The Healthcare Shift – Zayna Khayat I SingularityU Canada Summit 2019

The Healthcare Shift - Zayna Khayat I SingularityU Canada Summit 2019



here to talk about the healthcare shift please welcome to the stage Zana chi ad future strategist with se health please welcome to the stage Zana Chi Odd Future strategist with se health ok I don't know if there's much more I can add so we're gonna take it up a level and just kind of talk about the overall shift of healthcare to see where we're going it's important to remember how did we even get the healthcare system we have so some of you might remember about 15 years ago the CBC did a contest where Canadians voted across the country for who is the greatest Canadian of all time anybody remember don't kill my punchline hold on so if you're from Edmonton I gotta believe your thinking is this guy right son of the Edmonton Oilers with awesome hockey hair and so he was in the top ten but he wasn't the top Canadian he was followed by a lot of other great prominent Canadians who did a lot to kind of put our country on the map Prime Minister Don Cherry Sir Frederick Banting who founded insulin and gave that as a gift to the world I'll bring that up after but the number one Canadian that every Canadian voted in the CBC competition you probably might not even know his name Tommy Douglas and and he's not the top Canadian because he's the grandfather of Kiefer Sutherland but he is he was the seventh premier of Saskatchewan and this is in the mid 1900s and he was the first him and his cabinet introduced universally funded health care as the first jurisdiction in all of North America so when he's commemorated on this stamp he is the father of Medicare for this continent and that's a big deal to Canadians that we believed as a value that everybody should have health care as a right and funded by the public dime so as Canada and health systems around the world we're building their health care delivery models etc you know we can all say it's been wildly actually successful so if we look back these are the world in pictures so this is every country from left to right in order of life expectancy at birth in the 1800's before industrialization if you were born in India or the USA it wasn't a big difference the average person died at 27 years old globally now you kind of dial that forward another couple hundred years by 1950 the global life expectancy was about 48 years but you can see the huge lift kind of in the western countries on the right of that page and then another you know 60 years later everybody's boats are rising and we're at a global average of about 70 years with the biggest lift coming from the East and Canada is kind of in the top ten of the Wayne Gretzky's somewhere in there and as we saw from Jeff Rogers yesterday yeah we're living longer life expectancy has been on an exponential curve as has been world population so there's a lot of us and we're living a lot longer and while health care and medical technology can't take all of the credit so sanitation like Jacque talked about yesterday and agriculture and just less wars have all contributed but Health Care's had a huge play and so let's look back at about 2500 years of Medicine so major medical innovations going back to Hippocrates that have really brought completely new ways and tools to see the body treat things keep people alive policy innovations like the World Health Organization in the mid 1900s but all of these that were analog right when when innovations have been analog and that's all we've had to date in medicine they only can scale linearly as we build more buildings and hire more labor and more people we can spread them out to people but they've done a pretty good job but we got to remember who we you know evolved from right our ancestors you know stay alive very long but you know if we look at their health span against time they were extremely healthy their health span matched their life span because they ate the right foods and we're you know exercising all day and really what killed them was either you know cutting their foot and getting a disease they couldn't fight or you know bumping into a saber-toothed tiger well we're a little bit different now a few hundred years later so if you imagine you know this is what we evolved from we don't do labor as much we kind of are messed up with our clocks and our whole circadian rhythm we have access to smoking and fast food and a lot of stress and our health span kind of looks something more like this that little blip there is like when you have children it all goes down but then you recover maybe mine is a little lower you know but that that kind of area under that curve you know is what is sickness right when it's not kind of peaking at the top like it was for our ancestors that's absenteeism for your employees unwellness or dis-ease disease and so if you know our health span kind of looks like this you know the new goal isn't just to keep pushing that curve to the right and I will submit a lot of what we saw this weekend this week and what we see a lot of exponential medicine are continuing to be life extension technologies and that's great and some people believe we have a new immortality economy and so we will continue to push the boundaries of that but I'm going to suggest that the new goal of health care systems isn't just to keep us alive for how long as possible but to get that health span to match that life span now the key thing about this is in theory we have every tool and data we need to be able to achieve this we know exactly how to keep people healthy and then you know a quick fast painless death so the key caveat is it has to be at a cost that is acceptable to society and that's where this kind of scarcity versus abundance discussion comes in because to this day we just keep piling on more beds more buildings more doctors more tests more pills and we're not getting that kind of incremental gain in health and so that's what we would call a wicked problem when you want to get benefit to the masses and your business model fundamentally doesn't allow you and that's where Exponential's