immunotherapies for cancer, bioengineering human T-cell differentiation, and humanized animal models. Clinical work focuses on: bone marrow / hematopoietic stem cell transplantation for malignant and non-malignant diseases in adults and children, medical devices to enable stem cell based regenerative medicine, including marrow derived stem cell harvesting, processing and delivery. He also implemented the first text-paging system at Stanford Hospital. Dr. Kraft recently founded IntelliMedicine, focused on enabling connected, data driven, and integrated personalized medicine. He is also the inventor of the MarrowMiner, an FDA approved device for the minimally invasive harvest of bone marrow, and founded RegenMed Systems, a company developing technologies to enable adult stem cell based regenerative therapies. Daniel is an avid pilot and has served in the Massachusetts and California Air National Guard as an officer and flight surgeon with F-15 & F-16 fighter Squadrons. He has conducted research on aerospace medicine that was published with NASA, with whom he was a finalist for astronaut selection.

Other professional activities:
Founder, IntelliMedicine & RegenMed Systems
Inventor of the FDA approved MarrowMiner
Adviser to the X PRIZE Foundation (Life Sciences), helped conceive and design the Medical Tricorder XPRIZE, and is Bold Innovator for Cancer XPRIZE.
Adviser to Rock Health, Qualcomm Life, Nokia and several life sciences and Healthcare-IT startups
Kauffman Fellow

Education:
Bachelor of Arts in Biochemistry, Brown University
Medical Doctor, Stanford University School of Medicine
Residency: Harvard Combined Residency in Internal Medicine & Pediatrics
Fellowships: Stanford, Hematology/Oncology & Bone Marrow Transplantation


TRANSCRIPT:

This is auto-generated and may have mistakes. Please listen to the interview for accuracy.

Reena Jadhav: Hey guys. It’s Reena Jadhav welcome. And today in the house is a certified genius Dr. Daniel Kraft. Hi Daniel.

Dr. Daniel: Hi there

Reena Jadhav: Alright. A little bit about Daniel. So he is a Stanford Harvard trained physician, scientist, inventor, entrepreneur, and innovator and over 25 years of experience in clinical practice, biomedical research and health care innovation. He is. Well, You look like you’re 20 so clearly you must have started when you were five and of course you’re a faculty chair for medicine at Singularity University, a founder and chair of exponential medicine. And we could literally sit here and spend the next 45 minutes going over how amazing your background is and all the awards you’ve won from being a Kauffman fellow cancer x prize stems to a very exciting new precision pill startup that you were going to talk about hopefully soon. With that said, welcome. This is truly a privilege and I’m just super excited to dive right in. All right. What’s exponential medicine for those of our listeners.

Dr. Daniel: So you know, the term exponential is sort of the math when things sort of go in. So one, two, four, eight, 16, 32, 64, those numbers get really big. 30 exponential steps in here to a billion. And a classic exponential technology here in kind of valley is Moore’s law. The power of computing getting faster and cheaper, which is why new Apple Watch has more computing power and speed and price performance for more than a cray supercomputer from 20 years ago. And exponential medicine isn’t program. I started at singularity university seminar years ago. And the concept was there’s a lot of technology is moving quickly for Moore’s law and mobile and sensors to intelligence to big data, three d printing to genomics sequencing, dropping at twice the rate of Moore’s law, so things that are moving quickly and how might we think about using that mix of fast.

Dr. Daniel: We analogies with the reading faster, cheaper, more available to reshape and re-imagine, reinvent elements of health and medicine from health and prevention and wellness. Giving a Selfie to doing a better job diagnosing disease. Stage zero, stage three or stage four therapy more precise, less expensive from a political way to gene therapy of crispr that’s too quickly all the way to global health. How do we democratize healthcare? Power of an ai on your smart phone and a chat Bot. She opened up access to basic health and medicine on the planet, so a little bit of try to instill that speed of technology. We can mash it together to progress. During this conference, exponential medicine has grown from a hundred folks, at the NASA center to about $700. The meet every fall at a beautiful hotel Del Coronado, the oldest, the west coast, and spend four days crossing the spectrum.

Dr. Daniel: Unlike most medical conferences, it’s not all oncologists, those cardiologists or rheumatologists or Pharma or derm. It’s a mix of people from across the spectrum, from patients to investors and some sort of magical happens when you get up to speed with what’s happening with the latest in gene therapy or AI or a nano tech for mental health. So a lot of things happened in the website. We will still a few spots left, exponentialmedicine.com every year as we have amazing faculty, but sending me this year, a 500 participants are selected from around the spectrum. 50 startups and a lot of, of magical ideas of ordinances, inspiration for people. Kind of neat there. And it catalyzed by learning what’s already here.

