The Future of Medicine: How AI Can Transform Healthcare for Billions (FII Panel) | EP #133
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All right, let's jump into the episode. Our panel here today is titled how can AI democratize health for the next billion? And to contextualize this, i'll simply say that given the development of A I and wearable sensor technology, there is no excuse for world.

Ten years from now, without a massive increase in health, uh, there is no greater wealth in our health. Every mother wants one thing for her children to be healthy, and I think that's the world that's more peaceful and more prosperous. Where i'd like to do is a asked each of our panels to just take one minute and introduce themselves from the perspective in which they're here to speak about this. Each of them is bringing a very different, unique perspective on global democratization. Well.

would you kick us off? Yeah, absolutely, very happy to be here. Will omit am the founder and C E O of woop. uh. We build wearable technology to unlock human performance and improve health, uh, combination of metrics like sleep and recovery and exercise and stress, a bunch of physiological measurements like heart rate and view two max and POS cks skin temperature. These are all the things that woop is measuring.

And as I think about the potential of continuous health monitoring N A I, you can imagine a future in which you have this twenty four seven coach that's able to look at all of your data and really understand for you what you need right now. And that will include lifestyle decisions, that will include diet, that will include when you need to see a doctor or not. And I am pretty optimistic that the future of health monitoring will make the world a much healthier place one couple of day. I thank you.

Will could you agree more? Dr, as what perspective do you come to us with?

I have a fan of Peter diamond is if you follow what he is doing, you're probably do well in life but along the way I realized that um a heart surgeon by training and a match of what we knew was causing chronic illnesses among the people I was doing open heart surgery on could be avoided if they took some proof active measures.

So to try to tell folks outside the ivory towers of columbia university, where i'm on the fact that they had to do that, I started doing more media. I hosted the dog show, which air heard saudi arabia a for its entire course authority seasons at one hundred twenty other countries that I learned a lot about a people around the world. So the chAllenge is the health.

Early in this process, i'd launched to show with my partner, o pro info. We started the company called share care h that was run by jeff hunne, uh, who is the founder. B, D. And IT was the biggest digital health platform in the united states.

And we began to learn a lot about how to give people digital tools of the the big lesson we learn is you, anna, give them rewards, which will talk about a bit more as we come along. Some of the rewards are informational, but at times you just literally want to give them something, and is a very evident with people in the working place. So 还没 这么 and moment is a pediatric surgeon， our partner here.

But we launched a just a agreed with this with the national council on occupational tional health to bring this shaker platform to all one point two million businesses in this and the the kingdom, and the effort to get that more than ten million workers and many war coming from other countries over the next few years is projected is to get them to be healthier. And i'll just give you one fact about highlight why that matters financially. We ran the numbers in united states.

If you can get the average person to retire, not at sixty one, which is the average, but the sixty four, that three year difference in that one age cohort is worth trillion dollars to the U. S. economy. It's enough to close the U. S.

Debt, which is one third of all the debt we have in the world, is also enough to to make our social programs like dick are and social security solving the same would be true here in saudi arabia, this monograph, which the fii published. If you turn to page sixty, this is a list of the attended and what everyone is doing this, stay healthy, so you can pick these up, you know, in different places. But in this list you'll notice two things.

There's common products like tropico tics that being used by a lot of people. But twenty percent of the tends are asking and taking, maybe taking, but asking for that form, which is the prescription drug, is a link of longevity. So it's a very sophisticated group here that are looking for ways to the bio hack and even hack thirty, forty percent of doing cold plunges and when sona.

So there's a lot of awareness of prevention. How do we activate that? A I would be the best way to customer.

Amazing that could tell. Mom, please introduce yourself in your perspective on this.

Thank computer. Uh, another huge fan of years and thank you for having me. I'm a jim tana bomb. I run four side capital um were three happy edom health care of focus venture fund um have a great interest in the intersection of A A I uh and health care uh in general. We believe that over the next decade is going to be profound, a impact and change that comes through the to coming together. Um there are two categories of things that we're looking for, things that are more readily integrated on top of the existing healthcare infrastructure.

