Just over ten years ago, in 2011, I gave my second TEDTalk, “Medicine’s Future? There’s an app for that”… in which I covered the convergence of accelerating technologies (faster, smaller, cheaper, better), and examples of the cutting edge and possibilities for the not-so-distant future of health and biomedicine. Much of what I described has begun to integrate into clinical use or advanced significantly in the subsequent decade, and in many cases has only been accelerated further by the pandemic (as summarized in my 2021 TEDTalk, “How Covid-19 transformed the future of medicine”).

As a bit of an ‘accidental futurist’, now looking to the decade ahead, I rewatched my 2011 TEDTalk for the first time in years. It stimulated some thinking on where we were, where we are ten years later, and some prognostication on where health, medicine, and technology could take us by 2031. As healthcare makes the leap from the 3rd into the 4th industrial age, the next ten years will make the last ten look slow.

We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten.
-Bill Gates

My 2011 TED Talk: Medicine’s Future, There’s an App for That

Below is a rough set of observations that follows the arc of my 2011 TEDTalk, where we are 10 years later, and predictions on where we may be a decade from now.

Of course, I’ll be wildly off on some predictions (but I sure hope we are well into the everyday use of blockchain for privacy/security and still aren’t stuck with antiquated HIPAA laws and FAX machines as the predominant ‘tech’ to transmit health data in 2031!).

I summarized some of the current challenges, opportunities, and emerging solutions in the cover story I wrote in 2019 for National Geographic’s ‘Future of Medicine’ issue “Connected & High Tech: Your Medical Future’.

We still have a long way to go to effectively use many of these exciting and often exponential technologies and platforms. Technology alone isn’t enough, it has to be aligned with incentives, payment models, local culture, workflow, social determinants, regulatory and ethics, and integration into medical education. The effective leveraging of these solutions of today and tomorrow has the potential to truly democratize healthcare, bring quality care at lower costs, and meaningfully improve access to impactful prevention, care, health equity, public and global health across the planet.

From Genome to Multi’ome

I began my 2011 TEDTalk by sharing the story of how I’d met a ‘distant cousin’ via our shared haplotype. In 2011 you could get a 23andMe SNP profile as consumer genomics emerged. The past decade has seen millions gain access to their own personal code, from discovering unknown siblings to exploring genealogy and taking proactive action based on their genetic risks, to biohackers leveraging crowd-sourced genetic insights.

Today a full genome exome sequence costs tenfold less than in 2011, down to $1000 (at a cost that has dropped at twice the rate of Moore’s law). Clinical utility is catching up, with polygenic risk scores and population genetics furthering the need for services that will help interpret results. By 2031 expect genome sequence prices of $100 or less, including those done with 3rd Generation/ Long-Read Sequencing.

The price of sequencing has dropped at over twice the rate of Moore’s Law

Beyond the genome, now your Microbiome (from gut to oral biome), proteome and now your ‘Metabolome’ (via disposable Continuous Glucose Monitors CGMs) can be obtained. And of course, one’s ‘Digitome’ from a wide array of wearables and soon a more contextual ‘Sociome’ will be available.

The next decade will see further meaningful integration and application of these multiple ‘Omes’. While the big data from multi-omics may be the ‘New Oil’, it’s really the actionable insights generated from analytic engines parsing previously siloed data sets that is critical. In a decade individuals will regularly access via the cloud our individualized ‘Digital Twins’that through the AI-enhanced synthesis and integration of baseline and dynamic information will enable ever more accurate ‘predicalytics’… and modeling to virtually guide individualized ‘precision wellness’ and prevention, diagnostics, and tuned and optimally selected therapies, for example in my field of oncology. Eric Topol wonderfully covers this in Nature Medicine on the convergence of human and artificial intelligence. (figure below).

