TEDMED 2015
Todd Coleman: A temporary tattoo that brings hospital care to the home
Todd Coleman: A tatuaxe temporal que trae os coidados hospitalarios á casa
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E se os médicos puidesen monitorizar aos pacientes na casa co mesmo grao de precisión ca se estivesen no hospital? Todd Coleman, un innovador do ámbito da bioelectrónica, comparte a súa busca para desenvolver parches monitorizados, electrónicos, poñibles e flexibles que prometen revolucionar a asistencia sanitaria e facer a medicina menos invasiva.
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.
Preséntovos a Jane.
00:13
Please meet Jane.
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00:15
She has a high-risk pregnancy.
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O seu é un embarazo de alto risco.
00:17
Within 24 weeks,
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Ás 24 semanas de xestación
00:19
she's on bed rest at the hospital,
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ingrésana en repouso no hospital,
00:21
being monitored
for her preterm contractions.
for her preterm contractions.
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para monitorizar
as súas contraccións prematuras.
as súas contraccións prematuras.
00:25
She doesn't look the happiest.
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Non parece moi leda.
00:26
That's in part because it requires
technicians and experts
technicians and experts
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Iso é, en parte, porque require
que o persoal técnico e experto
que o persoal técnico e experto
00:30
to apply these clunky belts on her
to monitor her uterine contractions.
to monitor her uterine contractions.
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lle poña eses cintos pesados
para monitorizar as contraccións uterinas.
para monitorizar as contraccións uterinas.
00:35
Another reason Jane is not so happy
is because she's worried.
is because she's worried.
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Outra razón pola que Jane non está leda
é porque está preocupada.
é porque está preocupada.
00:40
In particular, she's worried
about what happens
about what happens
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En concreto, está preocupada
polo que pasará
polo que pasará
00:43
after her 10-day stay
on bed rest at the hospital.
on bed rest at the hospital.
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despois de estar dez días hospitalizada.
00:47
What happens when she's home?
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Que ocorrerá cando estea na casa?
00:49
If she were to give birth this early
it would be devastating.
it would be devastating.
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Se tivese que dar a luz tan cedo
sería devastador.
sería devastador.
00:53
As an African-American woman,
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Como muller afroamericana que é
00:55
she's twice as likely
to have a premature birth
to have a premature birth
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ten o dobre de posibilidades
de dar a luz prematuramente
de dar a luz prematuramente
00:59
or to have a stillbirth.
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ou de que o neno naza morto.
01:01
So Jane basically has one of two options:
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Así que Jane ten dúas opcións:
01:04
stay at the hospital on bed rest,
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permanecer en repouso no hospital,
01:07
a prisoner to the technology
until she gives birth,
until she gives birth,
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prisioneira da tecnoloxía ata dar a luz,
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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e pasar o resto da vida pagando a factura
01:14
or head home after her 10-day stay
and hope for the best.
and hope for the best.
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ou volver á casa despois de dez días
e agardar que todo vaia ben.
e agardar que todo vaia ben.
01:20
Neither of these two options
seems appealing.
seems appealing.
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Ningunha das dúas opcións é tentadora.
01:24
As I began to think
about stories like this
about stories like this
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Cando dei en pensar en historias así
e comecei a escoitar historias coma esta,
01:26
and hear about stories like this,
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01:28
I began to ask myself and imagine:
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empecei a preguntarme a a min mesmo:
01:30
Is there an alternative?
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Hai algunha 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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Hai forma de ter os beneficios
dunha monitorización de calidade
dunha monitorización de calidade
01:36
that we get with our trusted
partners in the hospital
partners in the hospital
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coma a que temos nos hospitais
01:39
while someone is at home
living their daily life?
living their daily life?
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mentres estamos na casa
facendo vida normal?
facendo vida normal?
01:42
With that in mind,
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Con isto na cabeza,
01:44
I encouraged people in my research group
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animei ao meu grupo de investigación
01:46
to partner with some
clever material scientists,
clever material scientists,
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a asociarnos con algúns
científicos enxeñosos
científicos enxeñosos
01:49
and all of us came together
and brainstormed.
and brainstormed.
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xuntarnos con eles
e facer chuvias de ideas.
e facer chuvias de ideas.
