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Well, Daniel, it's so great to see you. This has been a busy spring. I mean and, of course, we're just done with NextMed Health 2025 in San Diego, which was March 30 through April 2. Let's talk about some high notes there, in San Diego.
Daniel:Yeah. So NextMed Health is a program I've been curating for more than thirteen years, actually. This is our our our program we started in in San Diego in the Hotel del Coronado in 2013, where each year we bring together an amazing community to look at the future of health and medicine at this sort of super convergence of technologies, not just AI or medical devices or pharma or nanotech or biotech, but bringing people together to kind of get a taste of what's now, what's near to happening, and what's coming next, and what's needed to really catalyze the future of health and medicine. And this year, we had over 70 faculty and 25 sessions. So we really covered a lot about what's on the cutting edge and help people sort of catalyze the future of health and medicine.
Moira:Well, I'm gonna ask you about one person that I thought was absolutely brilliant. And, of course, his name is Larry Brilliant. Let's talk about that. He was in several sessions, but let's focus on his message.
Daniel:Well, doctor Brilliant, who's if you're not aware, is a famed epidemiologist. He played a key role in helping eradicate smallpox in the nineteen seventies with the WHO. He later ran google.org. He helped cofound Seva, which has helped with blindness for millions of folks around the planet. We sort of asked Larry as such a bit of a sage to kinda give us perspectives on, you know, how do we meet this current moment?
Daniel:You know, it's no secret that right now in the first few months of 2025, health and medicine and public health are a bit under threat from, you know, challenges to NIH budget to USAID to WHO. And Larry sort of gave us a bit of the perspective. You know, we seem like we're in difficult times. We've had worse times, the Cuban Missile Crisis, you know, World War two. And how do you sort of do well and do good in times that are challenging?
Daniel:And he sort of challenged us all to do, you know, something that helps somebody who's less, capable or or, lucky as we are as we try and make changes going forward. But also the perspective of taking the long view and how do we kind of learn to cross collaborate in challenging times. Because often it's the challenging windows that catalyze the future in unexpected and hopefully positive ways. And so, you know, in the next med health context, we wanted to have the perspective of history, but also how do you shape the future in in really empowering ways with the with our sort of core aim of how do we democratize health and medicine around the planet and make health more health more accessible and more equitable, whether it's rural California or rural Rwanda. And and Larry Brilliant, gave a great sort of lessons in in how to think about that future and how to even have perspective on our challenging times.
Moira:Well, I have to say that, I was especially moved when he talked about what it was like before vaccines. So because so many of those vaccines that we were kids, it's like, look. We have all these vaccines. They didn't always exist, and they were all pretty new and just what it was like to be there and to say we have to do something and then to be able to create them and go in and vaccinate. That's like, we kind of forgot about that, and we were also our expectations were modified given that, we had a COVID vaccine in a year.
Moira:So it's it's pretty easy. It's not easy.
Daniel:It's not easy. And and, also, we're we sometimes have short memories. Doctor Brilliant made the point that in the last century, fifty million people died of smallpox. Now it's eradicated. You know, fifty years ago, people were in iron lungs from polio.
Daniel:Now we have very few cases of polio. But with the changes in perception and some of the anti science and anti vaxx movement, in the last few months, we're seeing the first deaths of measles here in The United States, something hugely preventable. And so, we need to understand that our massive impacts on health span and lifespan are largely thanks to public health. And we need to be, not withdrawing from that, but enhancing our our our systems to both, you know, prevent diseases using vaccines and other measures, but also to think proactively about how do we design and optimize health span, for all of us.
Moira:Well, I have to say you had to do AI.
Daniel:AI or I like to call it more IA. I guess you've heard me say before, more intelligence augmentation. But, of course, a through line from NextMed Health this year was all the ways that AI, which is moving so quickly, is impacting everything from, you know, drug discovery. You know, the Nobel Prize last fall was won for, the ability to use computational LLMs and GPT type platforms to help
Moira:LLMs and GPT. Yeah. Yeah. Large language models and Yes. Chat GPT kind of things.
Daniel:Right. Where you can sort of probe load up your protein and potentially find understand how it folds and how you might identify particular drugs or molecules that might act as a a drug against those sort of targets. So we're really starting to speed up the ability to not in the old ways of screening thousands of molecules, but design the molecules using AI machine learning that might fit a particular protein or mechanism to start to cure diseases, in much faster and personalized and precise ways. So that's a bit of a through line. But what I thought was most interesting is now the ways that AI is enabling us to take all these new omics sets.
