Presented by Alger
Medicine    August 13, 2014
Dr. Daniel Kraft Conversations with Tomorrow
Posted by Daniel Kraft

DK:I think in the future in health and medicine there’s so many new technologies that are getting faster, cheaper, more powerful, they’re converging to a point where we can gnash them together in really powerful ways. It’s a really exciting era. There’s lots of opportunity for innovation and improvement. I’m Daniel Kraft. I’m a physician, scientist, entrepreneur. Looking into the future I thought, you know, what better way to do that than think about the world that my son and my daughter are going to grow into, which is changing really, really fast.

You know, our traditional model, I think our meme for the way we practiced healthcare is actually not healthcare, it’s been sick-care. We wait until often we get sick ... we have the heart attack, the stroke, the cancer that pops up. Where things are sort of heading, I believe, is from waiting for disease to happen to wellness and prevention. And 50 years from now, we’ll have the equivalent of almost an On Star for the body that’s going to be taking information from our environment, from our diet, from our social networks, from our genomics. Health will become something that’s truly infused and integrated into our life. It’s not for their doctor to be in charge of their health, it’s you own your own health information.

Many of the technologies which used to be super expensive are riding sort of Moore’s Law, that the poorest on the planet will have access to low-cost tablet technology, phone technology that can enable them to be connected with a physician in their local village, access to the best medical minds, the best medical databases, using artificial intelligence to understand the whole spectrum of publications, and guidelines, and omics. It’s not just about the data that’s important, it’s how it becomes actionable information to help guide you, just like a GPS would be, proactively.

What’s particularly exciting now and going into the next 50 years is we’re starting to unlock and understand the brain. The world of telepresence, which is just on the cusp of exploding with technologies like Oculus Rift, where you can feel like you’re in a virtual environment and not be able to tell the difference between that and reality. That can be hugely powerful for modulating behavior change. For example, if you can look in the virtual mirror and see future you if you’re not maintaining your exercise and your diet regimen and see yourself 50 pounds later or 10 years later if you keep smoking, that can change your mind and sensibility.

We’re seeing now new ways to train the brain, to interact with it, directly with technology, the world of brain computer interface. We’re on the cusp now of building optical prosthetics, basically, a bionic eye. As the sensors get smaller and better, they’re going to reach the point where we have almost normal vision.

To take a woman who’s completely quadriplegic, can’t move from the neck down from a stroke or a motorcycle accident, for example, put a chip on their motor cortex, which can read their thoughts, essentially. “I want to move my arm to the right or to the left” and she can now control a three-dimensional robotic limb to give her her first drink of coffee, for example, in 16 years. We’ll have those who have major disabilities connected back to not only prosthetic arms but maybe rewired and connected to their own.

Alzheimer’s today is a devastating diagnosis, which I think by 2064 will lead to a world where we won’t wait for someone to get Alzheimer’s. We’re on the cusp of having imaging modality so you can pick up the plaques in a patient’s brain 10 or 20 years before they’re showing any clinical signs of Alzheimer’s. We’ll be able to give them interventions, whether that’s mind games, or exercise, or other therapeutics that fits under not just personalized medicine but this idea of precision medicine to participatory medicine. It’s not just enough to treat a whole set of Alzheimer’s patients. We want to learn from every single one of those and contribute to the whole medical establishment.

Imagine elements like our human genome, which cost millions of dollars ten years ago, is down to about $1,000 price point, and in 50 years, maybe the equivalent of $5 or $1 or almost free. And I see the future being one where we’ll 3D print a pill with your name on it, with your combination of drugs that help prevent the diseases you’re at genetic and other risks for.

50 years from now, I would hope that many cancers are essentially cured because we’re going to find them early, we’re going to prevent them from happening in the first place for those who have the predispositions. We’ll be taking every single tumor, we’re going to sequence every tumor, we’re going to understand the expression profiles, we’re going to be able to model which drugs work for that individual patient in animal models and in simulations that are run in the cloud. And when you do need therapy it’s not going to be the one-size-fits-all pill that’s off the shelf. We’ll be personalizing that therapy using other agents that can scan the literature and know what’s worked for other patients with similar subtypes and molecular pathways. Many cancers will become chronic diseases or be cured because we’re going to apply very specific combinations of cocktails that really match that individual’s cancer.

I think the future of health and medicine will not be just going to the high-tech drugs and interventions and devices but being more attuned to our own rhythms, and diets, and exercise, and behavioral elements. You can have truly integrated care that’s smart and knows you and knows your physiology. It can manage the drugs and interventions in a much more personalized way than we have today, and much more a partnership between the doctor and the patient and healthcare team. So, it’s smart and infused in everything that we do. The future’s coming faster than we think. We won’t wait for disease to happen. We’ll start to cure the well before they even get sick.

VO:At Alger we’ve always believed great things when we think further. So we’re proud to mark our 50th anniversary by looking forward to 2064 and presenting “Conversations with Tomorrow”, a glimpse inside the minds of those who don’t wait for the future to happen ... they make it happen.