TEDMED 2015
Todd Coleman: A temporary tattoo that brings hospital care to the home
Todd Coleman: Privremena tetovaža koja bolničko liječenje donosi u vaš dom
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Što kad bi liječnici mogli pratiti pacijente kod kuće s istim stupnjem točnosti koju bi oni dobili za vrijeme boravka u bolnici? Inovator bioelektronike Todd Coleman iznosi svoj cilj da razvije nosive, fleksibilne elektroničke naljepnice kojima se vrši zdravstvena kontrola, koji obećavaju da će revolucionirati zdravstvo i učiniti liječenje manje invazivnim.
Todd Coleman - Bioelectronics innovator
UCSD bioengineering professor Todd Coleman integratively spans the disciplines of medical electronics, machine learning and public health. Full bio
UCSD bioengineering professor Todd Coleman integratively spans the disciplines of medical electronics, machine learning and public health. Full bio
Double-click the English transcript below to play the video.
00:13
Please meet Jane.
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Molimo upoznajte Jane.
00:15
She has a high-risk pregnancy.
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Ona ima visoko rizičnu trudnoću.
00:17
Within 24 weeks,
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U 24. tjednu trudnoće
00:19
she's on bed rest at the hospital,
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ona je na mirovanju u bolnici,
00:21
being monitored
for her preterm contractions.
for her preterm contractions.
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pod nadzorom zbog
prijevremenih kontrakcija.
prijevremenih kontrakcija.
00:25
She doesn't look the happiest.
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Ne izgleda najsretnije.
00:26
That's in part because it requires
technicians and experts
technicians and experts
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Dijelom jer su potrebni
tehničari i stručnjaci
tehničari i stručnjaci
00:30
to apply these clunky belts on her
to monitor her uterine contractions.
to monitor her uterine contractions.
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da joj postave nezgrapne pojaseve
koji prate kontrakcije maternice.
koji prate kontrakcije maternice.
00:35
Another reason Jane is not so happy
is because she's worried.
is because she's worried.
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Dijelom jer je zabrinuta.
00:40
In particular, she's worried
about what happens
about what happens
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Posebice je zabrinuta
jer ne zna što će se dogoditi
jer ne zna što će se dogoditi
00:43
after her 10-day stay
on bed rest at the hospital.
on bed rest at the hospital.
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nakon desetodnevnog
mirovanja u bolnici.
mirovanja u bolnici.
00:47
What happens when she's home?
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Što će se dogoditi kad dođe kući?
00:49
If she were to give birth this early
it would be devastating.
it would be devastating.
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Prijevremeni porod bio bi poražavajući.
00:53
As an African-American woman,
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Kao afroamerikanka
00:55
she's twice as likely
to have a premature birth
to have a premature birth
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ima dva put veću mogućnost
prijevremenog poroda
prijevremenog poroda
00:59
or to have a stillbirth.
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ili rođenja mrtvog djeteta.
01:01
So Jane basically has one of two options:
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Dakle, Jane u osnovi može birati između
dvije mogućnosti:
dvije mogućnosti:
01:04
stay at the hospital on bed rest,
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ostati u bolnici na mirovanju,
01:07
a prisoner to the technology
until she gives birth,
until she gives birth,
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biti rob tehnologije sve do poroda,
01:11
and then spend the rest
of her life paying for the bill;
of her life paying for the bill;
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a zatim provesti ostatak života
plaćajući bolničke račune;
plaćajući bolničke račune;
01:14
or head home after her 10-day stay
and hope for the best.
and hope for the best.
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ili pohitati kući nakon bolničkog boravka
i nadati se najboljem.
i nadati se najboljem.
01:20
Neither of these two options
seems appealing.
seems appealing.
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Ni jedna od ove dvije opcije
se čini privlačnom.
se čini privlačnom.
01:24
As I began to think
about stories like this
about stories like this
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Počeo sam razmišljati
o sličnim situacijama
o sličnim situacijama
01:26
and hear about stories like this,
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i zanimati se za slične slučajeve
01:28
I began to ask myself and imagine:
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Počeo sam razmišljati i pitati se
01:30
Is there an alternative?
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postoji li alternativa?