kick in so kind of looking back again at our current lifetime of medical technologies that have all been linear and analog/digital came on the scene in health care only ten years ago so we're like babies at this because that was ten years after the rest of society already was embracing digital and integrating it with their global core sectors and you remember the 60s of exponential development they start first by having things digitized and Tiffany showed us today we're finally getting there in healthcare that were digitizing whether it's that medical record that's going to be 15 kilometers high that Phil talked about or all of our biology in Canada we're barely on the curve we're barely on the curve however as we know from Exponential's once we get there with just kind of having largely digitized information then that's a tipping point and off we go and that is massive change so here's some signals that we're slowly getting there you might remember this great TV show called The Jetsons where they already imagine like in 1962 that you would not have to be at the same time in place as your doctor to have a visit and we still kind of don't really have that at scale available in this country but there's been some great developments you might have heard of this company Babylon health they are the provider of basically a doctor in your pocket 24/7 on demand in the National Health Service in the UK for 65 million people funded by the public and they just arrived in Canada in partnership with Telus and under the public purse are now available to citizens of British by the country of Rwanda is offering top-quality primary care to their citizens on the babylon platform I think this has huge opportunity for our First Nations populations or any of our rural Canadians and then what's coming next in the technology is getting better and better Microsoft now can tell a whole apart your physician or the nurse or the specialist into your mother's living room if they're sick and you don't want to be in an institution or a hospital and so that's gonna get cheaper easier faster and a lot more real than it is today we've got a way to go so in Canada we do a few hundred million doctor visits a year and they quantified about less than a percent of those today are in the virtual realm leading health systems like Kaiser Permanente in California they're at well over 50% they've kind of doubled down on this so just so you can relate to this other than as a patient which I'm sure you know what this is about imagine if your employer told you the only thing that counts as work and the only time you get paid as an employee is when you're in person at the office and having in-person meetings no emails no conference calls none of that stuff right that's the equivalent of what we're asking our healthcare system to do by not being digital and offering this channel so every Health System every province every hospital my organization we do homecare has made digital its top priority it's a huge focus tons of investment and everybody's got the right idea but we're pretty clear that that's not gonna be what gets us there it's gonna help the secret weapon in all this is going to be patients who are kind of used to living a digital life and they're you know every other part of their life and then they they're in a time warp when they enter the Canadian healthcare system Eric Topol who's a doctor at Scripps wrote a great book to really capture this kind of movement of patients kind of taking things into their own hands and they're almost behaving like consumers alright so what is a consumer a consumer pays out of their pocket for a good or service that meets their needs well health care isn't a consumer industry because we don't pay someone else pays and just get the service but we're behaving like consumers and so pick a metaphor consumerization retail ization modification uber ization amazon efficacious healthcare you know we're borrowing from these other industries that have figured out how to wickedly serve customers and it's actually showing better results in both costs and quality of care and so I think this is going to be the driving force and if you remember what Oren talked about at the opening and then Sean this kind of agency of the individual it's finally coming to health care and there's just so much untapped opportunity there so so put it all together now that we've digitized we have this digital layer the new technologies that are gonna show up on my map of the history of Medicine you know are nothing like we've seen before and so we've heard snippets of a lot of these each of the Exponential's we track a singularity are not only coming into healthcare on their own like you know the blockchain application that Tiffany talked about today or virtual reality to replace drugs but they are combining in wicked ways and each of them is on their own s-curve and so it's all amplifying and so just a couple quick highlights just to show you how much change is coming to healthcare you know if you imagine if this was how sick you were getting and you got a sore throat and you know you ended up getting into the formal healthcare system today about 90% of our resources are spent on formal sick care but you know your digital exhaust is now becoming clinical data what you searched on Google how much you walked all that digital biology that we heard about and now you know you combine those digital biomarkers with some interesting algorithms and we have a whole new business model called predicta lytx healthcare systems haven't changed for a hundred and fifty years on that sick care model and we're asking them to kind of re our Katan this kind of predictive model 3d printing we saw yesterday you know these 3d printed prosthetics that don't only bring kind of democratization and break a bit of a cost paradigm but hyper hyper personalized station I don't know if any of you know anyone who's had a prosthetic but like you're kind of shopping from the catalogue that everybody else gets at one-size-fits-all organs I was we've heard about the one that I'm keeping an eye on is 3d printed pills so