Daniel:Right? It's not just the genome. It's now the metabolome from a continuous glucose monitor. It might be the low cost proteome. It could be your sociome data, your digitome data from your smartwatches and wearables.
Daniel:And now we're able to start to put those together and be empowered. And one of my favorite talks was by he's a technologist turned patient named Steven Brown. And Steve had been in the med tech space twenty years ago and got back into it recently because, unfortunately, he was diagnosed with multiple myeloma. And he shared the story of being diagnosed with myeloma and how long it took for him to get diagnosed even though the doctors had his labs. He built his own sort of health agent.
Daniel:He's a super programmer and AI expert. He built sort of a Hippocrates and also his own virtual hematologist and cardiologist who looked at his data from before this diagnosis and said, oh, of course, you should get a bone marrow, and this looks concerning for a malignancy, in the marrow. And just as an example, if we're entering this age where you're gonna be interact with different agents of different specialties, it could be the overall master clinician like Hippocrates, it could be a nutritionist, it could be a workout coach that's gonna interact with you as a very smart agent, can leverage all these new LLMs, large language models from multiple sources, and really give you a new level of interaction. We're not waiting months to see the specialists, and will enable all of us to be much more proactive and engaged in our health. Where I think that's gonna head in the next couple years is we'll all have our own sort of self agents tuned to our age, our culture, our personality.
Daniel:I like to call them sort of, generative health. And these will be super tuned, they'll hopefully be proactive and preventative and keep you on track to a long lifespan and health span. But also when you do have a disease, we'll be able to sift through the data and pick it up early proactively and then guide you and your clinical teams to make the smartest, most personalized health recommendations, whether it's for something really challenging like myeloma or something as common as a sprained ankle. So really interesting ways that we can start to bring massive data to insights to something you can use in action on yourself.
Moira:And what I like about this is the idea of plug and play. Like, well, I'm really concerned about my voice and whether for me, there's a lot of recordings in my voice. You could tell the difference between it now and it thirty years ago if you wanted. But what is it now? We can tell things in your voice.
Moira:We can tell things in in your gait and how you walk. And for those things that are of concern to you, the ability to bring in those things that are of concern as opposed to, well, this is sort of imposed on you and all this is going on. That's fine when you're, like, you're in trouble. But the idea that you could decide that in your in your everyday life about what you want checked with the intelligence that's now behind it.
Daniel:Right. And that can almost be seamless. So the things you've just mentioned, your voice is being recorded all the time whether you want to on your smartphone or on a podcast. And we actually had a great session, led by the team at Click Labs, where they just recently published that the sound of your voice, the voice is a biomarker. They've been able to leverage to predict who has diabetes, who has early prediabetes because of high blood sugar or might even have diabetes and not know they have it, just based on the the AI analysis of your voice.
Daniel:They're also doing similar work where their voice can predict if you have high blood pressure. And also other folks have shown that voice biomarkers can predict predict early signs of neurologic disorders like ALS, Lou Gehrig's disease, or early forms of Parkinson's. So that's something that we're collecting ubiquitously and can be used for proactive early detection. Another example, talked about gait. Well, our smartwatches, our smart rings, our our Fitbits to beyond actually able to look at your gait and see subtle changes.
Daniel:In fact, on some platforms, it can tell you if you're likely to, have weakness in one leg or likely to have a fall. And so there's even this idea of mobility as a new vital sign, which really correlates to health span, risk of a fall, breaking a hip, for example. And so those are small examples of small data collected in interesting ways when you put them together in context, will start to give us our sort of health agents that will give us proactive warning and, early intervention.
Moira:Now I gotta say I got a lot more on my list, and I'm hoping you'll come back, with an another one of these next week. And in the meantime, it seems to me that you have a video of some of, the people who were speaking online. Isn't that right?
Daniel:Yes. If you go to nextmed.health and you look under videos, you can see our catalog of a lot of the talks from our prior NextMeds. We're starting to put up put up some of the new talks every week from this year's. It's a great place to get up to speed on all the things that are happening that are impacting health care. Again, not just the high-tech, but we leverage in design thinking and creativity, the sort of social determinants of health, health access and equity, is, I think, something that technology and getting everybody in the loop on can really expand where and how we do care.
