Daniel Kraft - 4 episodes - May, 2025

Episode Transcript

Moira (00:00):
Well, Daniel, it's so great to see you. This has been

(00:02):
a busy spring. I mean and, ofcourse, we're just done with
NextMed Health 2025 in SanDiego, which was March 30
through April 2. Let's talkabout some high notes there, in
San Diego.

Daniel (00:16):
Yeah. So NextMed Health is a program I've been curating
for more than thirteen years,actually. This is our our our
program we started in in SanDiego in the Hotel del Coronado
in 2013, where each year webring together an amazing
community to look at the futureof health and medicine at this
sort of super convergence oftechnologies, not just AI or

(00:39):
medical devices or pharma ornanotech or biotech, but
bringing people together to kindof get a taste of what's now,
what's near to happening, andwhat's coming next, and what's
needed to really catalyze thefuture of health and medicine.
And this year, we had over 70faculty and 25 sessions. So we
really covered a lot aboutwhat's on the cutting edge and

(00:59):
help people sort of catalyze thefuture of health and medicine.

Moira (01:03):
Well, I'm gonna ask you about one person that I thought
was absolutely brilliant. And,of course, his name is Larry
Brilliant. Let's talk aboutthat. He was in several
sessions, but let's focus on hismessage.

Daniel (01:16):
Well, doctor Brilliant, who's if you're not aware, is a
famed epidemiologist. He playeda key role in helping eradicate
smallpox in the nineteenseventies with the WHO. He later
ran google.org. He helpedcofound Seva, which has helped
with blindness for millions offolks around the planet. We sort
of asked Larry as such a bit ofa sage to kinda give us

(01:36):
perspectives on, you know, howdo we meet this current moment?
You know, it's no secret thatright now in the first few
months of 2025, health andmedicine and public health are a
bit under threat from, you know,challenges to NIH budget to
USAID to WHO. And Larry sort ofgave us a bit of the
perspective. You know, we seemlike we're in difficult times.

(01:57):
We've had worse times, the CubanMissile Crisis, you know, World
War two. And how do you sort ofdo well and do good in times
that are challenging?
And he sort of challenged us allto do, you know, something that
helps somebody who's less,capable or or, lucky as we are
as we try and make changes goingforward. But also the
perspective of taking the longview and how do we kind of learn

(02:19):
to cross collaborate inchallenging times. Because often
it's the challenging windowsthat catalyze the future in
unexpected and hopefullypositive ways. And so, you know,
in the next med health context,we wanted to have the
perspective of history, but alsohow do you shape the future in
in really empowering ways withthe with our sort of core aim of

(02:40):
how do we democratize health andmedicine around the planet and
make health more health moreaccessible and more equitable,
whether it's rural California orrural Rwanda. And and Larry
Brilliant, gave a great sort oflessons in in how to think about
that future and how to even haveperspective on our challenging
times.

Moira (02:57):
Well, I have to say that, I was especially moved when he
talked about what it was likebefore vaccines. So because so
many of those vaccines that wewere kids, it's like, look. We
have all these vaccines. Theydidn't always exist, and they
were all pretty new and justwhat it was like to be there and

(03:18):
to say we have to do somethingand then to be able to create
them and go in and vaccinate.That's like, we kind of forgot
about that, and we were also ourexpectations were modified given
that, we had a COVID vaccine ina year.
So it's it's pretty easy. It'snot easy.

Daniel (03:38):
It's not easy. And and, also, we're we sometimes have
short memories. Doctor Brilliantmade the point that in the last
century, fifty million peopledied of smallpox. Now it's
eradicated. You know, fiftyyears ago, people were in iron
lungs from polio.
Now we have very few cases ofpolio. But with the changes in
perception and some of the antiscience and anti vaxx movement,

(04:00):
in the last few months, we'reseeing the first deaths of
measles here in The UnitedStates, something hugely
preventable. And so, we need tounderstand that our massive
impacts on health span andlifespan are largely thanks to
public health. And we need tobe, not withdrawing from that,
but enhancing our our oursystems to both, you know,

(04:21):
prevent diseases using vaccinesand other measures, but also to
think proactively about how dowe design and optimize health
span, for all of us.

Moira (04:29):
Well, I have to say you had to do AI.

Daniel (04:33):
AI or I like to call it more IA. I guess you've heard me
say before, more intelligenceaugmentation. But, of course, a
through line from NextMed Healththis year was all the ways that
AI, which is moving so quickly,is impacting everything from,
you know, drug discovery. Youknow, the Nobel Prize last fall
was won for, the ability to usecomputational LLMs and GPT type

(04:53):
platforms to help

Moira (04:55):
LLMs and GPT. Yeah. Yeah. Large language models and Yes.
Chat GPT kind of things.