Reena Jadhav: So for a lot of us, we’re not going to have the opportunity to be there. So help us re-imagine healthcare the way it pertains to me as a consumer. You know, my experience, Daniel today is not that different from what it was, um, 20 years ago, which is I go to a doctor when I have a complaint, my doctor runs a bunch of tests and those of you who follow me know this, sometimes they don’t find anything despite your symptoms. And that’s true for 45 percent of us women and uh, and we kind of go from there to taking prednisone and pharmaceutical meds. How is the world out there being re-imagined by these brilliant geniuses who come to your events and you get to see sort of this awesome, you know, top down view of all the different things that people are doing. So what does our future look like and how soon as it here?

Dr. Daniel: Well, in many cases it’s somewhat already here. Now there’s a famous quote, the future’s already here. It’s just not evenly distributed. Yes. Silicon Valley, we think everyone has an apple watch and buy the Tesla. That’s for the rest of the world. And exponential medicine by the way, we live streaming for free. So at 1:00 on November fourth at 1:00, lots of talks that I’ve done lots of time out there, so catch it that way. But to answer your question, I think a lot of fields and moving quickly, we rented banking and how we get our entertainment and music. All these things have entered the fourth industrial age. Health and medicine seems a bit stuck in the second or third. We’re still using fax machines to communicate. You’re still probably going to the doctor and the same question to the number two pencil on a clipboard.

Dr. Daniel: You can down the street from Stanford and so a part of it is the challenge of innovation in healthcare different than shipping a product that’s a widget for consumer use or an APP or game and for good reason. We need some big regulatory elements. We have a reimbursement challenges. We want to prove that things. But the picture that you. You’ve experienced a lot of healthcare is really sick here. We have very intermittent bits of data. Only usually when you go into the four walls of the clinic and get your blood pressure checked in labs, and maybe your temperature of your way, so hopefully you’re only in a clinic or God forbid, hospital like one zero, zero, one percent life. Well, not all the data in your real life, your realized digital exhaust, your vitals to your mood to a term.

Dr. Daniel: It’s called you know, the genome and microbiome, but your digital increasingly interest, financial edge can be captured by a smart home and Smart Watch your mattress. So what will we have the potential to do is go from our intermittent sick care model where we wait for the disease to present to a new era where we’re much more continuous with our data and that data becomes information. That’s information that you as an individual consumer or patient make sense of and use in partnership with your team to help keep you healthy or picking up disease early or manage a problem. So when we moved from sick-care intermittent reactive to more continuous, proactive, personalized, real-time that’s infused with real time, big data information that matches you, like even that, even the best trained doctor today, the average be journal two or three hours a month, there’s no way place guidelines, information, let alone the explosion of Omex and the integrate and synthesize and do what was doing well with what, you know, AI, machine learning system file and you can do to kind of shift the medial as they move forward.

Dr. Daniel: And part of that’s a bit of a mindset, you know, millennials have a different relationship with their doctors and, and, uh, you know, I want to just talk like chat older generations, they expect to go to Dr Welby and they’ll tell them what to do and the youngsters today, you want to be empowered and, and own their health information and share it will make him. So there’s a lot of things moving evenly distributed technology. Um, and it’s really amazing age. Now we’re empowered entrepreneurs in patients like yourselves and catalyze and bringing things together to shift the needle, uh, across the healthcare continuum.

Reena Jadhav: Well, one of the things that I got really excited about was this video in one of your talks where the mirror is diagnosing me race. I’m brushing my teeth and imprinted on the mirror, all of these readouts which is telling me kind of what my internals are looking like today and I think you call it internet of body, Tom. A little bit about that. What is the Internet of body and how far away are we from it?

Dr. Daniel: Of Internet of things. You know, our homes are increasingly connected. I’m wearing a ring that’s, that’s my sleep and steps to next to my phone that can send that data to my medical director at Stanford. I can log in to adjust the temperature in my house. All these things are becoming super connected. She more available way, so there’s the Internet of things which is now not going to let this four g, but five g is really out this year, 100 times faster and then we have the opportunity to of body or net of health and medicine to connect the dots amongst all these elements and hopefully use that digital bread crumbs from our digital exhaust and our other data to help us be more proactive. To pick up a problem early. Let’s take something simple. A mattresses today. You can buy little sensor under the mattress that will track your sleep.