Daniel:And, again, I think that's a theme of bringing the future of health care to everybody, not just the super rich who can afford, you know, all the screenings and and new drugs, but to bring it to, for example, Nigeria. We had doctor Yomi, who's a physician from Nigeria, who brought the sort of lesson of you don't wanna just drop off a technology in Africa and say good luck. You wanna teach the folks there how to innovate and leverage and come up with their own solutions, often leveraging technologies. And in many cases, these technologies are leapfrogging what can happen in The United States and let's say Europe. They can go to Africa.
Daniel:They can go to India and be implemented. A small example is a company, called Jivi dot ai, which is an AI doctor in your pocket. Launched in India, available here now, where you can talk to it in Hindi or Farsi or French, and you'll have an AI clinician sense that can help triage you. It also can be a health coach for your nutrition. It also uses the camera to track your vital signs.
Daniel:So these are things that are often going to places where there almost is no doctor available, and it's gonna start to help, democratize care around the planet.
Moira:Nextmed.health. And, hopefully, you'll stay healthy. I'll see you next week.
Daniel:See you, Moira. Stay healthy.
Moira:Okay. Good. Now we'll go back and do another one.
Daniel:Yeah. That was a good riff. I mean, we we flowed okay, and there's so we just barely started it.
Moira:Slow you just you just slowed down and flowed great. And yeah. And so let's go to this will do
Daniel:Let's do one where we could talk a little bit about the the biotechnation session a
Moira:little bit. And health access and exhibit exhibitors. So
Daniel:Exhibit I think maybe we do kind of the maybe a little bit on on the brain and, you know, brain and neurotech because that people
Moira:want to couple of examples. Okay. So brain neurotech, health access, biotech, exhibitors, oh, and awards.
Daniel:Sneak in. I wanna sneak in I wanna sneak in Dean Kamen and the fact that we had Eric Trouple there. On women's health, we've talked about the women's, health span and women.
Moira:What about Dean Kamen?
Daniel:So I just wanna sneak in that he was there, in some form.
Moira:Yeah. He's been such an such an enigma with me. I have been with him. Teresa Hines and, I mean, all of these places I have been with him. I didn't know whether he doesn't dig me or he doesn't like women engineers, which is hard to believe, or he just I have no idea.
Moira:And it's like, I'm done begging him for interviews. Not gonna happen. And yet I've been a a judge at first. You know? I've been
Daniel:Well, I could certainly
Moira:Don't don't don't do it. It's don't do it. Too many people have tried. And, if he wants to, he knows where I am. He runs into me enough.
Moira:Gotcha. You know? I gotta run into him three or four times a year. And so at some point, he's gonna go, you know, this would be good. It's like, alright.
Moira:You know where I am. We'll we'll
Daniel:we'll we'll feature more of the army stuff with Jan McDonald and just mention that Dean
Moira:was there. No. No. We can know. Should do it exactly the way it is.
Moira:I was just telling you. Yeah. This is why. It's like, hey. Aren't you gonna interview?
Moira:Most people are like, yeah. No. Or wait a minute. And it's like, I've I've finally gotten it, Dean. I don't know.
Moira:There's something you do that we beg you or we're not doing it the right way. So I was like, fine. And, it's like, enough is enough. You know? If it was if it was Elvis, I'd be, you know, begging.
Moira:Elvis, you're back. It's biotech stories. Academy of biotech stories.
Daniel:Well, I think when he's got something to sell, like his new insulin pump or the the Daisy, you know, vaccine patch, Maybe that's the right angle on it. I don't know because he can cover so much.
Moira:He can cover so much, but I didn't know. I didn't know what it is. I don't I can't tell him I'm an engineer any more times than I have. You know? Okay.
Moira:And I was like, what are you gonna do? Okay. So which one should we start with?
Daniel:Let's start with the the the biotechnician part because that's that fits in.
Moira:Great. That's good. Well, Daniel, I'm so glad you're back.
Daniel:Always good to be back.
Moira:And, you know, last week, we were talking about, NextMed Health, 2025, which is just in San Diego April, May year. And, I wanna talk about the best session there, Biotech Nation.
Daniel:Well, of course, I'm not sure how I came up with the name for that amazing session that you were so kind enough to help curate and lead. But I I thought that was brilliant because it it kinda highlighted three very different but exciting areas of health and biotech. And maybe we can mention each of them briefly, and you can chime in since you were
Moira:I was there.