Daniel (05:01):
Right. Where you can sort of probe load up your
protein and potentially findunderstand how it folds and how
you might identify particulardrugs or molecules that might
act as a a drug against thosesort of targets. So we're really
starting to speed up the abilityto not in the old ways of
screening thousands ofmolecules, but design the
molecules using AI machinelearning that might fit a

(05:22):
particular protein or mechanismto start to cure diseases, in
much faster and personalized andprecise ways. So that's a bit of
a through line. But what Ithought was most interesting is
now the ways that AI is enablingus to take all these new omics
sets.
Right? It's not just the genome.It's now the metabolome from a
continuous glucose monitor. Itmight be the low cost proteome.

(05:43):
It could be your sociome data,your digitome data from your
smartwatches and wearables.
And now we're able to start toput those together and be
empowered. And one of myfavorite talks was by he's a
technologist turned patientnamed Steven Brown. And Steve
had been in the med tech spacetwenty years ago and got back
into it recently because,unfortunately, he was diagnosed

(06:06):
with multiple myeloma. And heshared the story of being
diagnosed with myeloma and howlong it took for him to get
diagnosed even though thedoctors had his labs. He built
his own sort of health agent.
He's a super programmer and AIexpert. He built sort of a
Hippocrates and also his ownvirtual hematologist and
cardiologist who looked at hisdata from before this diagnosis
and said, oh, of course, youshould get a bone marrow, and

(06:26):
this looks concerning for amalignancy, in the marrow. And
just as an example, if we'reentering this age where you're
gonna be interact with differentagents of different specialties,
it could be the overall masterclinician like Hippocrates, it
could be a nutritionist, itcould be a workout coach that's
gonna interact with you as avery smart agent, can leverage
all these new LLMs, largelanguage models from multiple

(06:49):
sources, and really give you anew level of interaction. We're
not waiting months to see thespecialists, and will enable all
of us to be much more proactiveand engaged in our health. Where
I think that's gonna head in thenext couple years is we'll all
have our own sort of self agentstuned to our age, our culture,
our personality.
I like to call them sort of,generative health. And these

(07:10):
will be super tuned, they'llhopefully be proactive and
preventative and keep you ontrack to a long lifespan and
health span. But also when youdo have a disease, we'll be able
to sift through the data andpick it up early proactively and
then guide you and your clinicalteams to make the smartest, most
personalized healthrecommendations, whether it's
for something really challenginglike myeloma or something as
common as a sprained ankle. Soreally interesting ways that we

(07:32):
can start to bring massive datato insights to something you can
use in action on yourself.

Moira (07:38):
And what I like about this is the idea of plug and
play. Like, well, I'm reallyconcerned about my voice and
whether for me, there's a lot ofrecordings in my voice. You
could tell the differencebetween it now and it thirty
years ago if you wanted. Butwhat is it now? We can tell
things in your voice.
We can tell things in in yourgait and how you walk. And for

(08:02):
those things that are of concernto you, the ability to bring in
those things that are of concernas opposed to, well, this is
sort of imposed on you and allthis is going on. That's fine
when you're, like, you're introuble. But the idea that you
could decide that in your inyour everyday life about what
you want checked with theintelligence that's now behind

(08:22):
it.

Daniel (08:23):
Right. And that can almost be seamless. So the
things you've just mentioned,your voice is being recorded all
the time whether you want to onyour smartphone or on a podcast.
And we actually had a greatsession, led by the team at
Click Labs, where they justrecently published that the
sound of your voice, the voiceis a biomarker. They've been
able to leverage to predict whohas diabetes, who has early

(08:43):
prediabetes because of highblood sugar or might even have
diabetes and not know they haveit, just based on the the AI
analysis of your voice.
They're also doing similar workwhere their voice can predict if
you have high blood pressure.And also other folks have shown
that voice biomarkers canpredict predict early signs of
neurologic disorders like ALS,Lou Gehrig's disease, or early

(09:04):
forms of Parkinson's. So that'ssomething that we're collecting
ubiquitously and can be used forproactive early detection.
Another example, talked aboutgait. Well, our smartwatches,
our smart rings, our our Fitbitsto beyond actually able to look
at your gait and see subtlechanges.
In fact, on some platforms, itcan tell you if you're likely

(09:24):
to, have weakness in one leg orlikely to have a fall. And so
there's even this idea ofmobility as a new vital sign,
which really correlates tohealth span, risk of a fall,
breaking a hip, for example. Andso those are small examples of
small data collected ininteresting ways when you put
them together in context, willstart to give us our sort of
health agents that will give usproactive warning and, early

(09:46):
intervention.

Moira (09:47):
Now I gotta say I got a lot more on my list, and I'm
hoping you'll come back, with ananother one of these next week.
And in the meantime, it seems tome that you have a video of some
of, the people who were speakingonline. Isn't that right?