01:31
Is there a way we could have
the benefits of high-fidelity monitoring
the benefits of high-fidelity monitoring
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Na koji način bi mogli uživati prednosti
visoko pouzdane kontrole
visoko pouzdane kontrole
01:36
that we get with our trusted
partners in the hospital
partners in the hospital
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koju nam pruža povjerljivo
bolničko osoblje
bolničko osoblje
01:39
while someone is at home
living their daily life?
living their daily life?
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u vlastitom domu dok živimo
svakodnevnim životom?
svakodnevnim životom?
01:42
With that in mind,
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Imajući to u vidu,
01:44
I encouraged people in my research group
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ohrabrio sam ljude u
istraživačkom timu
istraživačkom timu
01:46
to partner with some
clever material scientists,
clever material scientists,
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da se udruže s vrhunskim stručnjacima iz
područja materije
područja materije
01:49
and all of us came together
and brainstormed.
and brainstormed.
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i pozvao ih sve zajedno
na "oluju mozgova".
na "oluju mozgova".
01:52
And after a long process,
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Nakon dugog procesa,
01:54
we came up with a vision, an idea,
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došli smo do vizije, ideje
01:56
of a wearable system that perhaps
you could wear like a piece of jewelry
you could wear like a piece of jewelry
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nosivog sustava koji bi se možda mogao
nositi kao komad nakita
nositi kao komad nakita
02:00
or you could apply
to yourself like a Band-Aid.
to yourself like a Band-Aid.
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ili zalijepiti kao flaster.
02:03
And after many trials and tribulations
and years of endeavors,
and years of endeavors,
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Nakon brojnih testiranja i pokušaja
i godina nastojanja,
i godina nastojanja,
02:07
we were able to come up
with this flexible electronic patch
with this flexible electronic patch
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uspjeli smo realizirati fleksibilnu
elektronsku naljepnicu
elektronsku naljepnicu
02:11
that was manufactured
using the same processes
using the same processes
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koja je proizvedena
koristeći iste procese
koristeći iste procese
02:13
that they use to build computer chips,
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koji se koriste za izgradnju
računalnih čipova,
računalnih čipova,
02:16
except the electronics are transferred
from a semiconductor wafer
from a semiconductor wafer
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osim što je elektronika iz poluvodičke
podloge prebačena
podloge prebačena
02:21
onto a flexible material
that can interface with the human body.
that can interface with the human body.
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na fleksibilni materijal koji se može
povezati s ljudskim tijelom.
povezati s ljudskim tijelom.
02:25
These systems are about
the thickness of a human hair.
the thickness of a human hair.
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Ovi sustavi su otprilike
debljine ljudske kose.
debljine ljudske kose.
02:30
They can measure the types
of information that we want,
of information that we want,
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Oni mogu mjeriti vrste
informacija koje želimo,
informacija koje želimo,
02:33
things such as:
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kao na primjer:
02:35
bodily movement,
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tjelesno kretanje,
02:36
bodily temperature,
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tjelesnu temperaturu,
02:38
electrical rhythms of the body
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električne ritmove tijela
02:39
and so forth.
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i tako dalje.
02:41
We can also engineer these systems,
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Isto tako te sustave možemo projektirati,
02:43
so they can integrate energy sources,
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tako da mogu integrirati
izvore energije,
izvore energije,
02:46
and can have wireless
transmission capabilities.
transmission capabilities.
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i imati i bežične prijenosne mogućnosti.
02:50
So as we began to build
these types of systems,
these types of systems,
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Dakle, kad smo počeli graditi
ove vrste sustava,
ove vrste sustava,
02:54
we began to test them on ourselves
in our research group.
in our research group.
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istovremeno smo ih počeli testirati
na sebi u našoj istraživačkoj grupi.
na sebi u našoj istraživačkoj grupi.
02:58
But in addition, we began to reach out
to some of our clinical partners
to some of our clinical partners
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Osim toga, povezali smo se s nekim
od naših kliničkih partnera
od naših kliničkih partnera
03:02
in San Diego,
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u San Diegu,
03:03
and test these on different patients
in different clinical conditions,
in different clinical conditions,
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i testirali ih na različitim pacijentima
u različitim kliničkim stanjima,
u različitim kliničkim stanjima,
03:07
including moms-to-be like Jane.
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uključujući buduće mame kao što je Jane.