On the theme of Exponentials…

2011 We had the iPhone 4…

2021 Now I’m writing some of this by voice (NLP!) on my iPhone 13…

Ten years from now in 2031, much of what we use via smartphone we’ll take for granted as blended into our Augmented Reality enhanced world… we’ll likely be at iGlass version 8 by then… (Apples’ AR glasses are rumored to launch in 2022 as are AR platforms from Google) , to nextgen consumer version’s of Microsoft Hololens with many other AR/VR and XR offerings which will be embedded in our contact lenses, or our stylish AR enhanced spectacles. The nascent Metaverse will be maturing, and the ‘Med’averse will be a home for elements of medical education, VR-based treatment, and even healthy social engagement.

Moore’s Law has powered our ever more digitized, connected, mobile, and compute-driven world. The exponential trajectory has been maintained despite wars, depressions, and pandemics. While the compute that will fit on a silicon chip may soon be limited by physics, new forms of computing power are emerging, including Quantum Computing. Quantum computing has the potential to address problems that simply can’t be solved with a classical computer. By 2031 it will have likely begun to usher in profound new capabilities, from computing targeted designer drugs and biologics to making sense of the terabytes and soon petabytes of health data being generated by each of us. IBM has termed this next period the ‘Quantum Decade’

This graph above covers a 10,000,000,000,000,000,000x improvement in computation/$.

SmartPhone++

In 2011 the first applications for using the phone as a diagnostic device were becoming available (the iBGStar glucometer on smartphone)… beyond the ability to email your blood sugars, the glucose data was essentially silo’d on the mobile device, and challenging to effectively share with clinicians. In 2011, my friend Dr. Dave Albert had just demo’d his brilliant AliveCor 2-Lead ECG invention. 10 years later there are direct-to-consumer advertisements for the 6-lead Kardia on CNN, and their devices and software are doing 1000s of virtual EKGs a day, detecting atrial fibrillation, bradycardia, and more.

2021: Today we can leverage far more via our ‘Medicalized Smart Phones’, including via the exponentially improved cameras enhanced with AI/ML enabling a ‘medical selfie’ to detect vital signs , to perform urinalysis as pioneered by Healthy.io, as well as enabling tracking and quantification of wound care (disclosure, I’m on the board of Healthy.io). Smartphone microphones and speakers can be leveraged to detect ear infections, and are leveraging ‘Voice as a Biomarker’ to detect and measure neurologic disease, depression, anxiety, and more.

With Apple’s HealthKit on iPhones and the Common Health platform on Android, the information from thousands of Bluetooth-enabled wearables, sensors, scales, and more can be collected and communicated. Researchers can build and anyone can sign up to be part of a virtualized clinical trial via ResearchKit. The latest iOS15 allows data and insights to be shared with caregivers or transferred into an EMR for analysis and tracking.

2031: Wearables will continue to move beyond the wrist (and hopefully include a battery life of >1 week (one area that hasn’t advanced exponentially)… The next year will see FDA-cleared non-cuff-based continuous blood pressure monitors on patches and the wrist, and likely the ‘holy grail’ of accurate, non-invasive continuous blood sugar monitoring. Increasingly our wearables will be supplanted by ‘Invisibles’: ambient sensing via the Internet of Medical Things (IoMT) which will (with permissions granted) measure and make meaningful our digital exhaust, from vitals to the sound of our voice, to subtle changes in gait. Smart speakers and/or WiFi will bathe our living spaces with signals that measure the vitals of multiple inhabitants. Of course, privacy concerns and data ownership issues need to be carefully addressed.

Our mobile devices are run by apps. In 2011, only 3 years after the launch of the iTunes app store, there were approximately 30,000 health-related apps…. in 2021, there are over 350,000, with more than 90,000 apps released last year alone. Uptake will be unsustainable, many of these apps lightly touch on health (food and exercise tracking for example), while an increasing subset cross into true healthcare. The FDA has approved 100+ apps included five that are FDA cleared for mental health. I expect a consolidation in the future… more of ‘One App to Rule Them All’ type platforms that are less fragmented and more integrated and optimized to the users’ needs, diseases, social determinants, and beyond.