Daniel (10:05):
Yes. If you go to nextmed.health and you look
under videos, you can see ourcatalog of a lot of the talks
from our prior NextMeds. We'restarting to put up put up some
of the new talks every week fromthis year's. It's a great place
to get up to speed on all thethings that are happening that
are impacting health care.Again, not just the high-tech,
but we leverage in designthinking and creativity, the

(10:27):
sort of social determinants ofhealth, health access and
equity, is, I think, somethingthat technology and getting
everybody in the loop on canreally expand where and how we
do care.
And, again, I think that's atheme of bringing the future of
health care to everybody, notjust the super rich who can
afford, you know, all thescreenings and and new drugs,

(10:48):
but to bring it to, for example,Nigeria. We had doctor Yomi,
who's a physician from Nigeria,who brought the sort of lesson
of you don't wanna just drop offa technology in Africa and say
good luck. You wanna teach thefolks there how to innovate and
leverage and come up with theirown solutions, often leveraging
technologies. And in many cases,these technologies are
leapfrogging what can happen inThe United States and let's say

(11:10):
Europe. They can go to Africa.
They can go to India and beimplemented. A small example is
a company, called Jivi dot ai,which is an AI doctor in your
pocket. Launched in India,available here now, where you
can talk to it in Hindi or Farsior French, and you'll have an AI
clinician sense that can helptriage you. It also can be a
health coach for your nutrition.It also uses the camera to track

(11:32):
your vital signs.
So these are things that areoften going to places where
there almost is no doctoravailable, and it's gonna start
to help, democratize care aroundthe planet.

Moira (11:42):
Nextmed.health. And, hopefully, you'll stay healthy.
I'll see you next week.

Daniel (11:46):
See you, Moira. Stay healthy.

Moira (11:50):
Okay. Good. Now we'll go back and do another one.

Daniel (11:53):
Yeah. That was a good riff. I mean, we we flowed okay,
and there's so we just barelystarted it.

Moira (11:57):
Slow you just you just slowed down and flowed great.
And yeah. And so let's go tothis will do

Daniel (12:07):
Let's do one where we could talk a little bit about
the the biotechnation session a

Moira (12:10):
little bit. And health access and exhibit exhibitors.
So

Daniel (12:14):
Exhibit I think maybe we do kind of the maybe a little
bit on on the brain and, youknow, brain and neurotech
because that people

Moira (12:21):
want to couple of examples. Okay. So brain
neurotech, health access,biotech, exhibitors, oh, and
awards.

Daniel (12:29):
Sneak in. I wanna sneak in I wanna sneak in Dean Kamen
and the fact that we had EricTrouple there. On women's
health, we've talked about thewomen's, health span and women.

Moira (12:37):
What about Dean Kamen?

Daniel (12:38):
So I just wanna sneak in that he was there, in some form.

Moira (12:42):
Yeah. He's been such an such an enigma with me. I have
been with him. Teresa Hines and,I mean, all of these places I
have been with him. I didn'tknow whether he doesn't dig me
or he doesn't like womenengineers, which is hard to
believe, or he just I have noidea.
And it's like, I'm done begginghim for interviews. Not gonna

(13:05):
happen. And yet I've been a ajudge at first. You know? I've
been

Daniel (13:11):
Well, I could certainly

Moira (13:12):
Don't don't don't do it. It's don't do it. Too many
people have tried. And, if hewants to, he knows where I am.
He runs into me enough.
Gotcha. You know? I gotta runinto him three or four times a
year. And so at some point, he'sgonna go, you know, this would
be good. It's like, alright.
You know where I am. We'll we'll

Daniel (13:31):
we'll we'll feature more of the army stuff with Jan
McDonald and just mention thatDean

Moira (13:34):
was there. No. No. We can know. Should do it exactly the
way it is.
I was just telling you. Yeah.This is why. It's like, hey.
Aren't you gonna interview?
Most people are like, yeah. No.Or wait a minute. And it's like,
I've I've finally gotten it,Dean. I don't know.
There's something you do that webeg you or we're not doing it
the right way. So I was like,fine. And, it's like, enough is

(13:56):
enough. You know? If it was ifit was Elvis, I'd be, you know,
begging.
Elvis, you're back. It's biotechstories. Academy of biotech
stories.

Daniel (14:05):
Well, I think when he's got something to sell, like his
new insulin pump or the theDaisy, you know, vaccine patch,
Maybe that's the right angle onit. I don't know because he can
cover so much.

Moira (14:15):
He can cover so much, but I didn't know. I didn't know
what it is. I don't I can't tellhim I'm an engineer any more
times than I have. You know?Okay.
And I was like, what are yougonna do? Okay. So which one
should we start with?

Daniel (14:30):
Let's start with the the the biotechnician part because
that's that fits in.

Moira (14:33):
Great. That's good. Well, Daniel, I'm so glad you're back.

Daniel (14:40):
Always good to be back.

Moira (14:42):
And, you know, last week, we were talking about, NextMed
Health, 2025, which is just inSan Diego April, May year. And,
I wanna talk about the bestsession there, Biotech Nation.

Daniel (14:57):
Well, of course, I'm not sure how I came up with the name
for that amazing session thatyou were so kind enough to help
curate and lead. But I I thoughtthat was brilliant because it it
kinda highlighted three verydifferent but exciting areas of
health and biotech. And maybe wecan mention each of them
briefly, and you can chime insince you were

Moira (15:16):
I was there.