Daniel:Yeah. The first was a great talk by Hans Kierstedt, who's you know, a stem cell biologist and entrepreneur. He's also the CEO of something called the Human Immunome Project. And you've all heard of the genome and maybe the proteome, but the idea of the immunome is it's not just your t cells and your b cells, but what's happening with your adaptive immune system, what kind of t cells, what kind of b cells, how you might respond in a dish to a virtual vaccine, or how might, how quickly you might respond to a therapy for a cancer. And what's fascinating, I think, about this human immunome project, it was starting to characterize this at the human scale so that we can understand where someone's immune system is, how it might be responding or not responding to disease, how it can be improved to prevent you from getting sick, or how it can be leveraged, for example, in the amazing world of immunotherapy for cancer.
Daniel:So that's a whole interesting area. And he's developing a second technology company called Immunus and, using the secretome of progenitor derived from stem cells that seem to interact with the immune system and can help impact metabolic disease and maybe even help rejuvenate, tissues like muscle. So pretty exciting era in the immunologic space. What what do you think?
Moira:Now what do you I don't even know how to spell secretome, and I was there. How do you spell it?
Daniel:S e c r e t o m e. And it's this idea that a lot of, particularly, progenitor and some stem cell populations secrete a fair amount of sometimes very unique molecules. And no one molecule by itself is probably most efficacious as a therapy, but when you put them together, a bit of a gimmick, as I call it, that sort of cocktail in combination, is most biologically active. And so that's being actively looked at in the setting of now early human trials and might be, something quite impactful across many disease states.
Moira:Well and I think it's also important to know that Immunis, the the latter one, is a for profit. It's a company. He's he's built and sold and developed all kinds of companies. But the Human Immunome Project, that's a nonprofit. That's meant to bring this all together for the benefit of humanity.
Daniel:Right. Just like the Human Genome Project kicked off our ability to first with a few dozen individuals sequencing their genome. Now we're at millions of folks getting sequenced. The price of sequencing is down to about $80 today from companies like Ultima Genomics. You know, it's when you put these things together.
Daniel:I I think of, you know, a bit of a theme from Nexman Health is this idea of multi omics. We had Eric Topol there as one of our keynotes in a session thinking about the future of smart aging. And any part of health now is gonna be most informed by layering up different forms of information from your immunome to your secretome and to to your genome to your proteome. And that's where we can start to build our sort of future digital twin, interact with that through avatars and agents. And it's gonna really be a game changer for being proactive and preventative rather than reactive.
Moira:One thing that was exciting for me in the biotechnation session was that we're always talking about, well, let's, maybe we can, make this treatment, and it'll be one done. You know? Something will happen. It'll really actually treat somebody, and we met somebody.
Daniel:Yeah. We had, my friend and colleague, doctor Patrick Heinz. He's a pediatric ICU doctor who's been very involved in, developing therapies and tests for sickle cell disease, which is many of you might know is a genetic disease where the hemoglobin can sickle and cause a lot of pain crises and often early organ failure and death. It's a really crippling disease. And he's what was interesting about Patrick is last fall, he was on a fundraising expedition to climb Mount Kilimanjaro, which is in Africa.
Daniel:It's a very high mountain. You have to be fit and in shape. It's pretty high altitude. But he brought with him, a colleague named Jimmy, and Jimmy was able to summit Mount Kilimanjaro with him. And what's unique about Jimmy is he had sickle cell disease until a few years ago when he was one of the first to get cured, one and done, using CRISPR, taking out his bone marrow, blood forming stem cells, using CRISPR based technologies to reprogram those stem cells so they have normal hemo more normal hemoglobin.
Daniel:And now, incredibly, he can go to altitude and, is functionally
Moira:Hike around. Yep. So it's an What? That's Couldn't get out of his chair. Yeah.
Moira:And now he hikes around on Kilimanjaro.
Daniel:Well, many sickle cell patients can certainly have healthy windows, but there's an incredible human story. Alright? It's amazing to talk about CRISPR and it won the Nobel Prize, and Jennifer Dowden and colleagues have done incredible work. But to see an actual person whose life has been transformed and and cured, and now we're looking at using CRISPR to potentially cure thalassemia, maybe even HIV, and and even remote settings. And so we're seeing kind of the impact of that at the human level.
Daniel:I thought that was particularly impactful.
Moira:That's great. And then there was a final contributor to that session, which was interesting because it was nonmilitary, but also military. Let's talk about that.