Dr. Daniel: Um, you know, how much time you’re awake, restlessness, pick up heart rate and respiratory rate, and a, let’s say it notices your resting heart rate’s normally 55, but it’s creeping up to 70. Wow. Wouldn’t you like to know that that’s not normal, that you’ve changed 20 points or your doctor, cardiologist running internet of things from a mattress to, uh, how you use your smartphone, how you’re typing might indicate changes in neurologic conditions, mental health, depression, and then hopefully it can be a bit of that check engine light for the bonding. Look in the mirror, you can see your digital coach or your Amazon Alexa or Google home talks to you and helps give you a little prompt about it. You’re gonna. Go to the gym this morning. Oh, don’t forget to take your vitamin D or your blood pressure medication. So as he to get more connected, smarter and can attune to the individual, there’s a lot of opportunity to engage people in their health in a more sort of natural way. Then we need to go to the doctor and also to crowd-source that data so we understand what it means. You don’t really even know what to do with a lot of this, let alone know patients full genomes and microbiome data. Information that’s exploding it. Availability isn’t yet going from data to information

Reena Jadhav: and that’s the whole check your body light. The way you would check your engine light analogy comes from. And I think that is so cool. So do that. Set Daniel well, how do you check your body’s engine like these days? So you showed us your aura rang ’em, you’ve got your watch walk, walk our listeners and viewers through Kinda what is Daniel’s day look like with respect to self care.

Dr. Daniel: Simple things like, you know, you don’t need to be wearing that little capital on EKG and temperature and heart rate and all those other elements, attempts, vital connect. But sometimes the siblings like my scale, when you step on it, it shows you your change from last time you were on it. So I belong a long weekend has really been exercising or eating too much. It’s gone. Going up one point five pounds, boy that is a little bit of a check engine light, a little bit of a gauge to go away. I’m going to be watching my chloric intake or came to the jail. And so simple nudges like senior temperature delta can be there. Um, this ring or my Apple Watch, pretty pretty good job of tracking sleep or my coffee today. And sleep can be a real interesting thing that’s indicative to help you optimize your health and wellness.

Dr. Daniel: Did Energy Way to picking up problems with sleep apnea. You know, simple, you know, consumer wearable now can pretty much tell who’s a, has sleep apnea, which can lead to early death, hypertension, cardiovascular disease. Um, so I don’t do too many fancy things. I try and track my activity, my sleep. Um, last week I was in San Diego, I went to a company called human longevity, incorporated it in my second time around my full body scan with Mri. So it’s a rare type of checkup. It quantifies your brain cardiac activity screens for basic tumors. Then that’s not something most people need to or should be getting every year. What’s it costing decent? Come down quite a bit. I don’t know the exact weight today, but three or four years ago it was $25,000. Now it’s under $5,000. And uh, there’s a lot of debate about what kind of scans are special population level, reason to do the mammograms and don’t ask me these, but it was an interesting way to get a real quantification that they, my genome done full genome done three or four times by microbiome analyze.

Dr. Daniel: So luckily I’m pretty good genes from the side that I didn’t have obvious genes that can be hybrid production for Alzheimer’s or certain cancers with, but we know that while genetics are important, these are behaviors that are much more because you’ve all heard of a Braca one and the risk for breast cancer women to develop those cancer do not have those genetic markers which just gives you high reverse. So we can’t be complacent based on the fact that you’re 23 needs for values, you reasonably normal risk. So part of what I would like to do is use my technology, let me nudges, make sure I want to get my little badges or points that I’ve gone into the gym and rode my Peloton. I’d like to share that on facebook or on a, on another social platform to get the. Um. So there’s lots of ways I kind of try and use these digital edge is to encourage me to stay on the straight and narrow.

Dr. Daniel: And, and it’s also, it’s a coffee is one of the few things. It’s still good for you.

Reena Jadhav: If I said to you,Okay. Danielle, of all the things you’ve got, you can only keep one, which is the one thing that you would actually continue to keep.

Dr. Daniel: Well, I think what’s none of us want to be with like 50 wearables, Fitsi health apps. What’s interesting now is the convergence of all this. Now in my smartwatch is the next, you know, the new generation Apple Watch soon. It will. Well it tells the time I can try. I can try my real time, heart rate on it or I can even do this is before the apple.

Dr. Daniel: I can try to do the live demo right now. Bottom line, they’ll do an ekg on the watch before apple to do that. So that’s probably my go to a phone. So that’s cheating because it has so much capability. But it’s an example of all these sensors coming too easy to place location your watch and you know, uh, there’s a check engine light for the body. These are becoming that evil. Now detect a fall or if your heart rate is running 180 and it’s normally 80 when you’re sitting down. In fact that there was a gentleman who tweeted back in February on twitter, he showed a picture of his apple watches Apple Watch, one version. You said, nick forethought, a little stupid risks computer I bought three years ago. He saved my life, a southern. My heart rate goes, brought myself to the hospital, turned out I had a pulmonary embolism by noticing is digital data.

Dr. Daniel: Um, he says one eight years ago when we brought himself the yarn, founded very significant life that make the dilution now the future you’re watching will be calling your cardiologist, are bringing you the uber ambulance before you even know who my report. Next examples of where this could head. And as we now have millions of people without digital exhaust, we’ll start to learn what does that. Early scientists would have thought that a stroke or fall or heart attack, um, this can do an ekg. You can also look at the weight for the ekg and predictive lead is high. Or if I had atrial fibrillation, this current attachment in the live core, it’d been over a million pages a month or a big data company. So I keep that one for now.

