Walter De Brouwer is the founder and CEO of Scanadu, a personalized health electronics company.
Walter De Brouwer of Scanadu forecasts how advances in sensing will give access to our personal health feed and transform healthcare.
Interview conducted by Vinod Baya
PwC: Walter, can you please tell us about your company and why you started it?
WDB: Sure. Our company Scanadu is about two years old. We are creating products that empower consumers with medical tools that educate in real time. We were thinking, “What was the last thing that really surprised us in medicine as a consumer?” It was the medical tricorder that Dr. Bones uses in Star Trek to get real-time vitals and a diagnosis on the patient.
At the same time we saw the rise of the smartphone. It was clear to us that smartphone plus consumer plus medicine will be a whole new sort of medicine. What the consumer has now is a thermometer and Google. There is nothing in between. Bridging this gap is what we saw as the opportunity.
Consumers do not have the tools to monitor their health and make informed decisions about when they’re actually sick and need to see a doctor. We want to empower consumers to take control of their health and give them direct access to their personal health feed.
PwC: How will users experience such a device, and how will data be collected? Will it be passive or active?
WDB: I think consumers want their devices to watch them, and not them to watch their devices. So the device must fit seamlessly in their lifestyle. That will come. Rather than a separate device, it will eventually be integrated into the phone. Seamlessness is giving power to the people.
Today we are making a tricorder that will fit in a pocket. In the long term, it will be a tricorder in a chip that we can implant in the environment. And then the next thing will be our medical records in our body, where they belong in the first place. These visions will be solidified in the next 20 years and are certainly what we’re going for.
PwC: What are the capabilities of the tricorder you are building?
WDB: We are designing the tricorder to essentially be a hospital’s clinic in a smartphone. It will have a complete diagnostic experience, because consumers want to play with that and explore their health. We are designing it to be within 1 percent of accuracy and cost less than $150.
The device is a very convergent apparatus and we are building it from the ground up. It brings together sensors that blend technologies from many disciplines. It’s not only electrical engineering and mechanical engineering. It’s also imaging, physics, and molecular diagnostics, because you have to get into wet stuff, too.
Also, we do not expect the consumer to take this device and go to every part of his body to check. You must find one position on the body, and in 10 seconds it must give you all your vital signs. You simply hold our tricorder to your temple, and in fewer than 10 seconds it will be able to read your temperature, pulse transit time, heart rate, and blood oxygenation. It will send the information to an app on your smartphone via Bluetooth.
PwC: Why 10 seconds?
WDB: I was in telecom many years ago, so I will use a telecom analogy. In the late 1990s, we fought about the last mile. The last mile has cost us much money. Every meter cost about $20 million, because you really had to dig in—you had to bring cables to where there was nothing. I now think that we are no longer in the last mile, but we are in the last minutes. This is the instant gratification generation.
People think their microwaves are too slow. One minute waiting is too slow. So it’s about the last minute. If you have a device and you want to diagnose yourself, we think this device should give you all your readings in 10 seconds— actually in 8 seconds, because that is considered the attention span online.
PwC: Why do you want it to be in the smartphone rather than a separate medical device?
WDB: Because when you invite the smartphone, you invite the crowds. And when you invite the crowds, you make it peer-to-peer medicine. With the crowd, in just one minute I get more medically relevant information. That’s peer-to-peer medicine. It is going to change everything, I think.
Also, smartphones today come equipped with many sensing capabilities. A smartphone can be used as a reader that reads molecular diagnostics, the camera in the phone can be used as an imaging device, and your vital signs can be monitored by contact.
The first device maker that brings a health phone to the market will create an avalanche. Everyone will buy it, and all the other device makers will have to follow because it will introduce a new species of devices. But we are a few years away from this.
PwC: Such a device would collect a large amount of data. What are you learning with respect to how large amounts of data will be used in the future?
WDB: The first thing we learned about data is that when it comes to health, population averages are not adequate. Medicine today is mass medicine that is population scaled. At the same time, our vitals change throughout the day and vary from person to person. We each have our personal ranges. Health decisions shouldn’t be based on averages; they should be based on a real, accurate, and personalized health feed of data. Now we have the ability to give that to the consumer.
Another key benefit from a data standpoint is that all the data collected is pre-structured. It’s time-series data that is usable as soon as it is collected. If the data were unstructured or semi-structured, it would be a bigger challenge.
In a couple of years, with several devices on the market, there will be portals for medical data that will offer sandboxes for various use cases. You can try out several models, such as a consumer model or a physician model. People may not understand the mathematics behind the models, but they will be able to mine their health data stream. They will look at it as personal health metrics and use personal health analytics to understand, monitor, and improve their health.
PwC: What is the impact of such a device on the healthcare industry?
WDB: To be successful, we must build a goldilocks [just right] device that is loved by consumers, by hospitals, by government, and by doctors. Doctors should care, because whereas clinical medicine is accurate, tricorder medicine will be a lot more precise simply because we will not test on 100 or 1,000 people in a clinical trial, but on millions.
Out of that will emerge a medicine that is personal and versatile. And therefore people will ask for more advice and talk more about their health, because although we’re all the same, we’re all completely different.
Every government in the world knows that the place of care must be shifted to the home—where it was in the first place—that these hospitals are not hotels, and that the emergency room is not the doctor.
There is going to be impact on efficiency and effectiveness of the industry. The one thing I can say from my telecom experience is that a lot of jobs were lost or transformed all over the world in all the telecoms, not because machines cost less, but because they were more efficient and less prone to error. Every human in the process is an opportunity for error, so telecom companies replaced them with switches. I think the same message applies to other industries where errors can be costly. Machines such as tricorders will help medicine be more efficient and reduce errors. The impact on the healthcare industry will be profound.
PwC: What about identity, privacy, and security issues?
WDB: These are important issues. I agree with Kevin Kelly and his theory that data wants to be common. And that we all should be anonymous data donors. If we are already organ donors, we might as well give our data, because epistemology badly needs it.
On the other hand, you have privacy issues. However, the one thing I’ve learned in telecom and in banking is that there will be frauds. Try to minimize it with everything you do, but you cannot eliminate misuse. Concentrating on perhaps the 0.001 percent of misuse and not looking at the good side of things is also not good.
For the moment, we don’t know what the data actually is and how quickly this data will educate us and how consumers will react to it. But we believe it will be big.
PwC: What you are working on represents a tremendous change. What is the cosmic message for the long term?
WDB: The feed metaphor brings to life a lot of the transformation and change that’s happening. Each of us has a health feed, a time series of our vitals. Today, when we visit a doctor, she checks our vitals and asks us questions. What she sees is a Doppler effect,1 a distortion of our feed, since she does not have access to the full feed. And she is biased by the Doppler effect.
So it is our responsibility to tell her who we are and how we took care of ourselves. That is our full feed. Continual monitoring with devices such as what I am calling a health phone or tricorder makes that possible.
I think it’s a bit like surveillance cameras. In the beginning of surveillance cameras, we thought they would prevent crime because there would be people looking at all the images, and they would act when they saw someone commit a crime. For most of the cameras in use today, no one is watching. But when something happens, we go back and we see what happened. And we try to make sure it doesn’t happen again. This will be the big role of hospitals. They will learn enormously from our feed of data and keep us healthy.
1 A change in frequency and wavelength of waves that results from a source moving with respect to the observer. For example, the change in pitch of a car horn or ambulance siren (sources) as they pass by a spot on a sidewalk (observer). First explained in 1842 by the physicist Christian Doppler. More details at http://en.wikipedia.org/wiki/Doppler_effect.