Daniel (15:16):
Yeah. The first was a great talk by Hans Kierstedt,
who's you know, a stem cellbiologist and entrepreneur. He's
also the CEO of something calledthe Human Immunome Project. And
you've all heard of the genomeand maybe the proteome, but the
idea of the immunome is it's notjust your t cells and your b
cells, but what's happening withyour adaptive immune system,

(15:38):
what kind of t cells, what kindof b cells, how you might
respond in a dish to a virtualvaccine, or how might, how
quickly you might respond to atherapy for a cancer. And what's
fascinating, I think, about thishuman immunome project, it was
starting to characterize this atthe human scale so that we can
understand where someone'simmune system is, how it might

(16:00):
be responding or not respondingto disease, how it can be
improved to prevent you fromgetting sick, or how it can be
leveraged, for example, in theamazing world of immunotherapy
for cancer.
So that's a whole interestingarea. And he's developing a
second technology company calledImmunus and, using the secretome
of progenitor derived from stemcells that seem to interact with
the immune system and can helpimpact metabolic disease and

(16:23):
maybe even help rejuvenate,tissues like muscle. So pretty
exciting era in the immunologicspace. What what do you think?

Moira (16:30):
Now what do you I don't even know how to spell
secretome, and I was there. Howdo you spell it?

Daniel (16:35):
S e c r e t o m e. And it's this idea that a lot of,
particularly, progenitor andsome stem cell populations
secrete a fair amount ofsometimes very unique molecules.
And no one molecule by itself isprobably most efficacious as a
therapy, but when you put themtogether, a bit of a gimmick, as
I call it, that sort of cocktailin combination, is most

(16:58):
biologically active. And sothat's being actively looked at
in the setting of now earlyhuman trials and might be,
something quite impactful acrossmany disease states.

Moira (17:08):
Well and I think it's also important to know that
Immunis, the the latter one, isa for profit. It's a company.
He's he's built and sold anddeveloped all kinds of
companies. But the HumanImmunome Project, that's a
nonprofit. That's meant to bringthis all together for the
benefit of humanity.

Daniel (17:26):
Right. Just like the Human Genome Project kicked off
our ability to first with a fewdozen individuals sequencing
their genome. Now we're atmillions of folks getting
sequenced. The price ofsequencing is down to about $80
today from companies like UltimaGenomics. You know, it's when
you put these things together.
I I think of, you know, a bit ofa theme from Nexman Health is
this idea of multi omics. We hadEric Topol there as one of our

(17:47):
keynotes in a session thinkingabout the future of smart aging.
And any part of health now isgonna be most informed by
layering up different forms ofinformation from your immunome
to your secretome and to to yourgenome to your proteome. And
that's where we can start tobuild our sort of future digital
twin, interact with that throughavatars and agents. And it's

(18:08):
gonna really be a game changerfor being proactive and
preventative rather thanreactive.

Moira (18:13):
One thing that was exciting for me in the
biotechnation session was thatwe're always talking about,
well, let's, maybe we can, makethis treatment, and it'll be one
done. You know? Something willhappen. It'll really actually
treat somebody, and we metsomebody.

Daniel (18:31):
Yeah. We had, my friend and colleague, doctor Patrick
Heinz. He's a pediatric ICUdoctor who's been very involved
in, developing therapies andtests for sickle cell disease,
which is many of you might knowis a genetic disease where the
hemoglobin can sickle and causea lot of pain crises and often
early organ failure and death.It's a really crippling disease.

(18:52):
And he's what was interestingabout Patrick is last fall, he
was on a fundraising expeditionto climb Mount Kilimanjaro,
which is in Africa.
It's a very high mountain. Youhave to be fit and in shape.
It's pretty high altitude. Buthe brought with him, a colleague
named Jimmy, and Jimmy was ableto summit Mount Kilimanjaro with
him. And what's unique aboutJimmy is he had sickle cell

(19:13):
disease until a few years agowhen he was one of the first to
get cured, one and done, usingCRISPR, taking out his bone
marrow, blood forming stemcells, using CRISPR based
technologies to reprogram thosestem cells so they have normal
hemo more normal hemoglobin.
And now, incredibly, he can goto altitude and, is functionally

Moira (19:33):
Hike around. Yep. So it's an What? That's Couldn't get out
of his chair. Yeah.
And now he hikes around onKilimanjaro.

Daniel (19:40):
Well, many sickle cell patients can certainly have
healthy windows, but there's anincredible human story. Alright?
It's amazing to talk aboutCRISPR and it won the Nobel
Prize, and Jennifer Dowden andcolleagues have done incredible
work. But to see an actualperson whose life has been
transformed and and cured, andnow we're looking at using
CRISPR to potentially curethalassemia, maybe even HIV, and

(20:00):
and even remote settings. And sowe're seeing kind of the impact
of that at the human level.
I thought that was particularlyimpactful.

Moira (20:08):
That's great. And then there was a final contributor to
that session, which wasinteresting because it was
nonmilitary, but also military.Let's talk about that.

