TEDMED 2015
Todd Coleman: A temporary tattoo that brings hospital care to the home
Tod Kolman (Todd Coleman): Privremena tetovaža koja bolnicu donosi vašoj kući
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Šta bi bilo kad bi lekari mogli da nadgledaju pacijente dok su oni kod kuće sa istom preciznošću kao i tokom boravka u bolnici? Inovator bioelektronike, Tod Kolman, deli svoju potragu ka razvoju mobilnih, fleksibilnih elektronskih zdravstvenih nalepnica za praćenje koje obećavaju da dovedu do revolucije u zdravstvenoj nezi i medicinu učine manje invazivnom.
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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Upoznajte Džejn.
00:15
She has a high-risk pregnancy.
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Ona ima trudnoću visokog rizika.
00:17
Within 24 weeks,
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U 24. nedelji,
00:19
she's on bed rest at the hospital,
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ona je u bolničkoj postelji,
00:21
being monitored
for her preterm contractions.
for her preterm contractions.
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na posmatranju
zbog prevremenih kontrakcija.
zbog prevremenih kontrakcija.
00:25
She doesn't look the happiest.
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Ne izgleda baš najsrećnije.
00:26
That's in part because it requires
technicians and experts
technicians and experts
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To je delom zato što je potrebno
da tehničari i stručnjaci
da 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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postavljaju ove teške kaiševe na nju
kako bi merili kontrakcije materice.
kako bi merili kontrakcije materice.
00:35
Another reason Jane is not so happy
is because she's worried.
is because she's worried.
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Drugi razlog što Džejn nije srećna
je zato što brine.
je zato što brine.
00:40
In particular, she's worried
about what happens
about what happens
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Posebno brine šta će se desiti
00:43
after her 10-day stay
on bed rest at the hospital.
on bed rest at the hospital.
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nakon njenog desetodnevnog boravka
u bolničkoj postelji.
u bolničkoj postelji.
00:47
What happens when she's home?
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Šta će se desiti kada se vrati kući?
00:49
If she were to give birth this early
it would be devastating.
it would be devastating.
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Kada bi se porodila ovako rano,
to bi bila katastrofa.
to bi bila katastrofa.
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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ona ima dva puta veće šanse
za prevremeni porođaj
za prevremeni porođaj
00:59
or to have a stillbirth.
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ili da rodi mrtvorođenče.
01:01
So Jane basically has one of two options:
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Džejn praktično ima jednu od dve opcije:
01:04
stay at the hospital on bed rest,
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da ostane u bolničkoj postelji,
01:07
a prisoner to the technology
until she gives birth,
until she gives birth,
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kao zarobljenik tehnologije
dok se ne porodi,
dok se ne porodi,
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 da onda provede ostatak života
plaćajući bolnički račun,
plaćajući bolnički račun,
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 da izađe kući nakon 10 dana
i nada se najboljem.
i nada se najboljem.
01:20
Neither of these two options
seems appealing.
seems appealing.
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Nijedna od ove dve opcije
ne zvuči privlačno.
ne zvuči privlačno.
01:24
As I began to think
about stories like this
about stories like this
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Razmišljajući o ovakvim pričama
01:26
and hear about stories like this,
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i slušajući o njima,
01:28
I began to ask myself and imagine:
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počeo sam da se pitam i razmišljam
01:30
Is there an alternative?
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da li postoji neka 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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Da li postoji način da imamo prednosti
preciznog nadgledanja koje dobijamo
preciznog nadgledanja koje dobijamo
01:36
that we get with our trusted
partners in the hospital
partners in the hospital
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kod naših pouzdanih partnera u bolnici,
01:39
while someone is at home
living their daily life?
living their daily life?
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dok je pacijent kod kuće
i vodi normalan život?
i vodi normalan život?
01:42
With that in mind,
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Sa tim na umu,
ohrabrio sam ljude
u svom istraživačkom timu
u svom istraživačkom timu
01:44
I encouraged people in my research group
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01:46
to partner with some
clever material scientists,
clever material scientists,
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da se udruže sa izvesnim naučnicima
u oblasti pametnih materijala,
u oblasti pametnih materijala,
01:49
and all of us came together
and brainstormed.
and brainstormed.
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i svi smo se skupili i iznosili ideje.