Imaging and Diagnostics on the Exponential

2011 era imaging was already impressive, with high-resolution CT/PET/MRI and 3D reconstructions. 2021 witnessed the emergence of truly portable and relatively low-cost MRIs (I recently had my brain imaged in 5 minutes while on a boat floating down the Hudson, with the Hyperfine MRI plugged into wall power). Today full-body health screening MRIs are available for the wealthy (QBio, HLI, and Prenuvo for example). Faster, cheaper and AI-interpreted full-body scans will be prevalent by 2031, perhaps even available at the health centers being integrated into Walmarts, CVS Health Hubs, Boots Pharmacies, and others.

Similarly, on the getting smaller more portable dimension, the ultrasound, limited to a cart in 2011 has now shrunk to handheld AI-enabled versions like the Butterfly, Clarius, and VScan. All of these have the promise to help democratize diagnostics and bring them to rural and remote regions at a low cost. Startups like llara Health based in Kenya are using these and other diagnostic technologies to bring digitally-enabled care across Africa where there is a dearth of diagnostic capability.

2031: Diagnostics will become further AI-enhanced and portable (the ‘Digital Doctors’ bag) will enable advanced diagnostics to be done by a community health worker, sometimes guided by a remote physician, other times with interactive AI-driven adaptive protocols. Breakthrough novel diagnostics like those from OpenWater (leveraging novel lasers, ultrasonics, holographic systems) will be on the market, leading to truly low-cost imaging from anywhere by almost anyone. And the acceleration of AI-meets-Radiology (a field still in its relative infancy) to interpret the images will translate to more accurate and real-time results that will save lives.

Digital pathology will have almost fully replaced the glass microscope read by eye, and now the digital image of the tissue biopsy will not only rapidly identify potential malignancy, but what sub-type, as well as the molecular and genetic signatures only obtained today by expensive and time consuming molecular probes and sequencing.

The Radiologist, Pathologist, Dermatologist, Nurse... (Insert your favorite clinician category here) -- won't be replaced by AI, but those using AI will replace those who dont...

2011 saw examples of ‘Virtual Colonoscopy’. While these haven’t taken off (still need the bowel prep, and lesion biopsy isn’t possible)…today your Gastroenterologist can have your colonoscopy enhanced with real-time AI to help identify lesions that might have been missed or to prioritize areas for biopsy…or you may be skipping the scope altogether with well-validated molecular stool exams.

2031: ‘Smart Toilets’ may be regularly analyzing your bowel movements and urine, and identifying issues early based on subtle changes from an individual’s baseline. They will likely, in concert with your underlying genome, dynamic microbiome, and metabolic information help drive ‘precision nutrition’, and take us away from one-size-fits-all fad, and often ineffective or even dangerous diets or nutritional regimens.

Digital Health & Medicine, from concept to reality to clinical utility

In 2011, the term ‘Digital Health’ was just entering the vocabulary (Just watch the Google search trend line) and that year saw the 1st FDA-approved app. Beyond ‘Apps’ an explosion of wearables to Software as Medical Device (SaMD) has evolved, and the concurrent smart regulatory evolution led by the FDA’s Digital Health Center of Excellence has enabled the emergence of safe and effective ‘Digital Therapeutics.

Supporting this rapid growth are non-profits like The Digital Medicine Society (DiMe) launched in 2018 to foster collaborations across the healthcare industry and to develop playbooks and guides for digital clinical measures and remote monitoring, to consortiums to support virtual care.

Today you can dive into the rich array of academic research and study (see Digital Health focused journals listed on Digital.Health), and dozens of accelerators and incubators around the globe have fostered many novel and promising solutions.

There are over 40,000+ companies in the digital health space, and more are on the way thanks to Covid fueled record funding. UCSF Health Hub runs a terrific Digital Health Awards each year and CBInsights shares their Top 150 in Digital Health.