Daniel (20:18):
Right. Doctor Jennifer McDonald, is the lead one of the
leads at a group called ArmyAdvanced Regenerative
Manufacturing Institute that wascofounded by, the amazing
engineer Dean Kamen, was alsowith us at Xmed Health. And
Jennifer kind of showed us theart of the possible, and, you
know, we talk about stem celland regenerative medicine and
cell therapies. But thechallenge is often those are

(20:40):
very bespoke. You need a postdocin the lab under the tissue hood
trying to glow the cell cultureor build a three d structure to
make a new meniscus for a badknee.
And what they're building issort of meeting biology and
engineering at scale so that wecan take some of these even, you
know, cell therapies andimmunotherapies for for cancer
all the way to building newthree dimensionally printed

(21:03):
organs like lungs and maybehearts and kidneys and do that
at scale. And, of course,sometimes in military, which
should help support army, theinstitute, are help helping fund
this, but they are partneringwith academic and other members
around the country and the globeto sort of become that kind of
engineering hub to really scaleregenerative medicine. So I

(21:23):
think that's a really excitingdirection for for the future.

Moira (21:26):
Well, thank you, Daniel. See you next time.

Daniel (21:29):
I'll see you next time. And for folks who wanna check
out some of the talks fromNextMed Health, just go to
nextmed.health and look at ourvideos. We've got a lot of
amazing content, and I wouldencourage everyone listening to
be proactive about their health.And if they see a challenge that
they wanna solve, becomefuturists and help build the
solutions for for health carefor for all of us.

Moira (21:49):
Right. That's nice. I'm just trying to think if we
should just do a neuro one.

Daniel (21:58):
Yeah. We can do one that doesn't have to be so NEXMED
focused, but we can mention someof this

Moira (22:01):
was Yeah. That was, like, the two things. Yeah. Oh, yeah.
These are what was here.
I didn't mean to hog it with thebroad biotechnation, but it's a
good one. Let's just do a durala neuro one. Sure. And then we
got three in the can. Are wegetting to see that?
Three in the can? See

Daniel (22:16):
that? Three in the can instead of saying in the can.

Moira (22:20):
Any number in the can. It's just my hands. So I go
three three in the can. Don'tcount. Don't count on my
fingers.

Daniel (22:27):
Okay. I'm I'm I'm looking at my screen, so I'm not
seeing you. So if you're rollingthree, wasn't seeing you.

Moira (22:34):
Okay. You wanna do it wanna think about what you wanna
do here, and I'll

Daniel (22:40):
I think we'll kinda I'm trying to I think a little bit
about brain computer interfaces.And so we had Max Hodak from
Science Inc. We had MehronGerberts from Inner Cosmos, and
I wanna mention Meredith Perryand Ella Mine for sleep. And

(23:05):
then

Moira (23:07):
You know what? That's about what they can handle.

Daniel (23:10):
That's about three? Okay.

Moira (23:11):
So you can look at more and substitute that.

Daniel (23:14):
I'll skip that sleep one. I'm gonna go to the brain
computer interface side, andthen the noninvasive approach,
which is this company calledAmpahealth, which is using
transmembrane dextimulation tocure depression. So those are
three that's a good riff.

Moira (23:29):
That's a good one. And if we can get them to go out every
so often, we'll get them to goout. I'll even mention it. It's
like, oh, don't forget to lookat the videos out there because
you let them out one at a

Daniel (23:39):
Yeah. They're not they're not all these don't all
be out, but maybe I can try

Moira (23:42):
But that's it. But they see the past ones Yeah. And
they'll start to see if we'retalking about something, in
likelihood, they'll go out. So,you

Daniel (23:47):
know Exactly.

Moira (23:49):
While it's the completeness is good in math,
it's sometimes bad in bad inaudio. Okay. Alright. Daniel,
good to see you.

Daniel (23:59):
Great to see you. It's on radio, but I can hear you
great.

Moira (24:04):
Just definitional. Definitional. Say, there was so
much for a while there on braincomputer interfaces. And,
obviously, it's gonna itcontinues on, but I wanna know a
couple things. I want theessentially, just two.
I wanna know something that isimplanted in my brain, and I

(24:26):
wanna know something that'soutside my brain. And you can
even do more than two if youwant.

Daniel (24:30):
Sure. Well, I think we all are excited about our sort
of age of neuroscience. Thebrain is still our probably most
important organ and leastunderstood, but where technology
is starting to meet neuroscienceand neurotech is really enabling
some almost magicalcapabilities. You know, we've
now seen examples of braincomputer implants that enable

(24:52):
folks to think and to speak wholost their ability to speak
being locked in from a strokeor, things like Lou Gehrig's or
ALS disease. We were bothrecently at my NextMed Health
Conference, and we had severalsessions touching on the future
of neurotech.
One of our exciting sessions wason the future brain computer

(25:12):
interfaces. We had Max Hodak,who was the cofounder of
Neuralink, which is a well knowncompany, but has switched gears
to a newer company calledScience, science dot x y z. And
they're not trying to buildthose sort of metal, you know,
little postage sized plants,implants on the brain surface.
One's called the Utah array.They're trying to build, and

