What's the Big Idea?
Nanobots, the Mars Rover, dark matter, and artificial intelligence – subjects we often cover on Big Think – are all brain candy for curious minds fascinated by scientific discovery and the far reaches of human knowledge. But human health presents one of the most massive and ongoing practical challenges to our technological capabilities and personal understanding. The exciting opportunities and developments in medicine, as well as the daunting obstacles we still face, have led Big Think to partner with TEDMED 2013 – and to reach out to you, our readers, for your insights into the medical frontiers of the 21st century.
At 2012’s Nantucket Project, a conference Big Think co-produces, we brought together a panel of distinguished experts to address this simple (yet incredibly complex) question:
How can the United States collectively face rising health care costs, a broken healthcare system, and public health epidemics such as obesity and diabetes?
The panel included Dr. Toby Cosgrove, president and CEO of the Cleveland Clinic, ranked among the top three hospitals in America by US News and World Report, Dr. Daniel Kraft, who chairs the Medicine track at Singularity University, and Dr. Douglas Melton, co-director of the Harvard Stem Cell Institute. Drs Cosgrove, Kraft, and Melton proposed far-reaching solutions to the healthcare crisis, ranging from portable medical technology to a new vision of collaborative medicine.
1) Stem Cell Therapy
“Our body’s innate power for replenishment and renewal,” says Dr. Douglas Melton, holds the key to the future of personal health. Stem cells are responsible for the constant replenishment of red blood cells in our system. Our skin, too, is in an ongoing state of death and regrowth. “We should be able to harness that power and then make stimulants to keep us healthier and younger for a longer time,” says Melton.
The current health care crisis, Melton argues, is the result of our system’s focus on treating illness over preventing it. He believes we need to go much farther in supporting research into technological advances that eliminate illnesses in advance, and therefore the need to treat them.
Stem cell therapy is one such area. According to Melton, the ability to offer medical treatments that use stem cells to regenerate damaged muscle tissue isn’t far off. In the long run, stem cell therapies may enable the body to reverse the aging process in multiple areas, keeping us younger and healthier. These therapies, he believes, won’t be a substitute for exercise and healthy eating – rather, they’ll work alongside a healthy lifestyle as part of the package of total personal health.
2) Portable Medical Technology and Gamification
Dr. Daniel Kraft has a portable EKG on his cellphone. “It’s not yet FDA approved,” he admits, because the FDA isn't sure how to categorize such devices. By touching his thumbs to the two leads on the back of the phone, Kraft can see an instant picture of his heart rhythms. Better yet, he can see at a glance his EKG patterns over time and transmit them to his physician.
Having an at-a-glance snapshot of what your heart is doing when can be enormously useful in avoiding activities and environments that are cardiovascularly unhealthy. But it turns out that even more powerful is the “feedback loop” of sharing that data with your physician. In a study Kraft cites, diabetic patients who used a smartphone-based glucometer to track their blood sugar and shared that data with their doctor on a regular basis lowered their hemoglobin A1c (an indicator for diabetes) by 2 points, vs. .6 points for patients who tracked but didn’t share their info. Kraft argues that ongoing personal health data-tracking and sharing can “gamify” personal health care and thereby incentivize healthy choices.
Regular tracking can also enable individuals and their physicians to spot worrisome patterns – sleep disruption, heart fluctuations, blood sugar changes – far enough in advance to intervene before they manifest as illness.
On a larger scale, Kraft points out, the ability to track and collect individual, longitudinal health data on a grand scale will enable researchers to identify and analyze national health trends and make valuable correlations between behavior and health outcomes.
3) Cost Control Through Collaboration and Motivation
Taking the macro view, Dr. Toby Cosgrove of the Cleveland Health Clinic argues that one hospital “cannot be all things to all people.” Hospitals need to specialize, he says, and build hospital systems that enable them to transport efficiently “the right patient to the right place at the right time.” Increasingly hospitals including the Cleveland Health Clinic are doing just this – recognizing it as the only sustainable model in an age of rising healthcare costs and overburdened emergency rooms.
That’s how you lower costs at the systemic level. At the individual level, Cosgrove argues, we absolutely need to do something to stop unnecessary behaviors (like smoking) that lead to illness, and to promote positive behaviors (like exercise) that can prevent it. As a private institution, Cleveland Clinic has taken several steps in this direction. Smokers, for example, need not apply for jobs at the Clinic. The entire organization has banned smoking among its workers. Obesity? Well, the Americans With Disabilities Act forbids discriminating against an employee on the basis of obesity (which is viewed under the act as a disability), so the clinic has instead removed fried foods from its cafeterias and candy bars from its vending machines. New York City public schools have been taking similar steps, limiting the availability of “junk food” and promoting public health.
For things to change at a societal level, Cosgrove believes, we need to remain vigilant about public health education, and about disincentivizing unhealthy behaviors and incentivizing healthy ones.
Taken together the ideas presented in this panel tackle rising healthcare costs and public health issues on four main fronts: research, technology, education, and systemic organization. They offer complementary visions for confronting and overcoming the medical challenges we collectively face. TEDMED 2013 will continue to explore these challenges and the most exciting solutions emerging across disciplines.
We would be honored for you to join the Big Think delegation at TEDMED 2013, and in advance of this event, we invite you to contribute your ideas as well. Please lend your perspective by answering this question in the comments below:
"What is the most serious obstacle that needs to be overcome in order to ensure a healthy future?"