I have found it challenging to track what is out there and what digital health solutions may be of use for clinicians, payors and health systems. To address this my team and I have been putting together a new resource and platform, Digital.Health. You can get a sneak-peak at the new ‘Digital.Health Database and Formulary’ we’ve been building at beta.digital.health which will launch in Q1 2022.

2011: <20% of medical records in the US were ‘electronic’, with ~ 50% of clinical sites using some form of EMR. Stage-1 of Meaningful Use was implemented that year. Now EMRs and digital records are ubiquitous, yet interoperability remains a challenge, but FHIR and new initiatives to reimagine HIT are compelling. In 2021, ONC launched Health Interoperability Outcomes 2030.

The EMR (built more for billing than care) has come with downsides, with many doctors, nurses, pharmacists, and other providers now spending more time entering data into EMRs than true patient-facing time, contributing to clinician dissatisfaction and burnout.

2021: Charting help is arriving. In some settings, data entry is being facilitated with advancement in Natural Language Processing (NLP) applications listening to clinical encounters which can craft draft encounter notes and billing. While Google Glass (launched in 2013) has not been a consumer hit, it’s seen use for capturing clinical encounters via remote virtual scribing.

My hope is that by 2031, CMS initiatives launched during Covid like ‘Patients over Paperwork’, will bring more sanity, balance, and smarts to documentation and that NLP and related technologies will dramatically reduce charting burdens and bring back truly ‘patient-centered care, rather than ‘medical record centered care’.

Artificial Intelligence to Intelligence Augmentation

2011 saw the buzz and hype of IBM Watson and its Jeopardy victory. In subsequent years ‘Watson went to medical school’… but sadly flunked out, with the marketing buzz and reality not yet meeting the generated expectations.

Lest early excitement and pitfalls blind the downstream potential… let’s not forget ‘Amara’s Law’….”We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run…”

Amara’s Law

10 years later expectations are beginning to meet reality with a majority of hospitals using AI-based systems and 90% with an AI strategy and a wide array of startups building AI/ML-based solutions to address a widening array of healthcare pain points.

Google’s DeepMind and AlphaFold have demonstrated the immense potential of AI across diagnostics, to the ability to design proteins. AI played a role in speeding mRNA Covid vaccine development. This past year saw the first AI-discovered drugs make their way into clinical trials. It is only going to accelerate for biopharma from here and maybe quite disruptive to Big Pharma players that don’t jump into the AI drug discovery space (‘Pharmageddon?’).

2031: AI/ML/Big Data will infuse across the care continuum, and most critically into consumer/patient and clinician workflow… and help realize the promise of Big Data to Information and actionable, personalized insights and then narrow the gap to utilizing the insights and knowledge at the bedside or ‘webside’.

Crowdsourced data and insights shared from patients on platforms like StuffThatWorks could result in AI-generated guidance that appears on EMR interfaces to help guide therapeutic decision-making to match ‘Patient’s Like Mine’.

Telemedicine to Virtualized Care and ‘HomeSpital’

Big picture, our traditional models of care are based on intermittent data, traditionally only collected in the very limited fragments of time when an individual ‘presents’ within the four walls’ of a clinic, ER, or hospital room. Intermittent data leads to a reactive practice model, where problems regularly present at a late stage, resulting in increased morbidity and mortality. The accelerating capabilities for virtualized and connected care can lead to a future of continuous, proactive, personalized care, and bring us better outcomes at lower costs anytime, anywhere.

A decade ago, the first telemedicine platforms had launched, with slow initial uptake. A smattering of early home devices was just beginning to flow data in any meaningful way… with early examples and success in managing heart failure patients with connected scales and blood pressure cuffs.

Thanks to the pandemic, nearly everyone, from patient to clinician has experienced and participated in their first virtual care encounter. While the surge of virtual visits (enabled by reimbursement and regulatory relaxation) early in the pandemic, has come back to earth, the landscape and expectations are shifting. Today, virtual visits are still primarily relegated to synchronous screen-based encounters but are increasingly being blended with asynchronous chat bot-enabled triage and care, with platforms like Anthem’s SydneyCare, to Ada, to Sensely. In China, Ping An Good Doctor has grown to >350M users blending mobile, AI-enhanced virtual care and with in-person visits when needed.