And one way of thinking about this is that we have right now a health care delivery system in the united states globally, which has a very wide variation of standard of care and um and A I methods are gonna able to to narrow that variation so that were able to deliver more uniform best practices across patient population. And we think that those are the types of things that are gona roll out um over the the course of the next five years. And then there are larger questions about given what we know now, how do we redesign health care delivery.

And it's interesting here in sauty, uh in fact, the government has been embarking on that exercise and um uh in the united states is uh very hard to a to change the system that so uh in comber uh and um and has been around for so long. So um but nonetheless we have an interest in looking at a very long term project of recreating a reimagining health care delivery in the united states and hopefully over the next few years will get involved with something substantial that focuses on that. So those are our interest.

Thank you. Thank jim. A A mr. Robin, please introduce yourself in your perspective here.

Well, thank you. Great to be here. I'm in the fan club of this entire world people, so it's privilege. Be here. So um my background is in health care, innovation and delivery.

I used to be the CEO at stanford universities health system and then I was executive vice president at united health group big fortune five company, and then went to a start up one medical that reimagined the doctor's office and combine digital health and in person care. We took in public. And then we sold to amazon last year.

So if you're A U. S. Amazon prime member, you could add one medical for nine box a months.

Could all you can eat on the vantage al health? And then in thirty one markets across the U. S. In person care. And what i've seeing kind of across my experience is how do you take this great innovation that all these these amazing people have shared? And how do you fit IT into workplace of both kind of the demand side, the problem statements for consumers and importers and prayers and the supply side, physicians, conditions, nurses, care coordinators.

And so right now, I run a venture firm called healthier capital, and we're investing in the health tech, this intersection of how do we take these great, exciting technologies, but yet fit him into the workflow of clinicians. And I I use an example from one medical is the kind of things were looking for. So in one medical, a consumer within a minute can have twenty four, seven access to digital health, no copayment, no deductable, no claims.

And we charge the membership fee nine back a month. So how did we not overwhelm our providers with unlimited demand? So we built our own technology, and we precedes natural language processing.

Now, some general AI approaches that reads the emails based on the content pulled out of the physician in box. We then staff a national twenty four seventeen. Not all of them have to be physicians, or even conditions based on the content.

Then we had a human in the loop, but then generate A, I now helps draft the response so we can take fifty percent of the task off of a physician yet then have one to two minute response for the consumers. S, so it's an example of how do you blend technology into services. The Peter, I wanted throat back to you.

Uh so i'll play moderator on this in OK. You have an unbelievable background and been a students in fan uh of view and in the excise and I know you're a thought leader. Please share a little bit about how you're thinking about this in health care.

Are sure um I like studying how industries get massive disruptive, right? So the P T, T, the telephone lines around the world got disrupted when a service that was not ten times one hundred times Better came in and they getting a landline irrelevant, right? And so we see india with a you know and bones five g network just amazing um we saw google come in and make libraries irrelevance.

I'm interested in completely crushing, destroying a obliterating and reinventing the health care industry. And I do think that we're going to get there relatively quickly. There's a point at which, why would you ever go?

There is a point which, A I is the best physician, an period right, where smell practice to diagnose without A I in the loop. There is a point at which the most of your data is collected on your body, in your clothes, in your car, in your bed, in your urinal all the time. And that data fed up to your AI that's monitoring you not once a year for checks, but continuously through your day.

And finding things at the very beginning. So i'm interested in where what countries are going to like reinvent health care and make U. S.

Health care super jealous. So we don't have that. Yeah so i'm not interested in incrementalism. So I start with you moment um you have some fashioning data. How do you think about the the rising billion not call IT the possibility the rising billions and how this will support them. You mention A.

I and I share your belief get there studying by the way, in your panel when jack hitter was describing sand boxes, large quantitate money.

Thank you for that the opportunity you can moderate.