Reena Jadhav: Sounds good. So let’s have auto immune for a moment. There’s been a couple of interesting talks on the exponential, at the exponential conference around the fact that the microbiome has now been identified as potentially a leading cause of a lot of the autoimmune diseases including diabetes and ms and and crones. Well, what are you seeing in terms of the fact that autoimmune is a crisis. It’s an exponentially growing crisis and clearly we’ve got to come at it with an exponential solutions. Is there anything you’re excited about out there that you feel good to help? Those of us who have been, who dealt with it in the past?

Dr. Daniel: I think we’re in an interesting era now with autoimmune diseases and other diseases where we can start to define them at the molecular and genetic level. Let’s take something that’s often autoimmune related or can be a diabetes for type one, but also to, you know, they have a common sort of employee lecture. There’s one high, you might be insulin dependent or a type two diabetes often from folks who are overweight, a poor insulin sensitivity sensitivity. It’s called type two diabetes, but in reality, as we take enough thousands of type two diabetics and now analyze their genomes are at least three distinct subtypes that respond differently to drugs, died, another intervention similarly with this or a foundry bowel disease, inflammatory bowel diseases, chrones, or there’s different subclasses which can be potentially typed from the patient’s microbiome, which that’d be extended all the way to, you know, lets the immune type patients. Um, and uh, I think it’s super interesting that we can move faster, cheaper, and more available ways to integrate the data from thousands of patients and to make sense of this at the local level so that you’re not waiting to get a diagnosis based on a convergence of old symptoms that are ranked in some strange way. They can be even just discovered in real time by the patient themselves. Much good to go for prevention, diagnostics and therapy.

Reena Jadhav: And to what extent does regenerative medicine, which I know is a passion of yours, how does that play into this,

Dr. Daniel: if at all? Well, regenerative medicine is a pretty broad field. It’s that idea that we can repair, replace a damaged or traumatized tissues, whether that’s the heart left heart attack, you know,

Reena Jadhav: oh, diabetes, right? Getting your pancreas back to function again.

Dr. Daniel: If you’ve lost your Beta islet cells from autoimmune disease, removing your pancreas, it looks bad for titus, which is often autonomy. Loses money for instance. So there’s a, it’s a broad field. There’s a lot of hype around it for stem cell therapy. Um, I’m actually getting stem cell therapy, bone marrow transplantation versus the field. Like Brendan is a form of stem cell transplantation been doing for 50 years. Usually you treat cancer patients and reboot their immune system, but there are some interesting applications to take adults. And then Brianna, I can even these induced pluripotent stem cells to apply to certain diseases. So where we are today is yes, we can treat certain sensors quite well. We can start to treat some autoimmune diseases with stem cell transplants. It doesn’t affect our bit with wiping out the immune system that the forming stem cells that make b cells, these cells, etc.

Dr. Daniel: And replacing that of the patient’s own stem cells back. That’s what’s been used in some success with autoimmune disease. Um, that’s been done also now to treat genetic disorders like sickle cell thalassemia. The hope is we can even not need a transplant. We can do some genetic manipulation of crispr. gene editing to is a patient with sickle cell or senior and changed their stem cells, put them back in and redo that healthy blood embarrassing in regenerative medicine for autoimmune disease. It might demand if you have sources in the liver from an autoimmune disease and you need a new liver, well, it’s not really a ability to regenerate an entire liver in the test. You put it in. There’s some interesting work there. We might want to trigger it. How do you turn the liver to regenerate itself or the heart or the exam? Um, so it’s a broad field. I’ll stop there for a second.

Reena Jadhav: Now, have you banked your stem cells? Have you tested it out on yourself and, and what are your thoughts on adipose versus blood stem cells?

Dr. Daniel: Well, many of us, including my kids, I think their cord blood knowing as a pediatrician, then transplant doc, that the odds of using those are pretty minuscule, but it’s a bit of like an insurance policy.

Reena Jadhav: Yeah. As a character, you just feel compelled to sign on the dotted line because you just don’t know the future, but it’s a great bracket but given. But how did it all

Dr. Daniel: in adults now, the potential to a bank, your own bone marrow derived stem cells, blood.

Reena Jadhav: What do you think of adipose?

Dr. Daniel: It’s a very different types of stem cells in the fat adipose, and you can do with your little section. You can get a population of ms mesenchymal stem cells, nscs, which seemed to possibly play a role in tissue regeneration or healing of a joint, for example, could be standing outside the body and used in a variety of potential ways to treat everything from potentially from stroke, heart disease. We can also take cells from bone marrow or there’s a lot of varieties of cells and progenitors in both. Both that and then depending on what cell population, how you deliver it, what we’re patient population, you can get very different results and the jury is still out from any of these. Um, I developed a technology of stanford called the marrow miner because I was frustrated with my daughter’s married with a big needle. Um, if you watch a ted talk about the vision to device, which hopefully you get, which lets you get married out from a patient, a patient or donor much more quickly and more sells out, which could be used to do a bone marrow transplant or to treat finish the, uh, cardiac issue that might benefit from mayor, dress themselves or make your own marrow, um, years before you might have a pocket of people are making.