The concept of a ‘Medical Tricorder’ (I helped conceive and run the $10M Tricorder XPRIZE launched in 2012), and its winners have helped bring us easier to use, integrated diagnostics to be used by patients and caregivers that will further augment remote care and virtual visits. From TytoCare kits you can now purchase at a Best Buy to offerings from 19Labs, the capabilities for remote diagnostics and ‘healthcare data as a service’ integrated with virtual and collaborative in-person care are compelling. We are seeing the early impact of Remote Patient Monitoring (RPM), catalyzed again by new CPT codes, help shift care from hospital to home. Virtual visits can be augmented with integrated home diagnostics and RPM, like the Spire Health Tags which can live and transmit physiologic data from your underwear (‘Underwearables’ :-).

2031: Further convergence and connectivity (riding 6G, potentially 100X faster than 5G, and ~1000X faster than 4G) will provide connected care (almost) everywhere. The large swaths of rural America without broadband, and the 50% of the world population that today has no regular internet access, will be tapped into satellite-based systems from StarLink and emerging competitors. This has the potential to dramatically up-level telemedicine, global health, and improve health equity.

The Rapid Covid Testing XPRIZE

A key element of virtual and remote care is the ability for home-based diagnostics. The early stages of the pandemic harshly highlighted the unmet need for fast, frequent, accurate, cheap, and easy Covid testing. I’ve been chairing the XPRIZE Pandemic Health Alliance Task Force. Together with OpenCovid Screen we ran a $6M Rapid Covid Testing XPRIZE, generating over 700 entries from 70 countries. The innovations developed by the winning teams will not only lead to better Covid and infectious disease testing, but for non-infectious low-cost diagnostics critical for public and global health.

Quantified Self to Quantified Health

2011: In my TEDTalk, I mentioned the growth of wearables, not yet easily integrated into clinical practice, and suggested the possibilities for a ‘Check Engine Light’ for the body to make sense of disparate signals and lead to proactive, early warning.

Today, we can begin to pull these signals together, whether it’s fall detection on wearables or smart rings and smartwatches that can be used to predict who has Covid even while asymptomatic.

In 2021 we are still barely scratching the surface and potential. Very few clinicians have ever ‘prescribed’ a wearable. Many clinicians don’t want the data from a patient’s wearables and it’s difficult to integrate into clinician workflow, EMRs and reimbursement models.

By 2031 The era of ‘Quantified Self’ will blend with ‘Quantified Health’, catalyzed by value-based care models… it will be standard of care for your primary care physician or specialist to query your cloud-based log of your wearable+ ‘digital health stream’ to get a true handle on your cardiovascular status or other conditions.

Insights from crowd-sourced programs like Verily’s Baseline Trial and the NIH’s All of Us Research Program will help translate the knowledge gleaned from millions of patients and the multi-omic to wearable data and turn it into actionable insights that can be used across care paradigms.

Your clinician may even be reaching out proactively as personalized algorithms notice that you are heading dangerously out of range (i.e. on Blood Pressure), and adjust the formulation on your personalized 3D home-printed polypills (with the combinations and doses fully optimized and adjusted for the individual). Fundamentally, having an understood personal “biometric signature of health” and detecting early variance from baseline will be a big game-changer in proactive, preventative-focused care.

My 2018 TEDTalk: Personalize Polypills. Learn more at IntelliMedicine.com

‘Contextual Awareness to Drive Precision Digital Health

Many of us who wear the latest smartwatches have gotten the alert…. ‘time to stand and take a stretch break” …. while we might be stuck in the window seat of a cross-country flight. Health and medical apps will get smarter, know where you are and in context before sending nudges or more engaging suggestions. They will also take cues from psychological to social determinants to improve and personalize user interfaces (i.e. a 17-year-old with Type-I diabetes needs a different User Interface and design than a 70-year-old with the same disease). We’ll see personalized ‘Jarvis’ like avatars that will integrate data and share much more actualized insights aligned with our individualized predilections, incentives, and personality types.

