Friday, October 30, 2009

TED MED 2009 continued................

Marc Hodosh says TED MED is "about celebrating scientists and engineers and people who solve problems"... indeed there are extraordinary people at TED MED who have solved many many problems.
Below are a few representative synopses of key themes from the conference.....


A chord was struck by John Abele - co-founder of Boston Scientific who described the lack of collaboration in medicine - he says the word is over-used and in the medical dictionary there is no such word. John has bought the KingBridge centre and turned it into the

Kingbridge Collaboration Institute
Building Collaborative Cultures and Leaders

OK....... - this is interesting for pharmaceutical companies. Are we amongst those who use the word and don't actually practise?


There was a good degree of outrage by a notable cancer patient, Laura Ziskin and specialist doctors like David Agus (Professor of Medicine at the Unversity of Southern California) that we are not winning the war on cancer because we are not capitalising on what is available. David has founded and Navigenics. David has figures that say the death rate is the same today as it was 30 years ago. He wants to see the integration of the informatics and genetic information that can be gleaned today into the practise of medicine...NOW. Laura has founded Stand Up To Cancer which raised $100mUS and distributes this money to researchers with tough timelines for delivery according to the collective wisdom of the dream team of cancer specialists 'Blue Ribbon Committee'. The objective is to bring products to patients in 3 years!! There are smaller grants available for young inventors also. Bart Kamen (CMO from Case
Western Reserve University in Cleveland, Ohio) advocates treating the "whole patient" who has cancer and is an advocate of chronic regimes of therapy. We saw the power of driving behavioural change for young patients to ensure compliance on longer term therapies ie. following ALL (typically striking young teenagers who strive to get back to normal living and who risk relapse with poor complicance). Video games are showing great promise to influence behaviour - preventing relapse in half of the usual 20% of patients who relapse. David Ornish - frequently on US television talks about the proven impact on our gene expression profile of healthy living and eating - supporting our ability to influence our state of health directly with our lifestyle.
The future target for cancer treatment is the cancer stem cell - this is a growing agreed strategy and Keith Black of Mount Sinai Hospital where he is a brain surgeon is an advocate of cancer vaccination. He says that cancer stem cells are immunogenic and spend much energy in strategies to evade immune surveillance. His clinical work and interest is in the interplay between the immune system and medicine, for example how to work with chemotherapy and vaccination in unison. He said that Viagra has been shown to improve penetration of chemotherapy to the brain. He describes microwave technology also to minimise invasive surgery and showed remarkable tumour regression in a patient with this technique of both the primary treated tumour and a further tumour adjacent to the treated site which he attributes potentially to stimulated immune surveillance.
Continuing the theme of Non-invasive surgical procedures
Rick Satava, a US Army Medical Advisor described and showed pictures of the first full apendectomy, non-invasively performed through the mouth. Rick is acclaimed through his work with the Army to have great insights into future technology and it's impact on medicine. He is an advocate of simulation and believes that simulation systems of the human body should be more advanced today than they are - he interesting and challengingly says that the pharmaceutical and healthcare industry is the only major producer now that does not have a simulation of its target (the human body). Rick is an awesome mine of information and a challenging disrupter of the status quo. He also talked about a femtosecond lasar that can remove perform single gene manipulations and how we can now put animals into suspended animation for up to 6 hours - in which time they cannot die as they are technically not alive in this state by our criteria. They can be brought out of this state and are fine. Scary stuff and as he so correctly describes each advance brings moral and ethical questions and ultimately decisions.
We are what we eat

You have to view the wonderful pictures of Peter Menzel and his wife Faith D'Alusio following their round the world trip to photograph families and their food. Peter describes how they will try all diets but amongst the most concerning and stomach churning was beef from the high intensive farming practices of Texas. We are not progressing but regressing....

A key theme is to eat naturally, non-processed foods and to stop eating when you are 80% full and let the food enter your body and give the right signals. The growing obesity epidemic in the world and in particular it the US is a cataclismic disaster for healthcare and future generations' well being.

Behaviour change towards integrative medicine
TED MED 2009 vision....The future will involve and integrated healthcare system. One with empowered patients, who are in possession of their own data, accessed by their mobile phone. They will take care of their life style and choose to look after themselves and monitor their health. When in need of treatement they will choose their physicians and their doctors will be part of a team who are intent on treating the whole person, not just their cancer, but their mind and whole body.
This was the vision expounded by so many speakers and attendees. However Ezekiel Emanuel, brother of the Chief of Staff to President Obama's administration, is skeptical. Cautious and even, perhaps "silenced" on the topic of healthcare reform, it was evident that today's reality of getting heathcare to the masses is not a vision facilitated and supported by future technology and a mass of empowered and educated people who will act responsibly. For me this was a disconnect between the TED MEDsters and the reality and complexity faced by today's leaders. TED MEDsters are self selected, relatively wealthy, educated people and the enjoy visionary worlds. The are not wrong about the possible future but have some way to go before the future is a reality and the technology must keep coming in order to make it accessible to the the world at large.

'Business model malpractise'
Finally I need to mention Jason Hwang, Executive Director of Innosight Institute in San Francisco. He used the term "Business Model Malpractise". It is an a challenge to the way we think and is applicable to the pharmaceutical industry as it is to the whole healthcare system. He said that barriers we are experiencing today (as illustrated by the disconnect of the vision and the potential described in the previous paragraph) is because we are trying to fit new disruptive technologies into old business models. An example is that we feel we should have all our healthcare delivery eminating from one place - the hospital - this is not necessary or even desirable in the future yet we persist in building new large hospitals - when perhaps small local community clinics will be better. This is really food for thought for all business executives across possibly all industries at this time - but never more so than for those involved in healthcare and, I would argue, pharmaceuticals.
I have to stop there because you need to be at the next TED MED to get the full breadth and depth of insights and challenge. You can always ring me or write and ask for more........ Thanks for reading this far.

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