03:10
Here is a picture of a pregnant woman
in labor at our university hospital
in labor at our university hospital
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Ovo je slika trudnice u labaratoriju
naše sveučilišne bolnice
naše sveučilišne bolnice
03:15
being monitored for her uterine
contractions with the conventional belt.
contractions with the conventional belt.
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na pračenju trudova maternice
putem konvencionalnog pojasa.
putem konvencionalnog pojasa.
03:20
In addition,
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Osim pojasa,
03:22
our flexible electronic patches are there.
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nosi i naše elektroničke naljepnice.
03:25
This picture demonstrates waveforms
pertaining to the fetal heart rate,
pertaining to the fetal heart rate,
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Ova slika pokazuje valove koji se
odnose na otkucaje bebinog srca,
odnose na otkucaje bebinog srca,
03:29
where the red corresponds
to what was acquired
to what was acquired
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crveno se odnosi
na ono što je izmjereno
na ono što je izmjereno
03:32
with the conventional belts,
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konvencionalnim pojasem,
03:34
and the blue corresponds to our estimates
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a plava odgovara našim
procjenama dobivenih
procjenama dobivenih
03:36
using our flexible electronic systems
and our algorithms.
and our algorithms.
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korištenjem naših fleksibilnih
elektroničkih sustava i naših algoritama.
elektroničkih sustava i naših algoritama.
03:40
At this moment,
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U ovom trenutku,
03:42
we gave ourselves a big mental high five.
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čestitatali smo sami sebi.
03:45
Some of the things we had imagined
were beginning to come to fruition,
were beginning to come to fruition,
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Neke od stvari koje smo zamislili
počele su se koristiti,
počele su se koristiti,
03:48
and we were actually seeing this
in a clinical context.
in a clinical context.
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i zapravo ih vidimo
u kliničkom kontekstu.
u kliničkom kontekstu.
03:52
But there was still a problem.
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No, tu je još jedan problem.
03:53
The problem was, the way
we manufactured these systems
we manufactured these systems
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Način na koji smo prozvodili ove sisteme
03:57
was very inefficient,
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pokazao se neučinkovit,
03:58
had low yield
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imao je nizak prinos
04:00
and was very error-prone.
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i bio je sklon pogreškama.
04:02
In addition,
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Uz to,
04:03
as we talked to some
of the nurses in the hospital,
of the nurses in the hospital,
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razgovarali smo s medicinskim
sestrama u bolnici,
sestrama u bolnici,
04:05
they encouraged us to make sure
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koje su nam savjetovale da provjerimo
04:07
that our electronics worked
with typical medical adhesives
with typical medical adhesives
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da naša elektronika funkcionira
s tipičnim medicinskim ljepilom
s tipičnim medicinskim ljepilom
04:12
that are used in a hospital.
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koje se koristi u bolnici.
04:14
We had an epiphany and said,
"Wait a minute.
"Wait a minute.
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Sinulo nam je i rekli smo:
"Pričekaj minutu.
"Pričekaj minutu.
04:16
Rather than just making
them work with adhesives,
them work with adhesives,
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Umjesto da ih pravimo
tako da rade s ljepilom
tako da rade s ljepilom
04:19
let's integrate them into adhesives,
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integrirajmo ih u ljepilo,
04:23
and that could solve
our manufacturing problem."
our manufacturing problem."
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i to bi mogalo riješiti
naš proizvodni problem. "
naš proizvodni problem. "
04:26
This picture that you see here
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Ova slika koju vidite ovdje
04:28
is our ability to embed these censors
inside of a piece of Scotch tape
inside of a piece of Scotch tape
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je naša sposobnost da ugradimo ove cenzore
unutar jednog komada ljepljive trake
unutar jednog komada ljepljive trake
04:32
by simply peeling it off of a wafer.
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jednostavno ljušteći ih s podloge.
04:36
Ongoing work in our research group
allows us to, in addition,
allows us to, in addition,
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Zahvaljujući konstantnom radu našeg
tima moguče je, izmedu ostalog,
tima moguče je, izmedu ostalog,
04:39
embed integrated circuits
into the flexible adhesives
into the flexible adhesives
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ugraditi integrirane krugove
u fleksibilno ljepilom
u fleksibilno ljepilom
04:43
to do things like amplifying signals
and digitizing them,
and digitizing them,
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da bi radili stvari kao što je pojačavanje
signala te njihova digitalizacija,
signala te njihova digitalizacija,
04:47
processing them
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njihova obrada
04:48
and encoding for wireless transmission.