Daniel:Right. Doctor Jennifer McDonald, is the lead one of the leads at a group called Army Advanced Regenerative Manufacturing Institute that was cofounded by, the amazing engineer Dean Kamen, was also with us at Xmed Health. And Jennifer kind of showed us the art of the possible, and, you know, we talk about stem cell and regenerative medicine and cell therapies. But the challenge is often those are very bespoke. You need a postdoc in the lab under the tissue hood trying to glow the cell culture or build a three d structure to make a new meniscus for a bad knee.
Daniel:And what they're building is sort of meeting biology and engineering at scale so that we can take some of these even, you know, cell therapies and immunotherapies for for cancer all the way to building new three dimensionally printed organs like lungs and maybe hearts and kidneys and do that at scale. And, of course, sometimes in military, which should help support army, the institute, are help helping fund this, but they are partnering with academic and other members around the country and the globe to sort of become that kind of engineering hub to really scale regenerative medicine. So I think that's a really exciting direction for for the future.
Moira:Well, thank you, Daniel. See you next time.
Daniel:I'll see you next time. And for folks who wanna check out some of the talks from NextMed Health, just go to nextmed.health and look at our videos. We've got a lot of amazing content, and I would encourage everyone listening to be proactive about their health. And if they see a challenge that they wanna solve, become futurists and help build the solutions for for health care for for all of us.
Moira:Right. That's nice. I'm just trying to think if we should just do a neuro one.
Daniel:Yeah. We can do one that doesn't have to be so NEXMED focused, but we can mention some of this
Moira:was Yeah. That was, like, the two things. Yeah. Oh, yeah. These are what was here.
Moira:I didn't mean to hog it with the broad biotechnation, but it's a good one. Let's just do a dural a neuro one. Sure. And then we got three in the can. Are we getting to see that?
Moira:Three in the can? See
Daniel:that? Three in the can instead of saying in the can.
Moira:Any number in the can. It's just my hands. So I go three three in the can. Don't count. Don't count on my fingers.
Daniel:Okay. I'm I'm I'm looking at my screen, so I'm not seeing you. So if you're rolling three, wasn't seeing you.
Moira:Okay. You wanna do it wanna think about what you wanna do here, and I'll
Daniel:I think we'll kinda I'm trying to I think a little bit about brain computer interfaces. And so we had Max Hodak from Science Inc. We had Mehron Gerberts from Inner Cosmos, and I wanna mention Meredith Perry and Ella Mine for sleep. And then
Moira:You know what? That's about what they can handle.
Daniel:That's about three? Okay.
Moira:So you can look at more and substitute that.
Daniel:I'll skip that sleep one. I'm gonna go to the brain computer interface side, and then the noninvasive approach, which is this company called Ampahealth, which is using transmembrane dextimulation to cure depression. So those are three that's a good riff.
Moira:That's a good one. And if we can get them to go out every so often, we'll get them to go out. I'll even mention it. It's like, oh, don't forget to look at the videos out there because you let them out one at a
Daniel:Yeah. They're not they're not all these don't all be out, but maybe I can try
Moira:But that's it. But they see the past ones Yeah. And they'll start to see if we're talking about something, in likelihood, they'll go out. So, you
Daniel:know Exactly.
Moira:While it's the completeness is good in math, it's sometimes bad in bad in audio. Okay. Alright. Daniel, good to see you.
Daniel:Great to see you. It's on radio, but I can hear you great.
Moira:Just definitional. Definitional. Say, there was so much for a while there on brain computer interfaces. And, obviously, it's gonna it continues on, but I wanna know a couple things. I want the essentially, just two.
Moira:I wanna know something that is implanted in my brain, and I wanna know something that's outside my brain. And you can even do more than two if you want.
Daniel:Sure. Well, I think we all are excited about our sort of age of neuroscience. The brain is still our probably most important organ and least understood, but where technology is starting to meet neuroscience and neurotech is really enabling some almost magical capabilities. You know, we've now seen examples of brain computer implants that enable folks to think and to speak who lost their ability to speak being locked in from a stroke or, things like Lou Gehrig's or ALS disease. We were both recently at my NextMed Health Conference, and we had several sessions touching on the future of neurotech.
Daniel:One of our exciting sessions was on the future brain computer interfaces. We had Max Hodak, who was the cofounder of Neuralink, which is a well known company, but has switched gears to a newer company called Science, science dot x y z. And they're not trying to build those sort of metal, you know, little postage sized plants, implants on the brain surface. One's called the Utah array. They're trying to build, and they are building, biohybrid neural interfaces with the goal of sort of fusing these sort of brain computer bases that are built with biology, built with neurons themselves that can last for potentially years or decades, kind of redrawing the boundaries of the brain.