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 jedne 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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mobilnog sistema kojeg možda možete
nositi poput nakita
nositi poput nakita
02:00
or you could apply
to yourself like a Band-Aid.
to yourself like a Band-Aid.
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ili možete staviti kao flaster.
02:03
And after many trials and tribulations
and years of endeavors,
and years of endeavors,
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Posle dosta testiranja, problema
i godina napornog rada,
i godina napornog rada,
02:07
we were able to come up
with this flexible electronic patch
with this flexible electronic patch
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uspeli smo da osmislimo
ovu fleksibilnu elektronsku nalepnicu
ovu fleksibilnu elektronsku nalepnicu
02:11
that was manufactured
using the same processes
using the same processes
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koja je proizvedena
korišćenjem istih procesa
korišćenjem istih procesa
02:13
that they use to build computer chips,
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koji se koriste da se naprave
kompjuterski čipovi,
kompjuterski čipovi,
02:16
except the electronics are transferred
from a semiconductor wafer
from a semiconductor wafer
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osim što se elektronika prenosi
iz poluprovodničke pločice
iz poluprovodničke pločice
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 sa ljudskim telom.
koji se može povezati sa ljudskim telom.
02:25
These systems are about
the thickness of a human hair.
the thickness of a human hair.
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Ovi sistemi su debljine ljudske dlake.
02:30
They can measure the types
of information that we want,
of information that we want,
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Oni mogu izmeriti
vrste informacija koje želimo,
vrste informacija koje želimo,
02:33
things such as:
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stvari kao što su:
02:35
bodily movement,
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pokreti tela,
02:36
bodily temperature,
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temperatura tela,
02:38
electrical rhythms of the body
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električna ritmika tela
02:39
and so forth.
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i tako dalje.
02:41
We can also engineer these systems,
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Takođe možemo dizajnirati ove sisteme,
02:43
so they can integrate energy sources,
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tako da mogu da integrišu izvore energije
02:46
and can have wireless
transmission capabilities.
transmission capabilities.
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i da imaju mogućnosti bežičnog prenosa.
02:50
So as we began to build
these types of systems,
these types of systems,
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Kako smo počeli da pravimo
ove vrste sistema,
ove vrste sistema,
02:54
we began to test them on ourselves
in our research group.
in our research group.
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počeli smo da ih testiramo na sebi
u istraživačkom timu.
u istraživačkom timu.
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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Uz to, počeli smo da se obraćamo
nekim našim kliničkim partnerima
nekim našim kliničkim partnerima
u San Dijegu
03:02
in San Diego,
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i da ovo testiramo
na različitim pacijentima
na različitim pacijentima
03:03
and test these on different patients
in different clinical conditions,
in different clinical conditions,
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u različitim kliničkim uslovima,
03:07
including moms-to-be like Jane.
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uključujući buduće mame, poput Džejn.
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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Evo fotografije jedne trudnice na porođaju
u našoj univerzitetskoj bolnici
u našoj univerzitetskoj bolnici
03:15
being monitored for her uterine
contractions with the conventional belt.
contractions with the conventional belt.
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kojoj se posmatraju kontrakcije materice
sa uobičajenim pojasom.
sa uobičajenim pojasom.
03:20
In addition,
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Uz to, tu su naše fleksibilne
elektronske nalepnice.
elektronske nalepnice.
03:22
our flexible electronic patches are there.
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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 oblike talasa
vezane za otkucaje srca fetusa,
vezane za otkucaje srca fetusa,
03:29
where the red corresponds
to what was acquired
to what was acquired
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gde crveno odgovara onome što se dobija
03:32
with the conventional belts,
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sa uobičajenim pojasevima,
03:34
and the blue corresponds to our estimates
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a plavo odgovara našim procenama
03:36
using our flexible electronic systems
and our algorithms.
and our algorithms.
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korišćenjem naših fleksibilnih
elektronskih sistema i algoritama.
elektronskih sistema i algoritama.
03:40
At this moment,
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U tom trenutku,
03:42
we gave ourselves a big mental high five.
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uputili smo sebi čestitku.
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 da se ostvaruju,
počele su da se ostvaruju,
03:48
and we were actually seeing this
in a clinical context.
in a clinical context.
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i to zapravo vidimo u kliničkom kontekstu.
03:52
But there was still a problem.
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Ipak, i dalje smo imali problem.