think of the whole value chain of pharmaceutical manufacturing and distribution through pharmacy for most generic drugs more and more you'll be able to just 3d print them maybe at a little local center like your Loblaws or your so bays or in your home kind of like our little amino labs Easy Bake Oven think about all the applications right how many of you have to buy that crappy purple pills for your kids when they have a fever you like cut it to get the dosage right you know you can now really personalize the flavor the shape the dosing and at the exponential medicine stage which is the health stream of singularity last year the chair dr. Daniel craft shared a prototype that they're building of a print your pill for the day where each color of those globules is kind of individual medicines we work with seniors in my work most older adults are on five to twelve medicines a day and they're trying to manage all the dosages and morning and afternoon you can adjust the doses you could put your vitamins in there and if you're in Canada now you can put your cannaboids in there and print it over the day you know other things we're gonna look back at like that we used to cut people open and put them under to just biopsy a tumor so massive de physical ization of pretty routine procedures a lot of that is now at the sensitivity of a blood test and even that our kids will look back and be like you know that's like the bloodletting of today that more and more just from your breath will have pretty much most of the biological data we need to diagnose things so just a massive democratization and then finally just last example of an exponential you know I don't know if any of you had like been pregnant or had a partner who's pregnant where like you get that one picture of the ultrasound that one appointment because we timeshare radiology ultrasounds CT scans MRI scans because it's extremely capital intensive and labor intensive and the the technology is expensive so there's now a mobile ultrasound that just connects to your phone and dr. Eric Topol who's kind of the Guru of the future health see that doctor there with the stethoscope he predicts that'll be kind of an artifact of the past and and no doctor will walk around without a mobile altar sound in their pocket and then at exponential medicine last year there was like a collective mind blow like brain guts all over the auditorium when this woman who started this company called open water she is not a health care person she's developing a prototype now for a wearable MRI scanner so her prototype looked like a little ski toque so this completely changes so many variables of how we've used this extremely important imaging technology to detect our tumors and cancers and so many other things so so let's look for that and these are at you know what we call consumer electronics prices right $1,000 to $2,000 compared to hundreds of thousands of dollars and tons of technicians ok so put that all together this is like the money slide but this is gonna summarize all the themes you heard yesterday and today about where health is going along a few dimensions so as we've heard you know the big shift absolutely from a hundred and fifty years of sick care so waiting for things to be wrong too you know proactive and now predictive healthcare a massive shift in the precision from kind of a one-size-fits-all so imagine any other industry that operates on a segment of one to really like an n of one highly precise personalized and intelligence based wellness the channel again we've been relegated to kind of one channel you go to the institution the hospital or the clinic not a lot of choice extremely labor and capital intensive and that's all decentralizing d physical izing you know the word omni-channel is now a very common lexicon in healthcare and it's you know what I'm calling digital this kind of seamless play or other people call it fidget all whatever pick one but this kind of seamless interplay between digital and physical the duration you know we've made healthcare very episodic and intermittent you get the 10 minute visit you get the blood test every three months and as we've seen over the last two days we are gonna have a continuous stream and very very early warning signals of things going wrong and then you know what I get the most excited about is a massive massive power shift from the provider as we've heard to what I call people powered health care and then finally and this is where D monetization comes in you know but health care has had one business model for a hundred and fifty years right you know no company or organization that doesn't survive its you know business model is going to be around and it hasn't changed and all those stressors are now here you know focusing before on costs and inputs and fee per visit to a really outcomes based model so this is massive massive change for an industry that hasn't changed that much and it's kind of not in our DNA and so when Vivek Wadhwa makes a statement like this and sure you can scratch out medicine and put energy or education or pick a sector but for our industry this is really really scary because we do not have the tool sets the mind sets or any of the infrastructure to adopt at this scale and so just to bring it in relief if you look at some of these technologies that have you know quickly gotten to let's say 50 million users the speed at which that's happening just gets faster and faster I think if I put Pokemon go it'll be like one hour to get to 50 million people pick a study anywhere Canada the u.s. in the world consistently the time it's taken in medicine to go from something that we know works and is better for patients or lower cost to being widespread use let's say 50 million is 17 years so we've got this kind of of clock speeds of where patience and technology is pulling us and a system that can't adopt and so it's no wonder they pick a study then this is Accenture when they looked up global core sectors so the x-axis is how susceptible to disruption against how much has already happens like media and telecom will be in the top left o shows up in