Daniel:And, it's exciting to see that enter the clinical space. They've already even had some demonstrations in making that work to help, folks with blindness see. So, there's really kind of a new engineering of neural interfaces meets brain computer interfaces. That still takes something like a surgery to get them on the brain, but that's exciting. We also saw a different example, being applied in early trials today as well from a company called Intercosmos.
Daniel:An entrepreneur named Marron Gruberts has been developing with neuroscience and neurosurgeon colleagues a small implant that goes underneath the skin in the brain and can direct, some ultrasound to an area of the brain that when you buzz it with some ultrasound seems to be able to negate many forms of depression. And so that is a exciting potential, you know, relatively minimal implanted, brain computer type interface.
Moira:Hey. We're we're halfway. We're halfway up.
Daniel:That might be helpful for many folks with intractable, depression. And speaking of mental health challenges and brain computer interfaces, I think a really exciting area is how do you do that without any drills or any surgery? We heard from a company called Ampahealth with the CEO. It's a neuroscientist named Don Vaughn. They've been advancing this field of what's called TMS, transmagnetic stimulation, which is not a new technology, but usually requires a fair amount of capital equipment.
Daniel:And patients often with severe depression have to go in for a thirty day protocol where they have magnets essentially stimulating certain parts of the brain. There were often a month long protocol seems to be quite effective at reducing chronic depression. What they were able to innovate is to create sort of almost a handheld, almost iPhone type version of a mobile version of TMS that can be deployed almost anywhere, maybe even eventually at home, and develop a protocol in combination with what are called neuroadaptogens for a one day protocol, which in their first clinical trial of, I think, over sixty patients with, rare recalcitrant depression cured most of them, almost eighty percent for almost a six month period. So that's an example of a
Moira:Wow.
Daniel:Brain interface stimulation that might be a whole new modality that's gonna be impactful. And it may have a role not just in depression, but in everything from addictions to, brain, traumas. And so I think those combinations of new ways to bridge and blend technology with the brain, both on the surface and inside and on the surface of the brain, are really gonna be exciting.
Moira:Well, I have to say, seldom do I ask people one question and get a really great answer. So you win.
Daniel:What's what's on your mind today? You know? But these technologies, by the way, are somewhat coming to our home. You know, one thing that's super important to our brain health, and I I think there's a new framing instead of, you know, mental health and, you know, neurotech, this idea of brain health that we can take technologies to both treat diseases like Parkinson's and hopefully Alzheimer's, but also think about ways to optimize our brain health and health span. And one example we had at NextMed Health was a, entrepreneur named Meredith Perry who, along with technology from MIT, from Ed Boyden's lab, is developing a technology called Elemind, it's a wearable EEG.
Daniel:I've been trying it myself. You wear it when you're asleep, and the sensors there listen to your brain waves and play a feedback loop, some sound that, at least in the early studies, lets folks who have trouble falling asleep fall asleep much faster and potentially can be used to sort of hack our sleep, and improve our deep sleep and our REM sleep. So early days, but some of these technologies aren't gonna be just for the sick care side, but maybe the brain health care side of the equation. And, these are things you can start to try out yourself. Sometimes the jury is out on the long term studies, but I think it's exciting that consumer tech is starting to bridge with home tech.
Moira:Once again, I wanna give a Tech Nation, Biotech Nation award to your wife with you go to bed with all these devices on, and now you got a sort of this EEG number going on. She's such a lovely woman. She puts she puts you even had her Fitbit on for a while. I I don't know what to say, Daniel.
Daniel:Exactly. Well, I've got my Oura Ring and my Whoop and my Apple Watch. I'm I'm scoring and quantifying my sleep in all sorts of different ways, and I'll take whichever one gives me my best sleep score each night. But, it is an example of of how we can start to measure things that used to require sleep lab just from a a consumer device and and, start to help optimize our brain health, and and there's many ways to do that. Again, our colleague we know, Dean Ornish, has been showing that lifestyle interventions, exercise, diet, connection, meditation can even start to reverse, you know, early forms of Alzheimer's and dementia.
Daniel:So it doesn't take fancy neuroscience to often impact our our our brain spaces.
Moira:But it takes a very understanding life. Okay. Alright. Enough of that. Enough of that.