03:53
The problem was, the way
we manufactured these systems
we manufactured these systems
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Problem je što je način
na koji smo proizvodili ove sisteme
na koji smo proizvodili ove sisteme
03:57
was very inefficient,
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bio veoma neefikasan,
03:58
had low yield
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imao nisku proizvodnju
04:00
and was very error-prone.
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i bio podložan greškama.
Uz to, dok smo u bolnici pričali
sa nekim medicinskim sestrama,
sa nekim medicinskim sestrama,
04:02
In addition,
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04:03
as we talked to some
of the nurses in the hospital,
of the nurses in the hospital,
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ohrabrivale su nas da obezbedimo
04:05
they encouraged us to make sure
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04:07
that our electronics worked
with typical medical adhesives
with typical medical adhesives
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da naša elektronika radi sa tipičnim
medicinskim lepljivim materijalima
medicinskim lepljivim materijalima
04:12
that are used in a hospital.
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koji se koriste u bolnici.
04:14
We had an epiphany and said,
"Wait a minute.
"Wait a minute.
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Tad nam je sinulo: „Čekaj malo.
Umesto da samo napravimo da elektronika
radi sa lepljivim materijalima,
radi sa lepljivim materijalima,
04:16
Rather than just making
them work with adhesives,
them work with adhesives,
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04:19
let's integrate them into adhesives,
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hajde da je integrišemo u njih,
04:23
and that could solve
our manufacturing problem."
our manufacturing problem."
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i to bi rešilo naš problem proizvodnje.“
04:26
This picture that you see here
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Ova fotografija koju vidite
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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prikazuje našu sposobnost da ubacimo
ove senzore unutar lepljive trake,
ove senzore unutar lepljive trake,
04:32
by simply peeling it off of a wafer.
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jednostavno odlepljujući je sa podmetača.
04:36
Ongoing work in our research group
allows us to, in addition,
allows us to, in addition,
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Rad koji nastavlja naš tim istraživača
omogućava nam da, uz to,
omogućava nam da, uz to,
04:39
embed integrated circuits
into the flexible adhesives
into the flexible adhesives
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uključimo integrisana kola
u fleksibilne lepljive materijale
u fleksibilne lepljive materijale
04:43
to do things like amplifying signals
and digitizing them,
and digitizing them,
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da bismo mogli da dobijemo jači signal
i da ih digitalizujemo,
i da ih digitalizujemo,
04:47
processing them
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obradimo
04:48
and encoding for wireless transmission.
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i dekodiramo za bežičan prenos.
04:51
All of this integrated
into the same medical adhesives
into the same medical adhesives
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Sve ovo je integrisano
u iste medicinske lepljive materijale
u iste medicinske lepljive materijale
04:55
that are used in the hospital.
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koji se koriste u bolnici.
04:57
So when we reached this point,
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Kada smo došli do ove tačke,
04:59
we had some other challenges,
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imali smo neke druge izazove,
05:01
from both an engineering
as well as a usability perspective,
as well as a usability perspective,
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kako iz perspektive inženjeringa,
tako i upotrebljivosti,
tako i upotrebljivosti,
05:05
to make sure that we could
make it used practically.
make it used practically.
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da bismo bili sigurni
da mogu praktično da se koriste.
da mogu praktično da se koriste.
05:09
In many digital health discussions,
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U mnogim digitalnim diskusijama
vezanim za zdravlje,
vezanim za zdravlje,
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 veruju u ideju da prosto možemo
da digitalizujemo podatke,
da digitalizujemo podatke,
05:16
wirelessly transmit it,
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bežično ih prenesemo,
05:18
send it to the cloud,
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pošaljemo ih na „oblak“,
05:19
and in the cloud,
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a u oblaku izdvojimo
bitne informacije za obradu.
bitne informacije za obradu.
05:21
we can extract meaningful
information for interpretation.
information for interpretation.
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05:24
And indeed, you can do all of that,
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Zaista, sve to može da se uradi,
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.
05:29
Think about Jane for a moment.
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Pomislite na Džejn na trenutak.
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 živi na Beverli Hilsu.
05:35
What that means is,
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To znači da moramo
da uzmemo u obzir njen plan podataka
da uzmemo u obzir njen plan podataka
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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i koliko bi nju koštalo
da šalje stalne nizove podataka.
da šalje stalne nizove podataka.
05:39
for her to be sending out
a continuous stream of data.
a continuous stream of data.