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i kodiranje za bežični prijenos.
04:51
All of this integrated
into the same medical adhesives
into the same medical adhesives
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Sve ovo je integrirano u istim
medicinskih ljepilima
medicinskih ljepilima
04:55
that are used in the hospital.
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koja se koriste u bolnici.
04:57
So when we reached this point,
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Kad smo došli do ove faze,
04:59
we had some other challenges,
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pojavili su se drugi izazovi,
05:01
from both an engineering
as well as a usability perspective,
as well as a usability perspective,
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iz inženjerske perspektive kao
i iz perspektive upotrebljivosti,
i iz perspektive upotrebljivosti,
05:05
to make sure that we could
make it used practically.
make it used practically.
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morali smo biti sigurni da
ćemo ga moći koristiti.
ćemo ga moći koristiti.
05:09
In many digital health discussions,
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U mnogim digitalnim
zdravstvenim raspravama,
zdravstvenim raspravama,
05:11
people believe in and embrace the idea
that we can simply digitize the data,
that we can simply digitize the data,
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ljudi vjeruju i prihvačaju ideju da možemo
jednostavno digitalizirati podatke,
jednostavno digitalizirati podatke,
05:16
wirelessly transmit it,
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bežično ih prenositi,
05:18
send it to the cloud,
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poslati ih u oblak
05:19
and in the cloud,
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te u oblaku
05:21
we can extract meaningful
information for interpretation.
information for interpretation.
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izdvojiti značajne informacije
za interpretaciju.
za interpretaciju.
05:24
And indeed, you can do all of that,
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I doista, možete sve to učiniti,
05:26
if you're not worried
about some of the energy challenges.
about some of the energy challenges.
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ako vas ne brinu neki
energetski izazovi.
energetski izazovi.
05:29
Think about Jane for a moment.
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Razmislite na trenutak o Jane.
05:31
She doesn't live in Palo Alto,
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Ona ne živi u Palo Altu,
05:33
nor does she live in Beverly Hills.
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niti na Beverly Hillsu.
05:35
What that means is,
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To znači,
05:36
we have to be mindful about her data plan
and how much it would cost
and how much it would cost
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da moramo razmotriti njen plan podataka
i koliko će je koštati
i koliko će je koštati
05:39
for her to be sending out
a continuous stream of data.
a continuous stream of data.
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da šalje kontinuirani tok podataka.
05:44
There's another challenge
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Postoji još jedan izazov
05:45
that not everyone in the medical
profession is comfortable talking about.
profession is comfortable talking about.
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o kojem nije svima u medicinskoj
struci ugodno razgovarati.
struci ugodno razgovarati.
05:49
And that is, that Jane
does not have the most trust
does not have the most trust
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A to je, da Jane nema
previše povjerenja
previše povjerenja
05:52
in the medical establishment.
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u medicinske ustanove.
05:54
She, people like her, her ancestors,
have not had the best experiences
have not had the best experiences
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Ona, ljudi poput nje, njeni pretci,
nisu imali najbolje iskustvo
nisu imali najbolje iskustvo
05:59
at the hands of doctors and the hospital
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u rukama liječnika i bolnica
06:03
or insurance companies.
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ili osiguravajućih društava.
06:05
That means that we have to be mindful
of questions of privacy.
of questions of privacy.
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To znači da moramo uzeti u obzir
pitanje privatnosti.
pitanje privatnosti.
06:08
Jane might not feel that happy
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Možda se Jane neće svidjeti
06:10
about all that data
being processed into the cloud.
being processed into the cloud.
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ideja da se njeni podatci
obrađuje u oblaku.
obrađuje u oblaku.
06:14
And Jane cannot be fooled;
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A Jane se ne može prevariti;
06:17
she reads the news.
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ona čita vijesti.
06:18
She knows that if the federal
government can be hacked,
government can be hacked,
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Ona zna da, ako savezna
vlada može biti hakirana,
vlada može biti hakirana,
06:21
if the Fortune 500 can be hacked,
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ako Fortune 500 može biti hakiran,
06:24
so can her doctor.
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može i njezin liječnik.
06:27
And so with that in mind,
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I tako s tim na umu,
06:28
we had an epiphany.