Moira:Thanks so much, Daniel.
Daniel:Thanks, Moira. And if folks wanna take a look at some of the content on neuroscience and beyond, they can go to nextmed.health and catch some of our videos on the future of health technology and medicine.
Moira:Great. Perfect. Alright. That's good. Three three nice ones.
Moira:Three nice ones. Is that good enough?
Daniel:Well, we're here. We might as well think of what is
Moira:the story. The energy, I got the time. Alright.
Daniel:Yeah. Let's see.
Moira:Let me just look
Daniel:at it. Wanna talk about the future. I wanna talk about that, Larry, you weren't there that session, but smart patients, on the future primary care and the future of the sort of medical work. Like, it's a it's a bigger question, but it's we have Larry Smarr there. You know Larry Smarr?
Moira:Of course. I didn't realize he came this year. I guess he comes every year.
Daniel:He was there the last day with his son, Benjamin Smarr, and, their primary care doctor named Michael Cariso, who takes care of both of them. And we talked about this, you know, what's it like to take care of two of the most quantified guys in the planet. Ben Smahr actually did the studies at UCSF on the Oura Ring, you know, for looking at, you know, COVID and things like that. So I think a little bit about the future of smart primary care could be a fun session.
Moira:Okay. We can do that. Sure.
Daniel:Okay. Alright. That'd be I I think that's a that's a fun one.
Moira:Here we go. Okay.
Daniel:And then I can riff into that. What's the future of the workforce? So maybe you can ask a question. What does it mean? Who who gets to be a doctor next?
Daniel:How do we train them? What what's what's that Yeah.
Moira:Wait a minute. What are these doctors? Yeah. Okay. Well, hey, Daniel.
Moira:Great to see you.
Daniel:Great to see you, Moira.
Moira:Now I have to say, we always talk about all this technology. You can do this. You can do that. But we never actually expect maybe to go to our doctor's office, and the doctor says, okay. Now you're gonna do this and this and this, and he's gonna be all over this technology for you.
Moira:It's like, is that possible?
Daniel:Well, most doctors today, including myself, are often sometimes feel like there's a lot of technology available, but it still hasn't met the clinic or the hospital room or the ICU. We're living in this age of incredible possibility, but translating that to the bedside or the website, to the next generation of medical students and nurses and pharmacists is often a bigger challenge than technology. But it's starting to creep in. Right? We've talked in many sessions about artificial intelligence and how it might even be malpractice for your doctor not to have used the AI to help do a diagnostic workup or pick the right therapy.
Daniel:And we're starting to see some innovative physicians start to really kind of plug in the available technology and help catalyze the next generation technology to do, for example, smarter primary care. So I'll give you one example. At NextMed Health twenty twenty five, we had an amazing session with a primary care doctor named Michael Carrizo Carrizo, and he has two of the most incredible patients. Larry Smahr, who is a distinguished Emeritus professor at UCSD. He founded the California Institute of Information Technology.
Daniel:He's the most quantified guy in the planet. He got very into moving from astrophysics to his own biology and tracking almost everything about him. And and Michael is his doctor, which is an interesting challenge. He's also the doctor for Larry's son, Benjamin Swire, who's now also a professor at UCSD, who's been leading a lot of the work on using consumer technologies like smart rings to understand physiology of diseases like COVID, and even pregnancy. So I had them come together to go, how do you build the primary care clinic of the future, and how do you, as a clinician, as a patient, start to interact with all these massive forms of data to make it useful for care?
Daniel:And so what they've been doing is they're already super quantified. They're taking what I think is gonna be the the future of primary care and health care is long term data looking at someone's baseline information, where their resting heart rate is, how they're sleeping, what their heart rate variability is, their temperature, their movement, for example, and be able to make that part of your continuous physical exam and enabling pathways for that information to flow from someone's Apple Watch or Fitbit or AuraRing or Samsung Ring. Pick your technology. What they're enabling is to have that data flow come into the workflow of the primary care doctor because no doctor, nurse, pharmacist, physical therapist wants to see all the data from your wearables and your otherables and your genomic information, etcetera. They want the actionable information.
Daniel:So part of the future primary care is just gonna be somewhat continuous. We'll have, as we talked about, agents that might work in partnership with your medical team, helping to look after you, but plugging back in your primary care doctor to interact with all these new forms of multi omics to really not just be waiting for you to show up with a disease, but working with you collaboratively to optimize your health span, optimizing diet, what might be the the best workout regimen for you, and nutrition. Being able to find through your convergence of data when something's a little bit off before you end up with an advanced cancer or develop full on diabetes or develop a neurologic disorder. So it's a really interesting time to think.