Dr. Daniel: People are making their own fat stem cells. Um, it’s not through. That is an obvious use case for those yet. I’m also interestingly looking at taking marrow from organ donor, let’s say someone who’s debating in Oregon heart, liver, kidney after brain death, and also take a bone marrow from that organ donor to help polarize the recipient. Because as you might know, those folks who get an organ, like the liver or kidney are not receiving that from an identical twin, so they require me to suppression, so there’s now some looks at helping kind of transplant the immune system for analyzing her sophia with the bone marrow donor for. So we were working on harvesting romero, the organ donor as well as the orchids

Reena Jadhav: Should people consider doing stem cell banking. I mean I actually did it so I’m out there testing everything on myself. Then writing up my experiences in my blogs. So for those of you are listening and are interested, you can check out healthbootcamps blog on my experience and I’m flying out to Florida and and working with the stem cell organization which is a public company and in banking my stem cells. But is this something that’s still too questionable too early to know whether it’s worth the investment or is this something you recommend that everybody do? If they can afford it,

Dr. Daniel: there’s no recommendation. Chance everybody should do because it really depends on what population you’re talking about. The banks, these festivals are using them for adipose, for joint issue, for a cardiac issue, for a gi issue.

Reena Jadhav: Yes. Daniel, as you get older, uh, you know, you’re 20 so you don’t know how it feels for us. You know, 48 year old. It was the older we get. It seems like everything starts to need a little upkeep. RighT? So your gut starts to misbehavior, joined, starts to misbehavior, skin starts to fall down. You want to talk about exponential aging. You know, I think between the ages of sort of 45 and 65 is that exponential aging that occurs. And so the point is, stem cell therapy or stem cell banking be one of those preventative things where you bank it and every year you go get your stem cells shot and it goes in and it sort of slows down that process of injuries, internal injuries and slows down the process of age

Dr. Daniel: potential hope. But there is a lot of hype out there. There are frankly, a lot of oil salesmen or stem cell snake oil salesmen that say we’re going to take stem cells and it’s going to cure aging and ringing in your ear and hang nails and everything under the sun. So the trick is to become very clear, you know, who’s doing it? Is it some fly by night clinic, offshore, uh, are these done in a proper laboratory in the cells? How do they process manipulated if there were other clinical trials using that exact population on a population of problem like yours and it hopefully a double blind placebo controlled manner. It’s a tough nut to crack and I don’t Want to say there’s no use for stem cell or making yourselves, I just think you want to use will be the banker marrow derived cells, put them in the freezer and god forbid you develop a, the future where you could use those cells back cancer that could help, you know, and bone marrow transplant cancer setting. Um, and I don’t want to pretend to know every single indication that we field. I think they’re already clinics out there. We can get it somewhere else. Cells injected into your knee or your joints are using procedures to spine, spinal fusions and other orthopedic surgeries. So there’s a lot of potential applications. It’s still a bit scared.

Reena Jadhav: So for someone who’s listening to this, you know, what is your answer to the question? What is it that I don’t know and my doctor’s not me, given that the medical system, the doctors today, when they get re-certified, they don’t necessarily come and attend your events, right? They don’t necessarily have access to all the amazing things that are happening in kind of small pockets of our nation or even globally. So what is it that I as a consumer must know in regards to sort of being empowered to manage my own health today?

Dr. Daniel: A little bit about your. You are in your energy and appetite and the ability to start becoming engaged with you as you become the sort of CEO of your own health in a sense, and not wait for your finishing to come up with a magic solution because when reality is doctors are human, even if you know 50 percent of doctors are below average,

Reena Jadhav: but there were some who almost failed and barely made it.

Dr. Daniel: No, he graduated last in medical school class, but all of them fell back. Um, and, and there’s no one want to go to Dr. house And figure that they’re going to figure it all out and speaking to your house and find it. I’ve encouraged, encourage everybody need to become, you know, engaged in your own health. You can track your basic vital signs. You can get your labs done in the writing online services that you can then share and go through with your permission. Um, you can become a member of crowdsourcing and live in autoimmune disease. Let’s, let’s take one readmission instance disease. A guy named shawn is, he started a website called chronology, kind of like a facebook group for quotations to get together to share their lessons, what things work for them. They did their own crowdsource clinical trials, pinch me where you can kind of enter virtual trials and share your own data down speed up discovery, whether by the crowd, biopharma, there are things like smart patients by ronnie zeiger who used to be the chief naval cancer patients to find solutions and guidance from patients who’ve been through a cancer journey like you have a so you’re not scared and going through this learning the same mistakes and jumping in the same, following in the same holes.