(25:34):
they are building, biohybridneural interfaces with the goal
of sort of fusing these sort ofbrain computer bases that are
built with biology, built withneurons themselves that can last
for potentially years ordecades, kind of redrawing the
boundaries of the brain.
And, it's exciting to see thatenter the clinical space.
They've already even had somedemonstrations in making that
work to help, folks withblindness see. So, there's

(25:58):
really kind of a new engineeringof neural interfaces meets brain
computer interfaces. That stilltakes something like a surgery
to get them on the brain, butthat's exciting. We also saw a
different example, being appliedin early trials today as well
from a company calledIntercosmos.
An entrepreneur named MarronGruberts has been developing

(26:18):
with neuroscience andneurosurgeon colleagues a small
implant that goes underneath theskin in the brain and can
direct, some ultrasound to anarea of the brain that when you
buzz it with some ultrasoundseems to be able to negate many
forms of depression. And so thatis a exciting potential, you
know, relatively minimalimplanted, brain computer type

(26:40):
interface.

Moira (26:41):
Hey. We're we're halfway. We're halfway up.

Daniel (26:43):
That might be helpful for many folks with intractable,
depression. And speaking ofmental health challenges and
brain computer interfaces, Ithink a really exciting area is
how do you do that without anydrills or any surgery? We heard
from a company called Ampahealthwith the CEO. It's a
neuroscientist named Don Vaughn.They've been advancing this

(27:03):
field of what's called TMS,transmagnetic stimulation, which
is not a new technology, butusually requires a fair amount
of capital equipment.
And patients often with severedepression have to go in for a
thirty day protocol where theyhave magnets essentially
stimulating certain parts of thebrain. There were often a month
long protocol seems to be quiteeffective at reducing chronic

(27:26):
depression. What they were ableto innovate is to create sort of
almost a handheld, almost iPhonetype version of a mobile version
of TMS that can be deployedalmost anywhere, maybe even
eventually at home, and developa protocol in combination with
what are called neuroadaptogensfor a one day protocol, which in
their first clinical trial of, Ithink, over sixty patients with,

(27:47):
rare recalcitrant depressioncured most of them, almost
eighty percent for almost a sixmonth period. So that's an
example of a

Moira (27:54):
Wow.

Daniel (27:55):
Brain interface stimulation that might be a
whole new modality that's gonnabe impactful. And it may have a
role not just in depression, butin everything from addictions
to, brain, traumas. And so Ithink those combinations of new
ways to bridge and blendtechnology with the brain, both
on the surface and inside and onthe surface of the brain, are

(28:16):
really gonna be exciting.

Moira (28:18):
Well, I have to say, seldom do I ask people one
question and get a really greatanswer. So you win.

Daniel (28:25):
What's what's on your mind today? You know? But these
technologies, by the way, aresomewhat coming to our home. You
know, one thing that's superimportant to our brain health,
and I I think there's a newframing instead of, you know,
mental health and, you know,neurotech, this idea of brain
health that we can taketechnologies to both treat
diseases like Parkinson's andhopefully Alzheimer's, but also

(28:47):
think about ways to optimize ourbrain health and health span.
And one example we had atNextMed Health was a,
entrepreneur named MeredithPerry who, along with technology
from MIT, from Ed Boyden's lab,is developing a technology
called Elemind, it's a wearableEEG.
I've been trying it myself. Youwear it when you're asleep, and
the sensors there listen to yourbrain waves and play a feedback

(29:09):
loop, some sound that, at leastin the early studies, lets folks
who have trouble falling asleepfall asleep much faster and
potentially can be used to sortof hack our sleep, and improve
our deep sleep and our REMsleep. So early days, but some
of these technologies aren'tgonna be just for the sick care
side, but maybe the brain healthcare side of the equation. And,
these are things you can startto try out yourself. Sometimes

(29:31):
the jury is out on the long termstudies, but I think it's
exciting that consumer tech isstarting to bridge with home
tech.

Moira (29:38):
Once again, I wanna give a Tech Nation, Biotech Nation
award to your wife with you goto bed with all these devices
on, and now you got a sort ofthis EEG number going on. She's
such a lovely woman. She putsshe puts you even had her Fitbit
on for a while. I I don't knowwhat to say, Daniel.

Daniel (29:56):
Exactly. Well, I've got my Oura Ring and my Whoop and my
Apple Watch. I'm I'm scoring andquantifying my sleep in all
sorts of different ways, andI'll take whichever one gives me
my best sleep score each night.But, it is an example of of how
we can start to measure thingsthat used to require sleep lab
just from a a consumer deviceand and, start to help optimize
our brain health, and andthere's many ways to do that.

(30:17):
Again, our colleague we know,Dean Ornish, has been showing
that lifestyle interventions,exercise, diet, connection,
meditation can even start toreverse, you know, early forms
of Alzheimer's and dementia.
So it doesn't take fancyneuroscience to often impact our
our our brain spaces.

Moira (30:34):
But it takes a very understanding life. Okay.
Alright. Enough of that. Enoughof that.
Thanks so much, Daniel.