I've from the best the best try to learn but you well done .

that any award with uh quality work. Uh I the big the big opportunity was A I I think if is honest, honest. Now I ask if you sorry, not judgmental, no IT can be IT can .

make mistakes.

obviously can hlubi ate. But there's give, I give you two examples. The one classic example the jack herry share with eight years ago, when I first try to understand what this was, was pathology slides.

So if I get a pathology slides in a western country for prostate cancer, the pathologist will over read cancer. They'll see there's more country than they really is. Why would they do that? They do because they're humans.

They don't want to miss a cancer. So they'll say something is a more advanced tumor than IT really is just in case because they not sure catholic slide by A I don't make that mistake because there's just bluntly telling you what IT is. So you don't great number of people have their protest taken out.

That's true in the west is also true in the east. But the more pervasive issue today is we have a little bit of a illness industrial complex. There's a lot of money spent to make a sick making foods that aren't good for us subsidizing those foods.

Sometimes they are addictive foods, you know, we support, I think we probably put as much money in the debacle subsides in amErica as proof vest ables. You know, it's just not done in a way that I objectively honest person would want. But these historical realities, why these were done, and I blaming the people just is true that we're not doing our best.

A I generated advice will have to tell you the truth. IT doesn't fall pray to human fail ability because it's kind of be kind. And an effort to be kind hurts you like a parent who loves you, but there's the wrong thing.

By enabling ling behaviors, IT also will take on special interest groups that maybe don't want you to do the right thing. And I think if you put those together, we have an opportunity not just in the west, but also in umbria. Billion, to say honorably, your water is so poor that you can't be healthy, as healthy as you could, because you have arthenay levels, I know, hundred times more than the day. So as a country, you need to do Better job with water supply. These basic stuff is not just during polio, which be nice also, but IT actually sorts to get into these issues that I expose pathology that otherwise we would ignore.

Well, how many?

And I have .

to get yeah how how many loops are in circulation and what you mention, what you're measuring today, what what would be or the next three or four things that you would love to be able to measure physiologically on in the body.

Where are you going? Well, when we first started with, we looked at some of the sort of more capable medical technologies out there. And how could we put those in a smaller form factor? And so initially, IT was the P.

S. G machine, which is like the gold standard for sleep monitoring um IT was the electro cardio again, but in particularly beat of the measure how rate variability, which is is fascinating, lands entire your body's recovering. And IT was actually the chest strap, which is the hurray monitor from the eighties that athletes were to train and being of the measure heart rate accurately during all sorts of different activities. Now the good news is we've now been able to take those technologies and put them in a small foreign tor that has the same level of efficacy.

And if I think about, i'm going forward, all the new capabilities will probably go back to a similar place, which is just saying what are all the different pieces of technology that you find in a hospital room or that are off the shelf um you know more cumbersome pieces of technology that you'll be able to put in a much smaller foreign tor, much more affordable foreign factor and democratize. I mean, just think about the fact less than one percent of humanity measured their sleep last night. Yet we know that sleep is essentially one of the most important things you can do for longevity, for performance, for really reversing all sorts of disease states and everything that that could go wrong.

And yet, such a small percentage of society today is measuring IT. So it's often ask for what more can measure, what more can measure? I think a good starting point is just getting a lot more people to be measuring their bodies because you can only really manage what you measure. sure.

I am curious. Both of you have been in the medical system, are investing in the medical read. Is that do we start from from clean sheet and work up? Or do you try and take the existing systems and and improve them? Jim, how do you think about that? I mean, I like your catalist ation to simplify. But do you do you want to live? You going to live long enough to change is Better.

yeah. no. I mean, I, I, I, I hope hope springs a journal. L, I think, you know, you know, venture .

capitalist.

you start off with with mp protheus. The micro teams bring you to entrepreneurs and the entrepreneurs bring you to investment opportunities. Um so the macro theme is to use A I to you make care of living more uniform. Then the entrepreneurs, the ground that are delivering that have a spread of ways of going about IT. I would say, ironically, there is not a tight correlation between revenue growth and technology excEllence.