Dr. Daniel: There’s a lot of ability now to become more empowered, more engaged and more connected. use the social network elements and uh, be more of a copilot in their care rather than waiting for your doctor or now a completely uncoordinated with the specialists to figure out a complex case

Reena Jadhav: of all the things that are out there. There’s so many startups that are, you know, everyday get funded and digital health a, they hit new highs. It’s, it’s actually a really exciting time, I feel as an investor as well as an, as an entrepreneur to be in this space because the possibilities are infinite at this point. With that said, I’m sure you have a very interesting perspective of where you see lots of startups focusing versus areas of great opportunity that really no one’s sort of identified yet. So for those of us who are founders that are listening into this, where is there still a, what they would say, a blue ocean.

Dr. Daniel: I told you that.

Reena Jadhav: You don’t want to do everything right. So share the theories that you’re not focusing on.

Dr. Daniel: No, it’s amazing entrepreneurs. Often folks like yourself who didn’t staRt in healthcare. It might be, might be a good game engine designer, ui expert or a three printer first and you know, this idea that it’s this convergence of tools, technologies, mindsets, and all these unmet needs out there, but it’s remembering to take your meds or picking up early cancer or uh, you know, managing alzheimer’s and new ways of using uber and other patients. So it’s, it’s a hard to reach clinics is all kind of coming together, so you know, obviously the hot thing right now or startup can not add ai and blockchain in the name in digital health, a bit of a joke, but it is interesting now that ai is becoming a bit democratized and there’s now more data sets that we can apply to this lens and ai machine learning and deep learning to really get some insights out of, you know, training your app to look at your rash.

Dr. Daniel: Is that a melanoma or a mole to work that was done taking a picture of your retina with a pretty simple iphone, smartphone attachment that can predict a lots of diseases. We’re looking better, better, um, change. It can be super helpful to potentially keep some of those data safe and secure and to enable us to share it. So there’s lots happening in that sort of digital health data. Make the data useful. And from the tree where I think there’s some more open space, you know, we’re ending his age, the baby boomers $10,000 turning 65 every day. I think there’s a lot of opportunity to enable smart technologies for aging in place, uh, for everything from, you know, um, you know, hearing aids out. So if a smart coach at tractor, vital signs you can evaluate someone with dementia or just help them hear better and more situational awareness, there’s a lot of opportunity, particularly as an incentive shift from our secure model to healthcare to get paid for things that keep people healthy rather than waiting for disease to happen.

Dr. Daniel: So companies like amada health, one of the domains of digital health research just go, you developed a digital critical for taking prediabetics and putting the social network, step counter and social pressures, et cetera, and often turn people around from not becoming a type two diabetic that gets sick and expensive. So that’s an area as an example where there’s more and more opportunIty and that’s where we spend a lot of our dollars on the sick and he gets to carry the shift and some of that. And the proactive wellness side. This idea of precision wellness for their staff, the manager, micro biome, a personalize your diet. Some of the school has some ways to go, uh, companies out there claiming some things that are not always fully vetted, but a lot of energy in those spaces.

Reena Jadhav: So you’re working on something very exciting. Do you want to share information about the pale?

Dr. Daniel: Sure. I like to look at the angle of what’s a pain point that you might be able to solve the movie days. I went to the stanford biodesign technology pain point of obviously bone marrow, which one of the main point I finished a lot as a clinician. I trained in pediatrics that have kids and adults. It’s a general medicine. Knowing kids will measure a dose of the medicine down to the milligram dose break here for all this under 16 and one’s in the same size pretty much until you know, even if there are 300 pound football player or whether a frail people don’t take their medications. I’m definitely taking too many. We’ll just need to be on these buildings, but they’re not adjusted based on the age and relate. So two big main points. One is precision. Can we get the right dose and termination that matches you with me?

Dr. Daniel: Uh, the other one is adherence. Once you’ve met the right dose things, she’ll taking a bylaw pills. So this is a pain point to paypal. Instead of thought when this era of digital manufacturing, you could three d print your basis, your hearing aids, what if we could three d print your own personalized pill that matches you? So I started the company around that having a prototype and that should give a ted talk this summer which will go online and send back, come on October 18th. So take a look there to look at a bit of this convergence of how we can take somebody who date digital exhaust and translate that into new ways to manage common conditions like high blood pressure, which often requires three more pills a day or a cardiovascular disease and beyond. So that’s one thing I’m looking on tenant to make medicine more intelligent. Then hopefully pick the right to rubs combinations and matches for you for both prevention and therapy and the new ways where eventually we’ll print your pill at home in the morning and it’ll talk about for the dose combination you need that day.