01:52
And after a long process,
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Despois dun longo proceso,
01:54
we came up with a vision, an idea,
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xurdiu unha visión, unha idea
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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dun dispositivo que se puidese levar
como se fose unha xoia
como se fose unha xoia
02:00
or you could apply
to yourself like a Band-Aid.
to yourself like a Band-Aid.
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ou que se puidese poñer coma un apósito.
02:03
And after many trials and tribulations
and years of endeavors,
and years of endeavors,
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Despois de moitos intentos e tribulacións,
e anos de esforzo,
e anos de esforzo,
02:07
we were able to come up
with this flexible electronic patch
with this flexible electronic patch
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fomos quen de chegar
a este parche electrónico flexible
a este parche electrónico flexible
02:11
that was manufactured
using the same processes
using the same processes
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elaborado seguindo o mesmo proceso
02:13
that they use to build computer chips,
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ca os chips dos ordenadores;
02:16
except the electronics are transferred
from a semiconductor wafer
from a semiconductor wafer
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salvo que a electrónica transfírese
dunha oblea semicondutora
dunha oblea semicondutora
02:21
onto a flexible material
that can interface with the human body.
that can interface with the human body.
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a un material flexible que pode
comunicarse co corpo humano.
comunicarse co corpo humano.
02:25
These systems are about
the thickness of a human hair.
the thickness of a human hair.
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Estes sistemas teñen o grosor
dun pelo humano.
dun pelo humano.
02:30
They can measure the types
of information that we want,
of information that we want,
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Poden recoller o tipo de información
que queiramos,
que queiramos,
02:33
things such as:
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cousas como
o movemento corporal,
02:35
bodily movement,
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02:36
bodily temperature,
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a temperatura corporal,
02:38
electrical rhythms of the body
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os ritmos eléctricos do corpo
02:39
and so forth.
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e máis cousas.
02:41
We can also engineer these systems,
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Tamén podemos deseñar estes sistemas
02:43
so they can integrate energy sources,
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para que integren fontes de enerxía
02:46
and can have wireless
transmission capabilities.
transmission capabilities.
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e poidan ter capacidade
de transmisión sen fíos.
de transmisión sen fíos.
02:50
So as we began to build
these types of systems,
these types of systems,
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Ao empezar a construír
este tipo de sistemas,
este tipo de sistemas,
02:54
we began to test them on ourselves
in our research group.
in our research group.
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comezamos a probalos en nós mesmos
no noso grupo de investigación.
no noso grupo de investigación.
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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Contactamos tamén
con algúns socios clínicos
con algúns socios clínicos
03:02
in San Diego,
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de San Diego
03:03
and test these on different patients
in different clinical conditions,
in different clinical conditions,
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e probámolos en diferentes pacientes
e en diferentes condicións clínicas,
e en diferentes condicións clínicas,
03:07
including moms-to-be like Jane.
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incluíndo futuras mamás coma 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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Velaquí unha foto dunha muller
a piques de dar a luz no hospital,
a piques de dar a luz no hospital,
03:15
being monitored for her uterine
contractions with the conventional belt.
contractions with the conventional belt.
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co cinto convencional para monitorizar
as contraccións uterinas.
as contraccións uterinas.
03:20
In addition,
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Ademais,
03:22
our flexible electronic patches are there.
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poden verse aí os nosos parches.
03:25
This picture demonstrates waveforms
pertaining to the fetal heart rate,
pertaining to the fetal heart rate,
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Esta foto amosa as ondas
pertencentes ao pulso fetal
pertencentes ao pulso fetal
03:29
where the red corresponds
to what was acquired
to what was acquired
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onde as vermellas son as que rexistran
03:32
with the conventional belts,
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os cintos convencionais
03:34
and the blue corresponds to our estimates
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e as azuis corresponden coa estimacións
03:36
using our flexible electronic systems
and our algorithms.
and our algorithms.
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dos nosos sistemas electrónicos flexibles
e os nosos algoritmos.
e os nosos algoritmos.
03:40
At this moment,
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Nese intre
03:42
we gave ourselves a big mental high five.
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chocamos os cinco mentalmente.
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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Algunhas das cousas que imaxinabamos,
comezaban a concretarse
comezaban a concretarse
03:48
and we were actually seeing this
in a clinical context.
in a clinical context.