the bottom right corner right healthcare delivery this is why health care is one of the major streams of X of singularity University because we need a lot of help to kind of guide our patients our clinicians and our health systems through this ok so so what's it all about what does it mean for you there's been some pretty scientific stuff here today even for me and I'm a scientist so I think there's three lenses I want you to reflect on as you kind of head into whatever you do next the first is absolutely as a user and recipient of the system you fund it I don't know if you know but in every province something like 50% of the provinces budget is healthcare I've heard ministers of finance say I'm really the Minister of Health because half their budget is healthcare and and if you're not a patient yet or you haven't been you are or you're gonna be a caregiver you're gonna have a kid a spouse and certainly some parents who you're gonna be helping navigate their care and so what we're getting excited about is what people are literally calling this patient revolution books are being written about it and here's some signals of like crazy stuff that patients are up to now that they have got you know all the means of production and all the information and soon all their data so these patients got sick and tired of being sick and tired of the cost of generic drugs in Canada even we're the only Western country in the world that does not publicly fund drugs they form their own buying group just bypass all the intermediaries well why not in Switzerland taking a bit of a lesson from visa they formed a co-op to hold all their health data in a Health Bank on the blockchain platform and then remember I talked about Frederick Banting who you know when we discovered insulin in Toronto we gave that to the world for free for one dollar now in the US there's people mortgaging their house because of the price of insulin they can't afford it and people are you know it's life-saving medicine so you know with tools like what amino labs showed us people are kind of bio printing their own insulin and they formed a consortium to do that fully bypassing and disintermediating a major industry and many many more examples of patients becoming what we call patient printers you know these kind of Civic these citizen hackers of their own healthcare ok the next is as an employer some of you might remember when the auto companies were kind of imploding GM was lamenting that for every car that came off the track at their plants they were spending more on health care for their employees then on steel right the journalists were saying GM is a health insurance company that makes cars and every employer including here in Canada is seeing that their ability to have healthy people doing great work is going to be crippled by mental health diabetes and cardiovascular and now caregivers people who are at work but have massive stress because they're also caring for somebody and so we're starting to see employers become healthcare organizations Walmart runs its own clinics for its staff they're not gonna wait for the health care system to keep their employees healthy this is the biggest employer the United States and then like baffled everybody this year Amazon JP Morgan and Berkshire Hathaway who employ 1 million people have built their oh they're building their own health care system and they're decanting all the talent from the traditional healthcare system because it's just not gonna work to try to fix the old health system they're gonna build it from scratch I get super excited about some of what's coming out of here in Alberta you might know the company and live at a Calgary who just spun out well Oh which is you know targeting employers to build all these new tools for them to keep their people health I love their tagline healthy people do amazing things like work that would be a good thing and so they're providing kind of democratized 24/7 access to primary care in your phone at it lower than I spend on my Starbucks coffee every morning and really bringing tools so that employers don't actually have to do it Amazon did and build their own health care company and then finally you know the business opportunities startups are coming in and mocking it on this turf like crazy we're keeping a close eye on all these tech giants that never were a health care company are now getting into the game and I implore you if you're not in health care come partner with us and help us fix these problems and that's certainly what these guys are doing and so I always wonder you know all these asset intensive companies you know that are now you know major players who don't own any assets who's that gonna be for health care and so as healthcare shifts from being about just extending life to having our health span meet our lifespan you know I turn back to our two great Canadians and some wisdom they imparted when Tommy Douglas brought Medicare to North America he had this vision for Canada that the world would look up and see Canada as this jewel on the continent I should crop in orange face into there because I really feel that's his energy and his vision for singularity Canada and I think we do as Canadians have the you know we need to rise up and once again reshape healthcare and take advantage of all this but I think we should also follow the wisdom of Wayne Gretzky who said you know skate to the puck so that's what I want you to do go after these opportunities anticipate what patients need families employers and let's go after these opportunities to modernize health care with all these Exponential's thank you so much have a great lunch [Applause]

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2 thoughts on “The Healthcare Shift – Zayna Khayat I SingularityU Canada Summit 2019

  1. If we are all printing our prescription and recreational drugs we must now add drug dealers to the jobs at risk group.

  2. Obese with a background in health – Check

    Remind me not to trust such an Oxymoron

    Literally out of breath walking onto the stage… WTF

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