Reena Jadhav: I completely agree. I think we’ve reached the stage where you can personalize in order clothes on the internet. It’s about time we can personalize and order our pills as well. So clearly very exciting. And of course we’re going to put that in the show now. So for those of you who are watching or listening, keep an eye out on the show notes for the tedtalk and for the additional information on this, you know, one of the things that I’ve read over and over again which is concerning and yet is quite questionable in my mind, is the fact that ai is going to replace x percent of doctors. You know, there’s all kinds of numbers. So I read a report that said that 50 percent of radiologists will be obsolete, that a machine learning’s going to do it and then we’re going to need half less radiologists. There’s similar stats and on other areas like surgery for example, how real is that future where smart machines take over and so we really don’t care about that medical doctor crunch anymore because that’s the other thing that people are worried about is that we just don’t have enough doctors to take care of this incredibly aging population

Dr. Daniel: Shortage in doctors and nurses, specialists, supportive care in rural California, let alone the rest of the country and the planet and you know, a lot of people like to raise. Would it be speaking or essential medicine like sale? Eighty percent of doctors, 80 percent or so doctors could be replaced by a robot or AI. I like to think of it differently that 80 percent of doctors, nurses that are going to be augmented by AI, we’re still gonna need radiologists and pathologists, radiologists, but what they do might be a bit different than math has been 80 percent of the time looking for normal chest x ray was, or looking at normal rashes will be directed to help figure out the tougher cases, to communicate that, to synthesize the information. Um, there’s a shortage of radiologists in most parts of the world. I’m the shortest surgeons in many parts of the world.

Dr. Daniel: So in certain areas like the to very well he has always had to many special in concentration, but on balance I think, you know, the role of the clinician would changed in certain ways were selected and trained in medical school to memorize that always synthesize part of what these tools will enable to do is kind of use a different part of our brain to um, be a connector to help solve problems in new way to, to help patients use new connected tools and datasets and ass and that we as clinicians will wait for you to come in and after the bad problem we’ll go, we’ll check engine light that I’m going to call you today. And it’s like Your real question is running off with maybe you should be tweaking your microbiome regimen that will impact your risk for colon cancer. Other issue. So lots of ways.

Dr. Daniel: I think things will meld how we train the physicians of the future. That’s a big question. How do we leverage a lot of these new technologies that are here today into the workflow? I mean, it’s not just about changing patient or consumer behavior at aging dr. Behavior, we don’t, we don’t. Well, it’s both education but also user center design. I mean, that’s care. Electronic medical records today honestly suck. Epic fail because it takes us twice as much time to input the data that you have faced space with your patient, um, people who are working on lp systems to do charting these emr, electronic medical records systems today aren’t frankly made for my patient care outcome. They’re optimized for patient billing as we had a not evidenced based medicine, but a incentive based incentives around billing and charting. And so there’s a lot of things that need to go into shifting.

Dr. Daniel: Healthcare was many healthcare systems, especially United States. Something’s going to happen at a va or kaiser or a geisinger and the integrated system where you’re aligned with prevention of therapy, others will be slower. Um, some innovations Will leap frog the United States where everything’s done on mobile as a good doctor happening. two, a million users with a couple of years, uh, using it very actively, so comes into markets and opportunity fractures, not just here in the rest of the world, but in very underserved parts of the world as 3 billion people to come online in the next couple years as well.

Reena Jadhav: Absolutely. So as you look at the future, what is the one reality in healthcare that you’re most excited about?

Dr. Daniel: Cancer journeys are very complex. Those can be optimized and art could be owned by anyone app or drug company or device company or that. But it’s how do we create these integrated solutions that help us integrated in both. So that’s one piece. The other ones are, you know, still in this sort of crazy exciting there. A gene editing with crispr, six or seven year old technology is moving pretty quickly. I was in boston and if you go George Church, the chairman of genetics from harvard, who’s been working on using crispr gene editing to knock in human genes and knockout pink jeans from humanized pigs, pigs that are human sized. You can now think about talking about regenerative medicine. Yes. We want to be two to three d print organs. It’s a sexy idea, but still lots of challenges there. What if you get instead given the shortage of organs, take a pig from the, from an Oregon, use that, um, so they’re genetically modified pigs to New Zealand transplantation already incumbent models.

Dr. Daniel: And so it may be not sentenced friction and 10 years that if you need a new liver kidney heart, you’ll be getting that will be kosher, but you’ll be hearing it from a brahma pig should you really do that? And that’s an exciting example of convergence. Another one of my favorite areas, it’s really quickly is technology that zooming from, you know, the gaming world, virtual reality, augmented reality and starting to get healthcare, virtual reality oculus rift over there. Uh, I got this old $500 version that needs to hold computer. Now I’ve got the $200 version of as go incredible ability to put yourself in a virtual environment which can be used with therapy. Looks like acute or chronic pain can go to cold environments and the snowballs and lower their pain thresholds and use less pain meds. When you take a patient to have to go and have a surgical procedure and she lived to be more relaxed and see what’s going to happen, to take him to the beach all the way to being used for surgical education, take a surgeon, let them practice a ritual surgery with virtual instruments for that exact patient, so that’s another kind of exciting area that a is speeding up and what used to.