Rise of the Robots

In 2011 robotic surgery was becoming mainstreamed by Intuitive Surgical. Very early versions of augmented reality had been demonstrated in academic settings.

Less than a decade later, robot-assisted procedures account for >15% of all general surgeries in 2018, (up from just 1.8% in 2012). Dozens of innovative surgical robotic companies are coming to the market and augmented reality platforms have been FDA cleared for ‘See Through Surgery’ to enable minimally invasive procedures.

2031 we’ll move (like the advance of self-driving cars) from driver only, to ‘driver assist’ to ‘surgeon assist’ with ‘robotic assisted’ cases and in some cases to fully autonomous mode (for a sneak peek of ‘fully autonomous… this scene from the 2014 film Prometheus will show the dystopian potential :-) Clinicians will be able to teleport into humanoid robotic avatars to provide remote care as a bridge to more AGI and autonomous clinical robotics.

The robots will also get smaller, some will be ingestible. Robotic pills which can deliver biologics to the gut wall (bypassing the need for IV infusions or injections) are in human trials. Exoskeleton ‘wearables’ are now on the market for rehab and that enable paraplegics to walk, and we’ll see an explosion of consumer versions that will assist firefighters and EMS to help centenarians climb a mountain.

Upskilling the 50% of Clinicians who are Below Average…

Most of us who were trained as clinicians went through the harrowing process of ‘See One, Do One, Teach One’…. crossing the gamut from putting in an arterial line or chest tube, to reading an XRAY or performing cardiovascular bypass surgery.

Unfortunately, there is a great deal of variability in the quality of the ‘taught’ cases and in the vast array of clinical presentations and patient differences. Measuring clinical competency remains challenging.

The Proximie platform allows clinicians of all types to ‘virtually scrub in’ to an operating or procedure room, to coach less experienced clinicians and share their skills in real-time. As more procedures are recorded on video and AI analyzes massive data sets, platforms like Theator will upskill and guide average surgeons to perform as well as top percentile, providing a ‘GPS’ for procedures, that will improve outcomes and help bring surgical interventions to the 5-Billion people who today don’t have access to safe surgery.

VR-based medical simulation blending video game dynamics and graphics on low-cost consumer headsets as pioneered by OssoVR, will shift medical training from ‘See One, Do One, Teach One… to ‘Sim One, Sim One, Sim One’ before ever touching a patient. ‘Digitally enabled Surgery’ will become the norm, with every orthopedic implant perfectly positioned to match the patient’s anatomy, and more implants will come with embedded sensors to communicate the health of an artificial joint or device to the outside world, just like cardiac pacemakers do today.

Mental Health to Brain-Computer Interfaces: Brains 2.0

The next decade will see continued remarkable advances in neuroscience and mental health. Our ability to image, parse and interpret the brain’s activity in normal, stressed, to flow states and diseases states, is opening the door to what is now being termed ‘precision psychiatry’. This is being catalyzed from insights parsed from wearables to digital biomarkers from how we interact with our devices, to voiceprints, to new forms of imaging, and wearable EEGs. In the coming decade, combining these insights with personal genomics, pharmacogenomics the pharmacologic aspects of therapy will be less trial and error, and more tuning and objectively feedback-driven.

Digital Mental Health solutions are expanding rapidly today to meet the growing need/crisis and will become a standard element of care for optimizing mental well-being and for managing pathologies ranging from Anxiety and Depression to PTSD, Schizophrenia, and beyond. These approaches are especially valuable for those who don’t have regular or easy access to in-person mental health and can blend in-person sessions parsed with both human and virtualized psychologists and coaches. Our wearables, combined with sensing and gamification will play a role in diagnosing and managing clinical mental health conditions (Fitbit recently filed a patent on detecting bipolar disorder and depression).