Moira:Or why are you walking around with a 105 degree fever? Don't you know you have it? No. I don't. I just don't feel good.
Daniel:Yeah. We'll be able to quantify what what not feeling good is. A lot of things are subjective in health and medicine, you kinda get what you measure. And now we have lots of new ways to measure, disease and in new ways. Right?
Daniel:You know, the average temperature for most of us is not 98.6, which people seem to think is it might be the average temperature, but none of us are very average. And so as we go into the future of primary care and specialty care and AI and agentic enabled care, this idea of precision and personalized medicine, how do you look at someone in context of their data, not just the average datasets? And and how do you integrate that into workflow of a primary care doctor or specialist or the AI agent that's gonna be more and more involved in our our continuous medical monitoring and and therapy?
Moira:Well, if all of this technology is going to our doctors, what might our doctors look like? Are they gonna change?
Daniel:So as we think about these technologies enabling not just the doctor, but the community health worker, the nurse, the pharmacist, your physical therapist, your nutritionist, kind of upskilling almost everybody to leverage new forms of data insights. Often, you know, we're all starting to go to doctor GPT. Used to be going to doctor Google. That means our sort of pathways of care, our ability to do self care are changing. How we interact with our primary care doctor or specialist if you're lucky enough to have one if you need one.
Daniel:So that begs the question of, you know, what is it like to set up a clinical practice of twenty thirty five or twenty thirty? How do we take the medical student who today in 2025 won't finish medical school for four years and residency for another three? So they're not gonna be even be done with their basic training until 2033. How do you educate, you know, a medical student or nursing student today to be ready to integrate digital health, AI platforms, new forms of digital therapeutics, n of one drugs, the smart hospital to home movement where care is gonna move from the hospital increasingly to your own home, or remote care, or phygital, meaning blending physical, virtual. How do you teach good website manner, not just good bedside manner?
Daniel:Those are questions I don't think we have answers to, but I know that we do need to rethink our medical curriculum for medical schools. There's some of you may have heard the Flexner Report, which is from the early nineteen hundreds, which reframed how we do medical education. We most need a Flexner report two point o or three point o to make sure, you know, building those bridges to the future because things are moving so fast. The skill sets that clinicians are gonna need and who you select to be, the doctors, nurses, pharmacists of the future needs to be reimagined as well.
Moira:Well, this is such a huge topic. I can't wait to talk to you about it in the future.
Daniel:Well, we'll definitely talk about the future. And I think the challenge for all of us is to realize that the future is coming faster than we think. And in many cases, you don't need to wait for some of the future. You can be proactive. I've been building a database of medical solutions called digital.health.
Daniel:It's a website you can go to. And if you have a particular clinical challenge issue as a patient, as a clinician, as health care systems, you can find some of these existing solutions that aren't the future. They're here today. Our challenge and opportunity is to bring them into our health care workflows, align the incentives, to not wait for the future to happen, to but to enable us to catalyze it here today.
Moira:Great. Alright. Well, thank you so much.
Daniel:Thanks, Myra.
Moira:Super. Alrighty.
Daniel:Sorry for that plug. I just thought I should say that.
Moira:Well, what I'll do is I'll check I'll check out I'll check out if we can use it. This is
Daniel:Yeah. It's not I it was a
Moira:little There's well, the thing is I just listened. I I listened. It's like, no. No. Go for it.
Moira:Do do it the and you did it the right way. And I was like, okay. Great. And I could I could find out whether we have we can take it. We can if we can use it, we will.
Moira:If not, we'll just we're able to excise it. You see, you're a professional now and had a
Daniel:Yeah. Well, people plug in their companies all the time on your platform. I'm not plugging. I'm just saying it's a resource.
Moira:Yeah. They're not our they're not our chief correspondent.
Daniel:True. True.
Moira:True. That's true.
Daniel:Okay.
Moira:Instead of a say, it's like, actually, if let's say IBM was giving me, you know, a dollar or a million dollars to say, you know, underwritten in part by IBM, I couldn't interview. So we're giving you the you you got that line we're walking up to. So we'll it worked out. Don't worry. I'll check it out.
Moira:We won't get in trouble. So hey. Okay. Thank you so much. Don't move any mic.
Daniel:Okay.