Dr. Daniel: We’ve taken $10,000,000 worth of equipment in one lab that will be sent to you by facebook and now we’re seeing lots of doctors and other innovators building platforms to create mental health care solutions.

Reena Jadhav: I’m really excited about the vr stuff. I gave it a shot at the last meter, a conference and it’s pretty cool. I’m waiting for that to become pervasive where you know everyone can just get out there and pick their vr unit for migraines or pain and be able to use that at home. It sounds phenomenal.

Dr. Daniel: Ptsd, london, vacation. People are afraid of heights. All sorts of interesting applications that including the future of the documents. So right now we’re kind of on a zoom or skype, like connection you imagine when you literally like if you’re in the room with your doctor or to that person getting your virtual done. So the idea of a virtual checkup is not just the camera and monitor, it may be this whole virtual layer. There’s already this constantly moving miss situations to admit patients to home to the hospital, see the straightforward pneumonia. Normally they required Guinea in the hospital for several days extensively and he gets six running things. Now our sending folks to be in the dome with the nurse and see smart pumps, but really connect those dots. Do these virtual checking visits, was getting harder. Hopefully ending the concentrated on improving outcomes.

Reena Jadhav: Actually justify that, you know, that’s that whole model of the way uber’s disrupted like you don’t need to own, which means maybe the future of hospitals is there all your home, your home transforms into a hospital when you need one as opposed to having these incredibly expensive, heavy overhead buildings. Lots of, lots of exciting opportunities out there. So, um, last question, for those who are listening in who have some kind of a diagnosed condition already, so let’s say hard diabetes, et cetera, what is the one thing you want people to keep in mind as they think of, of their own treatment?

Dr. Daniel: Well, what is that? All of Us can become sort of health care catalysts. If you have family condition, hypertension, high blood pressure, no one, you’re going to the clinic once a week or month and getting your blood pressure checked and they changed her meds or go to the apple store or best buy or amazon by connective blood pressure cuff. Connect that to your smart phone. Look at the dashboard of data. If you can get some insights. One is running high or low. If you could send that to your doctor, what do they want to see it or not? Maybe you can encourage them to figure out ways to integrate that into, into your medical record. So that’s a little simple example of taking existing well worn path and hopefully improving care for yourself and maybe even educating your peers. Um, I would encourage, uh, there’s lots of interesting quantified self technology if you are a autoimmune patient.

Dr. Daniel: Um, there’s an app, sort of a new patient called mighty and y n e e, m, she’ll be speaking especially medicine. She started to solve our own problem with autoimmune disease by putting an app to track symptoms and clever ways and to blend that data together and to run clinical trials. So with these kind of flux on immune diseases, you can become a data donor and also get inside yourself. Um, I think, you know, part of the issue is not waiting for the future drive the idea that patient who’s going to be included in the innovation. If you have an idea, find a kid down the street and your local doctor and build the app that might solve that pain point. And because now in this exponential age where you literally can build their startup or a device or prototype with a three d printer for $100, that you stick a million dollars, a lot of opportunity to democratize innovation. Yet the diy movement, that’d be. We’re Not waiting for the whole population of type one diabetics and their families as part of hacking of insulin pumps to create artificial hand versus bigfoot biomedical data or examples of folks not waiting and taking their own for neural engineering and other accountabilities to catalyze things forward and not just waiting for traditional bio pharma medical device field. So

Reena Jadhav: exactly. It really is a beautiful time to be alive and to be contributing and owning your own health. So some great advice there. Daniel. This has been just a total blast. Thank you so much. I’ll see you soon. Maybe after the next big event that you’ve got and of course those, if you’re listening and make sure to check it out. It’s in november in san diego. Give us the url again. One more time.

Dr. Daniel: Exponentialmedicine.com. It’s at the historic and I kind of like it, not so we had a great experience. Breakouts, silent discos. It’s a bit of a, it’s not quite burning man meets medicine on the beach, but it’s a nice convergence of people and ideas and energy that sparked a lot of, uh, new collaborations across south here.

Reena Jadhav: Very exciting. Thank you so much again for the rest of you. I’m going to see you soon.

 

Health Bootcamps

 

KEY LINKS:

CONTACT:
Daniel Kraft
E: daniel.kraft@gmail.com

WEBSITE:
danielkraftmd.net
exponential.singularityu.org/medicine

SOCIAL MEDIA:
twitter.com/daniel_kraft
www.linkedin.com/in/dkraft

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