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sinulo nam je.
06:30
We cannot outsmart
all the hackers in the world,
all the hackers in the world,
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Ne možemo nadmudriti
sve hakere na svijetu,
sve hakere na svijetu,
06:33
but perhaps we can present
them a smaller target.
them a smaller target.
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ali im možda možemo smanjiti
mogućnost djelovanja
mogućnost djelovanja
06:36
What if we could actually,
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Što ako bi mogli,
06:39
rather than have those algorithms
that do data interpretation
that do data interpretation
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umjesto da algoritme koji čitaju podatake
06:43
run in the cloud,
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šaljemo u oblaku
06:44
what if we have those algorithms run
on those small integrated circuits
on those small integrated circuits
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te iste slati u male integrirane krugove
06:48
embedded into those adhesives?
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ugrađene u samim naljepnicama?
06:50
And so when we integrate
these things together,
these things together,
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Nakon što smo povezali
te stvari zajedno,
te stvari zajedno,
06:54
what this means is that now
we can think about the future
we can think about the future
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sada možemo razmišljati o budućnosti
06:57
where someone like Jane can still
go about living her normal daily life,
go about living her normal daily life,
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gdje netko poput Jane može
normalno živjeti svakodnevni život,
normalno živjeti svakodnevni život,
07:01
she can be monitored,
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ona može biti praćena,
07:03
it can be done in a way where
she doesn't have to get another job
she doesn't have to get another job
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na način da ne mora
imati dodatni posao
imati dodatni posao
07:06
to pay her data plan,
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kako bi to platila,
07:08
and we can also address
some of her concerns about privacy.
some of her concerns about privacy.
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možemo riješiti neke probleme
glede privatnosti.
glede privatnosti.
07:12
So at this point,
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Dakle, u ovom trenutku,
07:14
we're feeling very good about ourselves.
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smo jako zadovoljni sami sobom.
07:16
We've accomplished this,
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Postigli smo ovo,
07:17
we've begun to address some
of these questions about privacy
of these questions about privacy
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počeli smo se baviti nekim
pitanjima o privatnosti
pitanjima o privatnosti
07:20
and we feel like, pretty much
the chapter is closed now.
the chapter is closed now.
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i osjećamo se prilično kao da
smo zatvorili jedno poglavlje.
smo zatvorili jedno poglavlje.
07:24
Everyone lived happily ever after, right?
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živjeli su sretno do kraja života, istina?
07:28
Well, not so fast.
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Pa, ne tako brzo.
07:30
(Laughter)
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(Smijeh)
07:31
One of the things we have to remember,
as I mentioned earlier,
as I mentioned earlier,
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Moramo uzeti u obzir, kao
što sam spomenuo ranije,
što sam spomenuo ranije,
07:34
is that Jane does not have the most trust
in the medical establishment.
in the medical establishment.
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da Jane nema previše povjerenja
u medicinske ustanove.
u medicinske ustanove.
07:38
We have to remember
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Moramo uzeti u obzir
07:39
that there are increasing
and widening health disparities,
and widening health disparities,
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zdravstvene nejednakosti koje se
šire i rastu,
šire i rastu,
07:42
and there's inequity in terms
of proper care management.
of proper care management.
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a tu je i nejednakost glede
pravilnog upravljanja skrbi.
pravilnog upravljanja skrbi.
07:46
And so what that means
is that this simple picture
is that this simple picture
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To znači da ova jednostavna slika
07:49
of Jane and her data --
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Jane i njezinih podataka -
07:50
even with her being comfortable
being wirelessly transmitted to the cloud,
being wirelessly transmitted to the cloud,
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čak i ako se ona osjeća ugodno
da se oni bežično prenose u oblak,
da se oni bežično prenose u oblak,
07:54
letting a doctor intervene if necessary --
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s mogućnosti liječničke intervencije -
07:57
is not the whole story.
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nije cijela priča.
07:59
So what we're beginning to do
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Dakle, počeli smo
08:00
is to think about ways to have
trusted parties serve as intermediaries
trusted parties serve as intermediaries
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razmišljati o tome kako doći
do pouzdanih posrednika
do pouzdanih posrednika
08:05
between people like Jane
and her health care providers.
and her health care providers.
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između ljudi poput Jane i davaoca
njihovih zdravstvenih usluga.
njihovih zdravstvenih usluga.