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Postoji još jedan izazov
05:44
There's another challenge
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o kome nisu svi u medicinskoj profesiji
spremni da razgovaraju.
spremni da razgovaraju.
05:45
that not everyone in the medical
profession is comfortable talking about.
profession is comfortable talking about.
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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 Džejn nema bezuslovno poverenje
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 preci,
nisu imali najbolja iskustva
nisu imali najbolja iskustva
05:59
at the hands of doctors and the hospital
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kod lekara, u bolnici
06:03
or insurance companies.
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ili osiguravajućim kućama.
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 biti obazrivi
prema pitanjima privatnosti.
prema pitanjima privatnosti.
06:08
Jane might not feel that happy
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Džejn možda ne bi bila najsrećnija
06:10
about all that data
being processed into the cloud.
being processed into the cloud.
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da se svi njeni podaci obrađuju u oblaku.
06:14
And Jane cannot be fooled;
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Ne možete prevariti Džejn;
06:17
she reads the news.
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ona čita vesti.
06:18
She knows that if the federal
government can be hacked,
government can be hacked,
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Ona zna da, ako federalna vlada
može biti žrtva hakera,
može biti žrtva hakera,
ako jedna od najuspešnijih kompanija
može biti žrtva hakera,
može biti žrtva hakera,
06:21
if the Fortune 500 can be hacked,
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06:24
so can her doctor.
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može i njen lekar.
06:27
And so with that in mind,
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Imajući to u vidu,
06:28
we had an epiphany.
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sinula nam je ideja.
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 svetu,
06:33
but perhaps we can present
them a smaller target.
them a smaller target.
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ali možda im možemo predstaviti
jednu manju metu.
jednu manju metu.
06:36
What if we could actually,
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Šta ako bismo zapravo,
06:39
rather than have those algorithms
that do data interpretation
that do data interpretation
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umesto ovih algoritama za obradu podataka
06:43
run in the cloud,
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koja se odvija 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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šta ako bismo ove algoritme
pustili na ovim malim integrisanim kolima
pustili na ovim malim integrisanim kolima
06:48
embedded into those adhesives?
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ugrađenim u lepljive materijale?
06:50
And so when we integrate
these things together,
these things together,
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Tako kada integrišemo ove stvari,
06:54
what this means is that now
we can think about the future
we can think about the future
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to znači da sada možemo
da razmišljamo o budućnosti
da razmišljamo 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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gde neko poput Džejn može i dalje da vodi
normalan svakodnevni život,
normalan svakodnevni život,
07:01
she can be monitored,
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možemo da je pratimo,
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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to može da se uradi tako da ona ne mora
da radi još jedan posao
da radi još jedan posao
07:06
to pay her data plan,
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da bi platila prenos podataka,
07:08
and we can also address
some of her concerns about privacy.
some of her concerns about privacy.
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i takođe možemo da se osvrnemo
na neke njene brige o privatnosti.
na neke njene brige o privatnosti.
07:12
So at this point,
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Tako u ovom trenutku,
07:14
we're feeling very good about ourselves.
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mislimo da smo uradili nešto dobro.
07:16
We've accomplished this,
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Ostvarili 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 da se osvrćemo
na neka od ovih pitanja o privatnosti
na neka od ovih pitanja 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 smatramo da smo praktično
sada zatvorili jedno poglavljle.
sada zatvorili jedno poglavljle.
07:24
Everyone lived happily ever after, right?
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I svi su živeli srećno
do kraja života, je l' da?
do kraja života, je l' da?
07:28
Well, not so fast.
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Pa, ne tako brzo.
07:30
(Laughter)
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(Smeh)
07:31
One of the things we have to remember,
as I mentioned earlier,
as I mentioned earlier,
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Jedna od stvari koje moramo da zapamtimo,
kao što sam spomenuo,
kao što sam spomenuo,
07:34
is that Jane does not have the most trust
in the medical establishment.
in the medical establishment.
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je da Džejn nema potpuno poverenje
u medicinske ustanove.
u medicinske ustanove.
Moramo zapamtiti
07:38
We have to remember
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07:39
that there are increasing
and widening health disparities,
and widening health disparities,
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da sve više nastaju i povećavaju se
razlike u zdravstvu,
razlike u zdravstvu,
07:42
and there's inequity in terms
of proper care management.
of proper care management.
