字幕表 動画を再生する 英語字幕をプリント Thank you. Alright, we're going to start with an exercise. Raise your hand if you know how many steps you took yesterday. Come on! Okay, so fair number. Raise your hand if you know your average blood pressure over the last month. Okay, so, some people in the room - good. Maybe a bit less. And raise your hand if you know how to read your own electrocardiogram - EKG? Okay, so a few select maybe Stanford med alums in the room. We have unleashed the most powerful tool in medicine to date. The digitally empowered patient. These patients have over 30,000 mobile health apps and 115 wearable sensory devices at their finger tips. But these are not all created equally. I see them on a spectrum. On the one hand, products that require very little interpretation and on the other hand products that require some more. So on this end you have your exercise tracking devices and mood diaries. These are great tools and probably no one's going to die if they don't take enough steps in any given day. Moving towards the middle, we have apps that start to offer some medical advice. So prenatal tracking apps, apps that monitor and diagnose psychiatric conditions, and then on this end you have more of your medical devices - so these are handheld electrocardiograms, handheld ultrasound, at home blood tests that are starting to come on the market. Now the food and drug administration has corralled all of these products into a regulatory grey zone. So they call the medical devices but they're not subject to the same rigorous standards that traditional medical device - such as a hip replacement or cardiac stint - would be subject to. So companies don't have to spend hundreds of millions of dollars on clinical trials proving that their product is safe. Well, what are some safety concerns with these? Well, patient confidentiality - they can be hacked. Misinformation. And something I'm actually an expert in: hypochondria. Or rather, cyberchondria. Why am I an expert in this? Because I'm in medical school. So you start medical school - I started - cardiology block. Learned about the human heart. I thought I had a heart murmur that would stay with me forever and I had my friend check it out and it was fine. It was normal. In fact, we did infectious disease: I thought I had picked up a parasite on my study abroad trip in undergrad but I didn't have that. And on our neurology block I had stayed up too late one night - probably had too much caffine, fingers started twitching a little bit - and I thought I had Lou Gehrig's Disease. It's funny but in the moment it can actually be very scary. Now, I wasn't alone by any stretch of the imagination. There's a name for this phenomenon: they call it "medical student syndrome." And studies have shown that up to 80% of medical students suffer from this and it's actually a normal perceptual process. So an increased area of focus on a particular part of the body can start - the person can start to manifest disease that is not actually real. On the first day of medical school, we all took the Hippocratic oath which includes the adage first to "do no harm." Now, if you think about these products and the FDA is not going to fully regulate them and there's a lot of valid arguments that they shouldn't and the physicians who have vowed to protect patients are not necessarily involved and there are potential problems that come out of them. Who is left to protect the patients? Well, at the Graduate School of Business I have a lot of friends who are aspiring health tech entrepreneurs and I tell them that they should probably take their own version of the Hippocratic Oath because they are the ones creating these devices. Well, that's not going to happen over night. So I think it's actually going to be up to you guys: the consumers. In every good market, the consumers have the power to choose. So I'm going to leave you with three things today: 1) Cyberchondria happens. It happens to the best of us. You're probably fine. Most people are mostly healthy most of the time. 2) Choose wisely. Choose products based on sound clinical research and if they do end up towards that end of the spectrum that require medical interpretation, make sure that there's a feature built in where you can get your questions answered. You should be able to press a button and talk to a nurse practitioner or talk to a doctor. And finally, if all else fails, and you find yourself in the middle of the night worrying about some malady because you bought some gizmo that's telling you about some organ that you probably didn't know you had before - don't hesitate to call your doctor! The perspective that comes from spending tens of thousands of hours studying this information and taking care of patients cannot be programmed into an app. Thank you.