New modalities are becoming mainstream. From ADHD now treatable as of 2020 with an FDA cleared video game, to the emergence of evidence-based treatment of recalcitrant PTSD, addiction, and depression with psychedelics and new derivates to match the ‘Psychome’ of the individual.

The past decade has seen exciting advancements in Brain-Computer Interfaces (BCI), led by programs such as Braingate at my alma mater, Brown University. Today advanced BCI is experimental and primarily reserved for quadriplegics to enable control of robotics, cursors on a screen. This past year showed the ability of a neuroprosthesis to decode and restore communication in patients who can’t speak. For our tomorrow, Neuralink (yet another of Elon Musk’s companies) has aspirations to move initially from enabling the disabled, to super-enabling those of us fortunate to have full neurologic function. As brain implants get smaller in the next decade we will see the advent of ‘Digital pills for the mind’ now being developed as small implantables to treat depression and eventually other brain disorders.

Less invasive approaches are recently available- Kernal’s Flow, for example, a headset that can record real-time cortical hemodynamics to establish precise patterns of brain activity.

Organ Transplantation meets Humanized Animal Farm

Nearly 100,000 Americans are on the waiting list for a kidney transplant, and an estimated 6,000 die each year because an organ never became available. While tissue engineering, merging with stem cell biology and 3D printing has promise for less complex organs, the ability to create functional, vascularized complex organs remains a challenge. The tissue engineering/3D printing approach is likely to be disrupted by advances in Xenotransplantation. October of 2021 saw the first successful xenotransplantation of a humanized pig kidney(albeit short term for 54 hours into a brain dead human). This January 2022 the remarkable first transplant of a genetically modified pig heart into a human was reported. Academic groups and companies like eGenesis and United Therapeutics are enabling this game-changing progress… A decade from now, I expect pig-derived humanized kidneys, liver, heart, and others while not the norm (and is it Kosher?), maybe on the menu for human transplants when no human donor organs are available.

Catching Disease at Stage 0. From concept to reality

At the conclusion of my 2011 TEDTalk, I brought up the concept of ‘Stage 0 Medicine’… identifying problems early (pre-symptomatically) when intervention can lead to a cure and lives saved, especially relevant in regard to cancer. As an oncologist, it's been exciting to see this move from concept to reality. 2021 saw the launch of GRAIL’s Galleri test for blood-based early detection of over 50 types of cancer. Innovations from Guardant to those from Tempus and others are guiding therapeutic treatment selection (including in the realm of cancer immunotherapy). This work, leveraging the convergence of next-gen sequencing, big data, AI, to CRISPR technology wasn’t possible a decade ago. But riding the exponential rails and innovation and execution, what seemed like science fiction will become standard of care for cancer detection and therapy, and become less expensive and globally available.

There is a lot more to be optimistic about. The next year or two will likely see the first FDA-cleared CRISPR-based cures for genetic diseases like Sickle Cell disease. Stem cell and regenerative medicine approaches may soon reverse Type-I diabetes. mRNA-based vaccines to treat and prevent cancer and vaccines to prevent neurologic disorders are in trials. Watch this space…

The Decade and ‘Health Age’ Ahead

As we head into 2022, despite the uncertainties and challenges of the pandemic, I’m an optimist, and feel that with the immense power of currently available and rapidly developing technologies we are heading into a decade that can be a true ‘Health Age’.

As I summarized in my 2021 TEDTalk I believe this is possible “if we all get out of our linear mindsets, take exponential steps and collaboratively go forth collectively, not only to solve the challenges of this pandemic and predict the future of health and medicine but boldly to go forth together to accelerate a far better one for everyone on Spaceship Earth.” Let’s all work together to make that happen.

My 2021 TED Talk: How Covid-19 Transformed The Future of Medicine

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