Daniel (30:40):
Thanks, Moira. And if folks wanna take a look at some
of the content on neuroscienceand beyond, they can go to
nextmed.health and catch some ofour videos on the future of
health technology and medicine.

Moira (30:52):
Great. Perfect. Alright. That's good. Three three nice
ones.
Three nice ones. Is that goodenough?

Daniel (31:00):
Well, we're here. We might as well think of what is

Moira (31:02):
the story. The energy, I got the time. Alright.

Daniel (31:04):
Yeah. Let's see.

Moira (31:05):
Let me just look

Daniel (31:06):
at it. Wanna talk about the future. I wanna talk about
that, Larry, you weren't therethat session, but smart
patients, on the future primarycare and the future of the sort
of medical work. Like, it's ait's a bigger question, but it's
we have Larry Smarr there. Youknow Larry Smarr?

Moira (31:20):
Of course. I didn't realize he came this year. I
guess he comes every year.

Daniel (31:23):
He was there the last day with his son, Benjamin
Smarr, and, their primary caredoctor named Michael Cariso, who
takes care of both of them. Andwe talked about this, you know,
what's it like to take care oftwo of the most quantified guys
in the planet. Ben Smahractually did the studies at UCSF
on the Oura Ring, you know, forlooking at, you know, COVID and

(31:44):
things like that. So I think alittle bit about the future of
smart primary care could be afun session.

Moira (31:49):
Okay. We can do that. Sure.

Daniel (31:56):
Okay. Alright. That'd be I I think that's a that's a fun
one.

Moira (31:59):
Here we go. Okay.

Daniel (32:00):
And then I can riff into that. What's the future of the
workforce? So maybe you can aska question. What does it mean?
Who who gets to be a doctornext?
How do we train them? Whatwhat's what's that Yeah.

Moira (32:07):
Wait a minute. What are these doctors? Yeah. Okay. Well,
hey, Daniel.
Great to see you.

Daniel (32:12):
Great to see you, Moira.

Moira (32:14):
Now I have to say, we always talk about all this
technology. You can do this. Youcan do that. But we never
actually expect maybe to go toour doctor's office, and the
doctor says, okay. Now you'regonna do this and this and this,
and he's gonna be all over thistechnology for you.
It's like, is that possible?

Daniel (32:31):
Well, most doctors today, including myself, are
often sometimes feel likethere's a lot of technology
available, but it still hasn'tmet the clinic or the hospital
room or the ICU. We're living inthis age of incredible
possibility, but translatingthat to the bedside or the
website, to the next generationof medical students and nurses

(32:51):
and pharmacists is often abigger challenge than
technology. But it's starting tocreep in. Right? We've talked in
many sessions about artificialintelligence and how it might
even be malpractice for yourdoctor not to have used the AI
to help do a diagnostic workupor pick the right therapy.
And we're starting to see someinnovative physicians start to
really kind of plug in theavailable technology and help

(33:13):
catalyze the next generationtechnology to do, for example,
smarter primary care. So I'llgive you one example. At NextMed
Health twenty twenty five, wehad an amazing session with a
primary care doctor namedMichael Carrizo Carrizo, and he
has two of the most incrediblepatients. Larry Smahr, who is a
distinguished Emeritus professorat UCSD. He founded the

(33:35):
California Institute ofInformation Technology.
He's the most quantified guy inthe planet. He got very into
moving from astrophysics to hisown biology and tracking almost
everything about him. And andMichael is his doctor, which is
an interesting challenge. He'salso the doctor for Larry's son,
Benjamin Swire, who's now also aprofessor at UCSD, who's been
leading a lot of the work onusing consumer technologies like

(33:57):
smart rings to understandphysiology of diseases like
COVID, and even pregnancy. So Ihad them come together to go,
how do you build the primarycare clinic of the future, and
how do you, as a clinician, as apatient, start to interact with
all these massive forms of datato make it useful for care?
And so what they've been doingis they're already super

(34:18):
quantified. They're taking whatI think is gonna be the the
future of primary care andhealth care is long term data
looking at someone's baselineinformation, where their resting
heart rate is, how they'resleeping, what their heart rate
variability is, theirtemperature, their movement, for
example, and be able to makethat part of your continuous

(34:38):
physical exam and enablingpathways for that information to
flow from someone's Apple Watchor Fitbit or AuraRing or Samsung
Ring. Pick your technology. Whatthey're enabling is to have that
data flow come into the workflowof the primary care doctor
because no doctor, nurse,pharmacist, physical therapist
wants to see all the data fromyour wearables and your

(34:59):
otherables and your genomicinformation, etcetera. They want
the actionable information.
So part of the future primarycare is just gonna be somewhat
continuous. We'll have, as wetalked about, agents that might
work in partnership with yourmedical team, helping to look
after you, but plugging back inyour primary care doctor to
interact with all these newforms of multi omics to really

(35:20):
not just be waiting for you toshow up with a disease, but
working with you collaborativelyto optimize your health span,
optimizing diet, what might bethe the best workout regimen for
you, and nutrition. Being ableto find through your convergence
of data when something's alittle bit off before you end up
with an advanced cancer ordevelop full on diabetes or

(35:41):
develop a neurologic disorder.So it's a really interesting
time to think.