Can I ask conm to that, do you think that doctors will change or medical systems will change? I I don't believe so. I think it's they're so ingrained in how they do what they do. That to get people to actually change is almost impossible.

Well, I think there's small change in large change OK there enters enters who's at risk and who can benefit from change. Um and in places where people go at risk and they can deliver, we're involved in a cancer a care delivery company that's making some changes to the way the way that cancer care delivery. Um originally, we were hoping that they would be really heavy on the tech front. They've just been really heavy on the figure out how to get doctors to accept various changes that are uh, you know that are easy .

for them to accept. May have wanted to take for cardiologists to accept using A I to read E K G, right? I A set .

scope step, the scope just now. Just now we're getting dockers allow A I and analyze acoustic sounds, which were so bad at objectively. We're in flint murals.

And I think it's .

it's a great question, Peter. I think the answer is both and meaning, I think we're going to have innovation and continuous improvement from within the ecosystem and sometimes will have disruptions from without.

But if one is naive to how the ecosystem works, I like to say big health care always wins and so ah but I think also understanding the state color needs A I actually was just with a kind of cancer, uh almost customer relationship management software company that's helping manage patients, launch tutor and a lot of practices in community practices. They don't have either knowledge base and then the staff to manage kind of the symptoms and follow up on the on these other therapies. So they're not using the latest generation. So part of the answer there is OK. And by the way, they're not getting paid for that time.

And but this panel is about .

the next billion.

Yes, yes.

So I think then the end on the next billion is, however, then there is some approaches that can make frog these things. And we're seeing this now in a lot of this generate AI. So i've looked at a number of companies now where a doctor and impatient consider across each other, and not only have the system due transcription document with the dark, who is saying, but also say, kind of do the differential diagnosis, I think it's this, I think it's bad. I could be this consider ordering these exams.

And I think back to other point, Peter, I think this could be an area like we saw cell phones in some parts of the world, the frog glam lines, we could see the same here. We may have more regular ory burdens and more stuck in our current ways. U S. Um actually have been spending some time with the ministry of health these last couple days here in in in the kingdom.

And it's going to be the king IT is.

And it's also, however, good to have a national viewpoint of regulation. We have proven coins in the U. S. From cities and counties and states. But in terms of having a uniform digital highway, in terms of for having consistent standards, it's very hard to innovate .

that I put forward the thesis and get your feedback, which is the only they compared the U. S. Against africa in health.

The us. Has such regulatory burden and such a disease based industry, a sick care industry, that shifting the battleship will be extraordinary difficult. But take your favorite african nation, where there is little, but there's five g there's smart phones. And with the proper creation of sensor technologies, we can have a round up revolution using A I democrazy health. Just like in africa, we saw um uh the first cell phone based currency exchanges using minutes, right, which is innovation I still would love to have in the us. So do you imagine that we might see in five years time and or remind you guys five years now, I said this that we have standards of health care improving in the rising billion um at the mass level, not the wealthy but at the the general populist level.

Well I think I think the I think the place that has the most likely for that type of scenario OS actually here for the U A. A saute or U A. Yeah, and they're already starting and they're doing planning and they're y're making earnest mirrors, is just spent the last couple days banging around the health of authority here and he can make more comments but mean, you need a lot of factors. You need um uh you need uh government um that that can actually be empower to make change um alignment a long term thinking money um and a lot of the factors .

are here .

and and .

I think one needs the right financial incentives. We can do IT also in the U S. I mean the system is responding exactly as .

the financial sentence .

A I and health care we all know where is supplied respond new collections claims that all the first money is to be made in A I in healthcare. And you know everything that doctor s was talking about, our digital pathology, digital ology there, but is much, much slower. Why is that? F, D, A approval is in for cms, can built for IT.

How do you get reivers? But we've seen, for example, in medicare for seniors in the us. We have fifty percent of seniors now in medication emos.

Medicare are advantage or there is a financial sentence for the insurance companies, for the groups. And it's not a perfect model far from IT. But I think to jims point, IT takes leadership at the national level, at the country level and then takes the right incentives. The entrepreneurs will come up with the ideas.