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e estabamos véndoo alí
nun contexto clínico.
nun contexto clínico.
03:52
But there was still a problem.
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Mais había un problema:
03:53
The problem was, the way
we manufactured these systems
we manufactured these systems
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a maneira de fabricar estes sistemas.
03:57
was very inefficient,
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Era moi ineficiente,
03:58
had low yield
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cun rendemento baixo
04:00
and was very error-prone.
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e moi proclive a erros.
04:02
In addition,
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Ademais,
04:03
as we talked to some
of the nurses in the hospital,
of the nurses in the hospital,
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falando co persoal de enfermaría
do hospital,
do hospital,
04:05
they encouraged us to make sure
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animáronnos a asegurarnos
04:07
that our electronics worked
with typical medical adhesives
with typical medical adhesives
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de que funcionaban cos adhesivos médicos
04:12
that are used in a hospital.
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que se empregan no hospital.
04:14
We had an epiphany and said,
"Wait a minute.
"Wait a minute.
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Tivemos unha revelación e dixemos:
“Un momento.
“Un momento.
04:16
Rather than just making
them work with adhesives,
them work with adhesives,
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Mellor ca facelos funcionar con adhesivos
04:19
let's integrate them into adhesives,
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imos ver se os podemos integrar neles
04:23
and that could solve
our manufacturing problem."
our manufacturing problem."
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e resolver así o problema da fabricación”.
04:26
This picture that you see here
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Nesta foto vese
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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como puidemos integrar os
sensores nunha cinta adhesiva
sensores nunha cinta adhesiva
04:32
by simply peeling it off of a wafer.
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despegándoos dunha oblea.
04:36
Ongoing work in our research group
allows us to, in addition,
allows us to, in addition,
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Continuar co noso traballo de
investigación permitiunos tamén
investigación permitiunos tamén
04:39
embed integrated circuits
into the flexible adhesives
into the flexible adhesives
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introducir circuítos integrados en
adhesivos flexibles
adhesivos flexibles
04:43
to do things like amplifying signals
and digitizing them,
and digitizing them,
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para, por exemplo,
amplificar e dixitalizar sinais,
amplificar e dixitalizar sinais,
04:47
processing them
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procesándoos
04:48
and encoding for wireless transmission.
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e codificándoos para a transmisión
sen fíos.
sen fíos.
04:51
All of this integrated
into the same medical adhesives
into the same medical adhesives
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Todo isto integrado nos mesmos
adhesivos médicos
adhesivos médicos
04:55
that are used in the hospital.
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que se empregan no hospital.
04:57
So when we reached this point,
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Cando chegamos a este punto
04:59
we had some other challenges,
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presentáronsenos outros retos
05:01
from both an engineering
as well as a usability perspective,
as well as a usability perspective,
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relacionados tanto coa enxeñaría
coma coa usabilidade,
coma coa usabilidade,
05:05
to make sure that we could
make it used practically.
make it used practically.
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para estar seguros de que podiamos
facelos sinxelos de usar.
facelos sinxelos de usar.
05:09
In many digital health discussions,
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En moitos debates sobre saúde dixital
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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crese e transmítese a idea
de que podemos dixitalizar os datos,
de que podemos dixitalizar os datos,
05:16
wirelessly transmit it,
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transmitilos sen fíos,
05:18
send it to the cloud,
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envialos á nube
05:19
and in the cloud,
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e unha vez alí
05:21
we can extract meaningful
information for interpretation.
information for interpretation.
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extraer información valiosa
para interpretalos.
para interpretalos.
05:24
And indeed, you can do all of that,
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De feito pódese facer todo iso,
05:26
if you're not worried
about some of the energy challenges.
about some of the energy challenges.
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se ignoramos os desafíos enerxéticos.
05:29
Think about Jane for a moment.
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Pensemos en Jane un momento.
05:31
She doesn't live in Palo Alto,
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Ela non vive en Palo Alto
05:33
nor does she live in Beverly Hills.
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nin en Beverly Hills.
05:35
What that means is,
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Isto significa
que temos que considerar
a tarifa de datos e o custo
a tarifa de datos e o custo
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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05:39
for her to be sending out
a continuous stream of data.
a continuous stream of data.
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que supón para ela enviar datos
continuamente.
continuamente.