08:08
For example, we've begun
to partner with churches
to partner with churches
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Na primjer, počeli smo
surađivati s crkvama
surađivati s crkvama
08:11
and to think about nurses
that are church members,
that are church members,
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i razmišljati o medicinskim sestrama
koje su vjernici,
koje su vjernici,
08:14
that come from that trusted community,
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i dolaze iz pouzdane zajednice,
08:16
as patient advocates and health coaches
to people like Jane.
to people like Jane.
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kao o zaštitnicama i zdravstvenim
trenerima pacijentima poput Jane.
trenerima pacijentima poput Jane.
08:21
Another thing we have going for us
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Još jedna stvar koja radi za nas
08:23
is that insurance companies, increasingly,
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je da su osiguravajuća društva, sve više,
08:25
are attracted to some of these ideas.
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privučena nekim od ovih ideja.
08:27
They're increasingly realizing
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Oni su shvatli
08:29
that perhaps it's better
to pay one dollar now
to pay one dollar now
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da bi možda bilo bolje
platiti jedan dolar sada
platiti jedan dolar sada
08:32
for a wearable device and a health coach,
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za nosivi uređaj i zdravstvenog trenera
08:35
rather than paying 10 dollars later,
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nego plaćati 10 dolara kasnije,
08:38
when that baby is born prematurely
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kada se dijete prerano rodi
08:40
and ends up in the neonatal
intensive care unit --
intensive care unit --
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i završi na neonatalnom
odjelu intenzivne njege --
odjelu intenzivne njege --
08:43
one of the most expensive
parts of a hospital.
parts of a hospital.
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jedanom od najskupljih u bolnici.
08:47
This has been a long
learning process for us.
learning process for us.
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To je bio dug proces učenja za nas.
08:50
This iterative process of breaking
through and attacking one problem
through and attacking one problem
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Ovaj iterativni proces
rješavanja problema
rješavanja problema
08:54
and not feeling totally comfortable,
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kada se nismo osjećali ugodno,
08:56
and identifying the next problem,
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i identificiranja sljedećeg problema,
08:58
has helped us go along this path
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pomogao nam je napredovati tako
09:00
of actually trying to not only
innovate with this technology
innovate with this technology
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da zapravo ne pokušavamo samo
inovirati s ovom tehnologijom
inovirati s ovom tehnologijom
09:03
but make sure it can be used for people
who perhaps need it the most.
who perhaps need it the most.
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već da budemo sigurni da je mogu koristiti
oni kojima je najpotrebnija.
oni kojima je najpotrebnija.
09:07
Another learning lesson
we've taken from this process
we've taken from this process
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Još jedna lekcija koju smo
naučili iz ovog procesa
naučili iz ovog procesa
09:10
that is very humbling,
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je da je on u drugom planu,
09:11
is that as technology progresses
and advances at an accelerating rate,
and advances at an accelerating rate,
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jer unatoč ubrzanom ritmu
napredovanju tehnologije,
napredovanju tehnologije,
09:16
we have to remember that human beings
are using this technology,
are using this technology,
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moramo imati na umu da su
ljudska bića ta koja je koriste,
ljudska bića ta koja je koriste,
09:20
and we have to be mindful
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moramo biti svjesni
09:21
that these human beings --
they have a face,
they have a face,
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da ti ljudi -
imaju lice,
imaju lice,
09:25
they have a name
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imaju ime
09:26
and a life.
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i život.
09:27
And in the case of Jane,
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U slučaju Jane,
09:29
hopefully, two.
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nadamo se, dva života.
09:32
Thank you.
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Hvala vam.
09:33
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Todd Coleman - Bioelectronics innovatorUCSD bioengineering professor Todd Coleman integratively spans the disciplines of medical electronics, machine learning and public health.
Why you should listen
Todd Coleman's research develops multi-functional, flexible bioelectronics and novel analytics methods to benefit patients and clinical decision-makers.
After a PhD in electrical engineering at MIT, Coleman did a neurosciences post-doc and became an assistant professor in electrical and computer engineering and neuroscience at University of Illinois before joining the faculty of UCSD. An avid public health advocate, Coleman understands the value of collaborating with community health programs to truly implement and deliver sustainable innovations to those who need it most.
Todd Coleman | Speaker | TED.com