But just to feed off that, i've been to saw you maybe of five times this year.

Well.

so and I, as you have been talking .

to the mouse aby.

sorry, they got to think of flier miles that we have not been able to use one day. I still donating in the will, but I I, but i've noticed here anyway, is that the real waiting game for health is going to come back down to the issues of make IT easy to do the right thing through the blue zones approach, and is probably a blue zones in the part of.

So if you know the other places where there are blue zones, organ organic, they have done things that just every single push you to walk a little more, which, by the way, that by itself is probably the single biggest driver of longevity. Ves, the average american walks four thousand a steps day in sought abby is less because everyone's indoors. So often they well over time, but let's just say seven.

But that's just a basic example that work can monitor and keep track of. I think those are the kind of things that ultimately allowed the extra billion people that were talking about to rise up. And I broke on monday at the african summit the same basic idea, the leap frogging that mention is happening.

They are already with technologies and orbis, the company that looks at retina images and does A I evaluation to everything inside your brain. But a lot of all the metals as well. Again, if we don't do that in in most parts of the world, but they just can screen a lot of people, monitoring is a big part of IT.

What i'd like to do in our final eight minutes is give each of you two minutes to address that question. How can AI democratize health for the next billion? Want to bring us back there? Well.

yeah and just reflecting on on the conversation here, a lot of how, at least I thought about building wood is very customer first. You're like, you know, individual first. And IT strikes me that we've talked a lot about, you know different regulations and you know what doctors officers are going to do.

And we've almost looked at, at more from the bureaucracy standpoint. But I think that when you talk about a billion people, it's going to come from the users first. And you know, we might be learned something in the education .

system right now.

So IT wasn't like generate A I I want to the education system and said, hey, we're interested in rolling out you know, large language models. We're interested in, you know helping the students Better understand how to write papers and answer questions. IT was just like, all of a sudden, every school around the world walk up to the fact that their students can now write a paper entirely from a large language model.

And now every schools trying to figure out what the how do we do with this new world, and they're changing way fast to the neighbor thought they would. And I think what we're going to see happen in health care is that level of disruption where all of the sudden answers are going to be at the fingertips of individuals around the world. They'll be someone wearing a wop.

And the A I layer that sits on top of that is going to tell them they're about of a heart attack and thirty minutes. And guess what, they're not going to call their doctor, ask. They're just going to go to the E R, right? And all of when these things start to happen in real time, the system is going to have to adapt rapidly. And I think it's so powerful about A S talk about billion people is that the cost of that level of intelligence is going to be so low that it's going be touching every individual. And so that was going to push the .

system of a mayor.

One unix. Yeah, I think we could have a doctor in everybody's pocket.

exactly.

And I think actually technology wise, that's here today at least kind of .

a trio and diagnostic.

Well, I still believe we humanity and compassion and also do not .

think that A I can be more empathetic than a human.

I, I, I think for IT that most humans probably possibly.

I do think that show that right.

I think that's right. Good, good data on that. But I I think the key here is today, there's a lot of barriers to access this information.

And even if you have great insurance or great resources, uh, even if your names on the side of a building, I just visited somebody at the and harvard whose named on the side of the building, I said, how long is to take you to get an appointment he said when I saw in his practitioner in ten days and his teams are them on one of the buildings. So you know, everybody wants that immediate access in service. And so there was initial questions I think we could have assessed.

And I think to well is good point. I was just visiting with the red present team, the ambuLance E M S services here. And they have now got kind of remote telemetry ary.

You can measure E, E G in the fields or so you can get uh, stroke protocol going or doctor balloon time faster. But if he was on your boop, yeah I can get that even faster. So that's, I think, all very doable.