05:44
There's another challenge
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Hai outro desafío máis
05:45
that not everyone in the medical
profession is comfortable talking about.
profession is comfortable talking about.
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que a moita xente do mundo médico
non lle resulta doado de abordar.
non lle resulta doado de abordar.
05:49
And that is, that Jane
does not have the most trust
does not have the most trust
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É que Jane non confía plenamente
05:52
in the medical establishment.
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no colectivo médico.
05:54
She, people like her, her ancestors,
have not had the best experiences
have not had the best experiences
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Ela e xente coma ela, os seus devanceiros,
non tiveron boas experiencias
non tiveron boas experiencias
05:59
at the hands of doctors and the hospital
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nas mans dos médicos e do hospital
06:03
or insurance companies.
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ou das compañías de seguros.
06:05
That means that we have to be mindful
of questions of privacy.
of questions of privacy.
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Por iso temos que pensar na privacidade.
06:08
Jane might not feel that happy
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Jane pode que non se sinta cómoda
06:10
about all that data
being processed into the cloud.
being processed into the cloud.
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cos seus datos procesándose na nube.
06:14
And Jane cannot be fooled;
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Jane non é parva,
06:17
she reads the news.
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le as novas.
06:18
She knows that if the federal
government can be hacked,
government can be hacked,
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Sabe que se o goberno federal
pode ser hackeado
pode ser hackeado
06:21
if the Fortune 500 can be hacked,
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ou as empresas da «Fortune 500»,
06:24
so can her doctor.
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tamén pode selo o seu médico.
06:27
And so with that in mind,
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Con isto en mente
06:28
we had an epiphany.
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tivemos unha revelación.
Non podemos ser máis listos
ca todos os hackers do mundo
ca todos os hackers do mundo
06:30
We cannot outsmart
all the hackers in the world,
all the hackers in the world,
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06:33
but perhaps we can present
them a smaller target.
them a smaller target.
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pero si podemos presentarlles
un albo máis pequeno.
un albo máis pequeno.
06:36
What if we could actually,
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Que pasaría se no canto de ter
06:39
rather than have those algorithms
that do data interpretation
that do data interpretation
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eses algoritmos de interpretación
06:43
run in the cloud,
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funcionando na nube,
06:44
what if we have those algorithms run
on those small integrated circuits
on those small integrated circuits
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os fixésemos funcionar
neses pequenos circuítos integrados
neses pequenos circuítos integrados
06:48
embedded into those adhesives?
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incorporados nos adhesivos?
06:50
And so when we integrate
these things together,
these things together,
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Cando integremos todas esas ideas
06:54
what this means is that now
we can think about the future
we can think about the future
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significará que podemos
pensar nun futuro,
pensar nun futuro,
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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onde alguén coma Jane
poderá facer unha vida normal,
poderá facer unha vida normal,
07:01
she can be monitored,
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estar controlada
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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sen que teña que ter outro traballo
07:06
to pay her data plan,
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para pagar o plan de datos.
07:08
and we can also address
some of her concerns about privacy.
some of her concerns about privacy.
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Tamén poderemos responder algunhas
das súas preocupacións pola privacidade.
das súas preocupacións pola privacidade.
07:12
So at this point,
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Neste punto
07:14
we're feeling very good about ourselves.
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sentiámonos realizados.
07:16
We've accomplished this,
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Logramos isto,
07:17
we've begun to address some
of these questions about privacy
of these questions about privacy
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comezamos a atallar o tema da privacidade,
07:20
and we feel like, pretty much
the chapter is closed now.
the chapter is closed now.
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e cremos que este capítulo
está case pechado.
está case pechado.
07:24
Everyone lived happily ever after, right?
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Todos felices para sempre, non si?
07:28
Well, not so fast.
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Pois non tan rápido.
07:30
(Laughter)
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(Risos)
07:31
One of the things we have to remember,
as I mentioned earlier,
as I mentioned earlier,
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Unha das cousas que temos que lembrar
é que Jane non confía moito
no colectivo médico.
no colectivo médico.
07:34
is that Jane does not have the most trust
in the medical establishment.
in the medical establishment.
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Cómpre lembrar
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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que hai crecentes disparidades
en materia de saúde
en materia de saúde
07:42
and there's inequity in terms
of proper care management.
of proper care management.
