What 'exponential medicine' means for global health

Daniel Kraft, faculty chair for medicine at Singularity University. Photo by: SU Global Summit

SAN FRANCISCO — Daniel Kraft, the faculty chair for medicine at Singularity University, is focused on the impact that technologies such as artificial intelligence are having, and will have, on biomedicine and health care.

Kraft prefers the term “rapidly developing technology” to “exponential technologies,” but both of them describe technologies that double in processing power and halve in cost year after year.

“Look at a problem and say: What convergence of exponential technologies — AI, robotics, 3D printing, nanotech, genomics, etc., could be applied not just with a 2018 lens but with a 2028 or at least 2022 lens?” he told Devex this month at the Singularity University Summit, which focused on how exponential technologies can help solve global challenges.

Here are some of the key messages Kraft shared with Devex about what exponential medicine means for global health.

Information is power.

While Kraft often speaks to the power of technologies such as AI, for him, the most basic application of exponential technology to global health is the mobile phone.

“What I think is exciting about today's technology is that smartphones are in the pocket of almost everybody on the planet. In a couple of years, people on SMS phones with a version of early Android will have the equivalent of my iPhone x, and the bandwidth will improve,” he said.

That process of “democratizing access” to higher powered mobile phones will open up a range of new possibilities, Kraft said. Simply having cell phone access can enable someone to reach a specialist they might never have accessed before, he said.

Integration is key.

Asked which technologies are currently undervalued, Kraft pointed to tablets.

“What is undervalued, potentially, is the fact that your smart tablet can be your virtual doctor, telehealth platform, access to information, prevention, diagnostics, and guidance for therapy,” he said.

He hopes to see further integration of apps for preventing and managing common conditions.

Technology will replace experts.

Peter Diamandis is both the co-founder of Singularity University and the founder of the XPRIZE Foundation, a nonprofit organization that puts on public competitions for the development of technology to benefit humanity. Earlier this year, he announced an avatar challenge.

Representatives of the XPRIZE Foundation see the potential global health implications of operators to be able to interact with a physical environment that is over 100 kilometers away from their physical location.

Kraft pulled out a device that lets anyone perform their own electrocardiogram, or EKG, measuring their heart’s electrical activity.

“This is a cheap, available way of democratizing an EKG, which is going to get better and better,” he said, suggesting that as costs come down, community health workers might carry these with them.

Kraft also mentioned Zebra Medical Vision, which offers AI-based chest X-rays for $1 per scan.

“Devices that can collect data at the point of care are now increasingly being layered with other sources information so you know what to do with the data — you don’t need to be a pathologist, cardiologist, radiologist,” he said.

Kraft said one of the challenges that technologists developing solutions for health will face is what to do with pushback from people whose paychecks might be at risk.

“Is that cardiologist going to like the fact that you're using that cardiology EKG app when it will bypass them?” he said.

User experience matters.

Project Masiluleke, better known as Project M, did not use emerging technologies, but rather the ubiquity of SMS cell phones in South Africa, to spread information about public health crises. Turning an HIV test kit, designed for a clinical setting, into something that might be used in the household was not so much a technical challenge as a design challenge, which is why the partners engaged Frog Design, a global design firm, in the project.

“We need some work on user-centered design elements, including what happens when it hits the ground, and tracking and measuring that so you can optimize,” Kraft said.

He explained that no matter how great the technology, the best new gadgets for a given global health challenge — diagnosing and treating malaria, for example — will never be utilized if there is not enough attention paid to the user experience and user interface.

Connect the dots to move from pilots to progress.

Kraft mentioned Marc Koska, who developed a low-cost syringe that can’t be used twice, to prevent the transmission of HIV and other blood-borne diseases.

“A lot of innovations have been done and work really well, but aren’t scaled or aren’t shared — or there’s death by pilot,” he said.

Koska was able to scale his invention in partnership with the global health community, when the World Health Organization adopted a safe injection policy using his auto-disable syringe.

While innovation and invention are needed to drive global health outcomes, pilots cannot turn into progress without implementation science, which examines why some of those innovations that work in the lab fail in the field.

“Can solutions be built with existing platforms, with existing technology, connecting the dots to address some pretty important unmet needs?” Kraft asked.

Atul Gawande — the surgeon, writer, and researcher — has called systems innovation, versus front end discovery, the next big opportunity to advance human well-being.

But Kraft acknowledged some of the barriers to connecting the dots and scaling up what is working in the global health space.

“In the NGO world, there’s a lot of competition and turf battle,” he said. “How can you start to align incentives and collaborate and create collaboration platforms that can help people contribute at their highest level without always stepping on each other?”

Overhype is to be expected.

Asked how he feels about blockchain, Kraft referenced the Gartner Hype Cycle.

The methodology captures how a technology will evolve over time, from innovation trigger, to peak of inflated expectations, to a trough of disillusionment, then a slope of enlightenment, and finally a plateau of productivity.

“You sometimes need that peak of inflated expectations to get people all excited about it, thinking about it, trying to use blockchain in convergence with other technologies to solve a pain point,” Kraft said.

“What’s exciting about a lot of these rapidly developing technologies is you can think about them in the context of a problem area and apply that. So while, yes, blockchain and even AI is a little overhyped, there are so many unmet needs where [they] could be applied, and it provides a focus for folks outside of health care to bring that expertise to the problem area.”

Design for tomorrow’s technology.

In some final words of advice for the global health community, Kraft warned against building solutions that are out of date by the time they roll out.

“A lot of folks are saying, ‘here’s a problem,’ and they're thinking about solving it with today's technology and realizing that you know, we do have a pretty rapid evolution of technology,” he said.

“We've only had 10 years of the smartphone. 5G is coming into parts the world. How do you future-proof ... and also design into your solutions what's coming — whether it’s low cost 3D printing, or distributed AI and machine learning, or Google Loon access to the internet?”

Organizations working with community health workers should be asking what the specifications are likely to be for tablets in 2020, versus designing for tablets from 2015.

In November, Kraft will bring experts together to discuss the future of health care at Exponential Medicine, an annual conference in Southern California.

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    Catherine Cheney

    Catherine Cheney is a Senior Reporter for Devex. She covers the West Coast of the U.S., focusing on the role of technology and innovation in achieving the Sustainable Development Goals. And she frequently represents Devex as a speaker and moderator. Prior to joining Devex, Catherine earned her bachelor’s and master’s degrees from Yale University, worked as a web producer for POLITICO and reporter for World Politics Review, and helped to launch NationSwell. Catherine has reported from all over the world, and freelanced for outlets including the Atlantic and the Washington Post. She is also the West Coast ambassador for the Solutions Journalism Network, a nonprofit that trains and connects journalists to cover responses to problems.