Moira (35:45):
Or why are you walking around with a 105 degree fever?
Don't you know you have it? No.I don't. I just don't feel good.

Daniel (35:52):
Yeah. We'll be able to quantify what what not feeling
good is. A lot of things aresubjective in health and
medicine, you kinda get what youmeasure. And now we have lots of
new ways to measure, disease andin new ways. Right?
You know, the averagetemperature for most of us is
not 98.6, which people seem tothink is it might be the average
temperature, but none of us arevery average. And so as we go

(36:13):
into the future of primary careand specialty care and AI and
agentic enabled care, this ideaof precision and personalized
medicine, how do you look atsomeone in context of their
data, not just the averagedatasets? And and how do you
integrate that into workflow ofa primary care doctor or
specialist or the AI agentthat's gonna be more and more
involved in our our continuousmedical monitoring and and
therapy?

Moira (36:33):
Well, if all of this technology is going to our
doctors, what might our doctorslook like? Are they gonna
change?

Daniel (36:41):
So as we think about these technologies enabling not
just the doctor, but thecommunity health worker, the
nurse, the pharmacist, yourphysical therapist, your
nutritionist, kind of upskillingalmost everybody to leverage new
forms of data insights. Often,you know, we're all starting to
go to doctor GPT. Used to begoing to doctor Google. That
means our sort of pathways ofcare, our ability to do self

(37:02):
care are changing. How weinteract with our primary care
doctor or specialist if you'relucky enough to have one if you
need one.
So that begs the question of,you know, what is it like to set
up a clinical practice of twentythirty five or twenty thirty?
How do we take the medicalstudent who today in 2025 won't
finish medical school for fouryears and residency for another

(37:22):
three? So they're not gonna beeven be done with their basic
training until 2033. How do youeducate, you know, a medical
student or nursing student todayto be ready to integrate digital
health, AI platforms, new formsof digital therapeutics, n of
one drugs, the smart hospital tohome movement where care is
gonna move from the hospitalincreasingly to your own home,

(37:44):
or remote care, or phygital,meaning blending physical,
virtual. How do you teach goodwebsite manner, not just good
bedside manner?
Those are questions I don'tthink we have answers to, but I
know that we do need to rethinkour medical curriculum for
medical schools. There's some ofyou may have heard the Flexner
Report, which is from the earlynineteen hundreds, which
reframed how we do medicaleducation. We most need a
Flexner report two point o orthree point o to make sure, you

(38:06):
know, building those bridges tothe future because things are
moving so fast. The skill setsthat clinicians are gonna need
and who you select to be, thedoctors, nurses, pharmacists of
the future needs to bereimagined as well.

Moira (38:16):
Well, this is such a huge topic. I can't wait to talk to
you about it in the future.

Daniel (38:21):
Well, we'll definitely talk about the future. And I
think the challenge for all ofus is to realize that the future
is coming faster than we think.And in many cases, you don't
need to wait for some of thefuture. You can be proactive.
I've been building a database ofmedical solutions called
digital.health.
It's a website you can go to.And if you have a particular
clinical challenge issue as apatient, as a clinician, as

(38:42):
health care systems, you canfind some of these existing
solutions that aren't thefuture. They're here today. Our
challenge and opportunity is tobring them into our health care
workflows, align the incentives,to not wait for the future to
happen, to but to enable us tocatalyze it here today.

Moira (38:56):
Great. Alright. Well, thank you so much.

Daniel (39:00):
Thanks, Myra.

Moira (39:01):
Super. Alrighty.

Daniel (39:04):
Sorry for that plug. I just thought I should say that.

Moira (39:06):
Well, what I'll do is I'll check I'll check out I'll
check out if we can use it. Thisis

Daniel (39:10):
Yeah. It's not I it was a

Moira (39:11):
little There's well, the thing is I just listened. I I
listened. It's like, no. No. Gofor it.
Do do it the and you did it theright way. And I was like, okay.
Great. And I could I could findout whether we have we can take
it. We can if we can use it, wewill.
If not, we'll just we're able toexcise it. You see, you're a
professional now and had a

Daniel (39:27):
Yeah. Well, people plug in their companies all the time
on your platform. I'm notplugging. I'm just saying it's a
resource.

Moira (39:31):
Yeah. They're not our they're not our chief
correspondent.

Daniel (39:34):
True. True.

Moira (39:34):
True. That's true.

Daniel (39:36):
Okay.

Moira (39:37):
Instead of a say, it's like, actually, if let's say IBM
was giving me, you know, adollar or a million dollars to
say, you know, underwritten inpart by IBM, I couldn't
interview. So we're giving youthe you you got that line we're
walking up to. So we'll itworked out. Don't worry. I'll
check it out.

(39:57):
We won't get in trouble. So hey.Okay. Thank you so much. Don't
move any mic.

Daniel (40:04):
Okay.