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i da postoje nejednakosti
u pogledu valjanog sprovođenja nege.
u pogledu valjanog sprovođenja nege.
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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Džejn i njenih 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 da je njoj u redu
da se oni bežično prenesu na oblak
da se oni bežično prenesu na oblak
07:54
letting a doctor intervene if necessary --
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i dopusti lekarima
da reaguju ako zatreba -
da reaguju ako zatreba -
07:57
is not the whole story.
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nije cela priča.
07:59
So what we're beginning to do
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Ono što počinjemo da radimo
08:00
is to think about ways to have
trusted parties serve as intermediaries
trusted parties serve as intermediaries
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je da razmišljamo o načinima da imamo
učesnike od poverenja kao posrednike
učesnike od poverenja kao posrednike
08:05
between people like Jane
and her health care providers.
and her health care providers.
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između ljudi poput Džejn
i njenih zdravstvenih radnika.
i njenih zdravstvenih radnika.
08:08
For example, we've begun
to partner with churches
to partner with churches
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Primera radi, počeli smo
da se povezujemo sa crkvama
da se povezujemo sa crkvama
i da razmišljamo o medicinskim sestrama
koje su članovi crkve,
koje su članovi crkve,
08:11
and to think about nurses
that are church members,
that are church members,
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08:14
that come from that trusted community,
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koje dolaze iz krugova od poverenja,
kao o zastupnicima pacijenata
i zdravstvenim trenerima
i zdravstvenim trenerima
08:16
as patient advocates and health coaches
to people like Jane.
to people like Jane.
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za ljude poput Džejn.
08:21
Another thing we have going for us
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Još jedna stvar koja nam ide na ruku
08:23
is that insurance companies, increasingly,
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je da osiguravajuće kuće sve više i više
08:25
are attracted to some of these ideas.
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privlače neke od ovih ideja.
08:27
They're increasingly realizing
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One sve više i više shvataju
08:29
that perhaps it's better
to pay one dollar now
to pay one dollar now
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da je možda bolje sada platiti jedan dolar
08:32
for a wearable device and a health coach,
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za mobilni uređaj i zdravstvenog trenera,
08:35
rather than paying 10 dollars later,
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nego platiti 10 dolara kasnije,
08:38
when that baby is born prematurely
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kada se ta beba prevremeno rodi
08:40
and ends up in the neonatal
intensive care unit --
intensive care unit --
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i završi na neonatalnoj intezivnoj nezi -
08:43
one of the most expensive
parts of a hospital.
parts of a hospital.
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jednom od najskupljih delova bolnice.
08:47
This has been a long
learning process for us.
learning process for us.
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Ovo 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 učestali proces napretka
i rešavanja jednog problema,
i rešavanja jednog problema,
08:54
and not feeling totally comfortable,
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pri čemu nemate skroz dobar osećaj,
08:56
and identifying the next problem,
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a već prepoznajete sledeći problem,
08:58
has helped us go along this path
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pomogao nam je da idemo putem
09:00
of actually trying to not only
innovate with this technology
innovate with this technology
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gde ne samo da ćemo pokušati
da inoviramo sa ovom tehnologijom,
da inoviramo sa 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 ćemo obezbediti da je koriste
ljudi kojima je možda najviše potrebna.
ljudi kojima je možda najviše potrebna.
09:07
Another learning lesson
we've taken from this process
we've taken from this process
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Još nešto što smo naučili iz ovog procesa,
što je vrlo utešno,
09:10
that is very humbling,
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je da, kako tehnologija
napreduje vrlo brzo,
napreduje vrlo brzo,
09:11
is that as technology progresses
and advances at an accelerating rate,
and advances at an accelerating rate,
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09:16
we have to remember that human beings
are using this technology,
are using this technology,
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moramo zapamtiti da ljudska bića
koriste ovu tehnologiju,
koriste ovu tehnologiju,
09:20
and we have to be mindful
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i moramo imati na umu
09:21
that these human beings --
they have a face,
they have a face,
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da ova ljudska bića imaju lice,
09:25
they have a name
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imaju ime
09:26
and a life.
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i imaju život.
09:27
And in the case of Jane,
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A u slučaju Džejn,
09:29
hopefully, two.
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nadamo se, dva.
09:32
Thank you.
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Hvala vam.
09:33
(Applause)
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(Aplauz)
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