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e hai desigualdades na xestión adecuada
da atención médica.
da atención médica.
07:46
And so what that means
is that this simple picture
is that this simple picture
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Iso significa que a simple imaxe
07:49
of Jane and her data --
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de Jane e os seus datos,
07:50
even with her being comfortable
being wirelessly transmitted to the cloud,
being wirelessly transmitted to the cloud,
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--incluso se ela está cómoda
deixando que se transmitan á nube,
deixando que se transmitan á nube,
07:54
letting a doctor intervene if necessary --
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deixando que un médico interveña,
se cómpre--
se cómpre--
07:57
is not the whole story.
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non é toda a historia.
07:59
So what we're beginning to do
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Así que comezamos a cavilar
08:00
is to think about ways to have
trusted parties serve as intermediaries
trusted parties serve as intermediaries
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en ter intermediarios de confianza
08:05
between people like Jane
and her health care providers.
and her health care providers.
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entre persoas como Jane
e os profesionais da saúde.
e os profesionais da saúde.
08:08
For example, we've begun
to partner with churches
to partner with churches
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Por exemplo: comezamos
a asociarnos con igrexas
a asociarnos con igrexas
08:11
and to think about nurses
that are church members,
that are church members,
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e procuramos persoal de enfermaría
que sexa membro delas,
que sexa membro delas,
08:14
that come from that trusted community,
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que veñan desas comunidades de confianza,
08:16
as patient advocates and health coaches
to people like Jane.
to people like Jane.
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para que actúen como defensores
e asesores de saúde de xente coma Jane.
e asesores de saúde de xente coma Jane.
08:21
Another thing we have going for us
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Outro elemento ao noso favor
08:23
is that insurance companies, increasingly,
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son as compañías de seguros,
cada vez máis interesadas nestas ideas.
08:25
are attracted to some of these ideas.
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08:27
They're increasingly realizing
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Estanse dando conta de que
08:29
that perhaps it's better
to pay one dollar now
to pay one dollar now
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quizais é mellor pagar un dólar agora
08:32
for a wearable device and a health coach,
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por un dispositivo poñible
e un asesor de saúde
e un asesor de saúde
08:35
rather than paying 10 dollars later,
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que pagar dez despois
08:38
when that baby is born prematurely
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cando o bebé naza prematuro
08:40
and ends up in the neonatal
intensive care unit --
intensive care unit --
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e remate na unidade
de coidados intensivos neonatais,
de coidados intensivos neonatais,
08:43
one of the most expensive
parts of a hospital.
parts of a hospital.
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unha zona das máis caras do hospital.
08:47
This has been a long
learning process for us.
learning process for us.
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Este foi un longo proceso de aprendizaxe.
Este proceso repetitivo de avanzar e
atacar un problema,
atacar un problema,
08:50
This iterative process of breaking
through and attacking one problem
through and attacking one problem
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08:54
and not feeling totally comfortable,
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non estar cómodos de todo co resultado,
e identificar o seguinte problema,
08:56
and identifying the next problem,
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08:58
has helped us go along this path
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axudounos a seguir neste camiño
09:00
of actually trying to not only
innovate with this technology
innovate with this technology
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de tentar non só innovar coa tecnoloxía
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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senón asegurarnos de que a poida usar
quen máis a precisa
quen máis a precisa
Outra cousa que aprendemos neste proceso,
09:07
Another learning lesson
we've taken from this process
we've taken from this process
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que obriga ter moita humildade,
09:10
that is very humbling,
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09:11
is that as technology progresses
and advances at an accelerating rate,
and advances at an accelerating rate,
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é que a tecnoloxía avanza
cada vez máis rápido
cada vez máis rápido
09:16
we have to remember that human beings
are using this technology,
are using this technology,
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e temos que pensar que quen usa
esta tecnoloxía son persoas,
esta tecnoloxía son persoas,
09:20
and we have to be mindful
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e darnos conta
09:21
that these human beings --
they have a face,
they have a face,
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de que teñen unha cara,
09:25
they have a name
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un nome
09:26
and a life.
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e unha vida.
09:27
And in the case of Jane,
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No caso de Jane,
09:29
hopefully, two.
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afortunadamente, dúas.
09:32
Thank you.
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Grazas.
09:33
(Applause)
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(Aplausos)
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