The integration into the existing ecosystem is where it'll fall. But I I agree with what we will see if we can put IT in the hands of consumers, of people. We'll have that information. Um and I think the technologies here and it's available, and so I am very .

excited about that. So and I agree with the line that everybody y's going down doctor in a pocket concept is is already here and now and but the problem is uh is hard to get a person to trust a an AI to deliver their care you that the whole that .

generational over .

time IT will be however， I was going to silly different place which is that um I think that the place where places where will likely get adopted more readily is where the doctors are accepting of the A I um with the patient. And I think there's economic alignment in places that are capitated where you for example, you have six months of waiting and you can effectively make a much more string line system because now is on mental effectively, but still doctors in luu.

Do you think, jim, that. Physicians will spend a quarter million or a half a million dollars going through medical school if they're playing second field to an AI that a nurse practitioner .

could easily well, well, I don't think there's any I don't think there's any decrease in uh in um uh uh acceptance ah you know rates know various medical schools are still possible to get into medical schools. So there's a great deal of interested and I think the role of a physician and this is actually something i've been interested in philanthropic ally um you know it's going to change and evolve. What's your vision? Um my vision is more of a business, a business man, a woman you know what of uh objective watch the best you know sort of uh processes for me to um adopt in order to be able to deliver measurably the best care, the least .

expensively of a health coach and a consult.

Um could be could be although the A I could power up the doctor too. I mean, you're talking about the last mile. You and the last mile could come in a much different ways.

I mean, you could be in your cell one that way you like mile IT could be delivered you by a nurse practitioner, you know as well if you want the human interaction. But I think that in general um physicians that that adopt these tools are going to be advantaged and are going to be advantaged in various systems Better than others. But I think capitation is in one place where you know they they there is a fixed pot. They could do something more efficient. They can share more than .

that pot that take his homes. On the topic.

I think you you teach .

people how to treat you.

That's true in our personal lives. It's gonna true in the medical care system. IT has not historically been the case because there was an assembly c advantage to physicians because they had domain expertise. They were doctor, don't mean doctor a teacher. We're supposed to be teachers that orders.

And I do think the economics of medicine have always been driven to making more money for the people who are providing the care, but the people who deserve more value, who will ultimately use A I to drive IT for the extra billion entering the system. Are the employers, the governments and people need the productivity of people. Just being very pragmatic about this, if i'm learning a business and my employees are present presented m, they're there, but they are not really a full speed or they're not there because a various healthy and that's a problem.

It's why we focus so hard in the U. S. And employee and occupational health is why we're working with the natural council occupational healthy with this big program. It's mission critical for the saudi's to have a workforce that is healthy because they don't have enough people to do the work. And it's gonna be that way.

I think for the billion people as they come into the system, they are gonna want to have jobs and stay in those jobs and earn money and build well for themselves and have a confidence for the future, and therefore consume and runs the whole cycle. We've never thought of healthcare as that. Health care always seen as a drain on the economy, trillion dollars coming out of the economy as supposed to, generating a lot of value for the nations that have high quality health care.

So keeping clean water, awarding community diseases, making sure that you've got folks that able to get basic preventive care, and they all can live with a health span that that in the way they want to live until they're least eighty five, is something this valuable. But I do have aspirations that will go in higher than that. I think one twenty when you venture maybe longer.

But I think of how much value that is to someone whose severity, five years old to learn all that we can offer back because they have been capable. You only way to keep the system on is a supporter, arbiters and A I is the only thing in my lifetime is sitting close to doing that. So it's going to allow all these transformations to happen.

And without A I am is a lot of arguments about to go to the bed. A I is not going to be. The problem is people who use A I who weren't good.

I'm going to work at time. And I do a survey of the four year o quick, here's the question. When will IT female practice to diagnose a patient without A I in the loop? Your answer, within five years, within ten years, within twenty years, or never only. Start with you.

I would say, within five years.

within five years, one year, within one year, within one year, to be this complicated diagnoses, why would you not just searching is right there amazing, jim.

I would say less than five.

I would say practically within five years when the legal system evolves is a different question. You or how would you answer .

IT and how would you i'm like, i'm going to push in hard. I can as soon as I can. I think within five years is my answer. Let's give you up for our amazing panel, everybody, you.

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