It's medicine, Jim, but not as we know it. The future of healthcare is changing, thanks in large part to the smart phone. Is this the first step towards robot hospitals and true patient power? I met with Scanadu founder Walter De Brouwer to find out, and discover how a personal tragedy saw him join the race to build the world's first Star Trek-style medical scanner and put "an emergency room in the palm of your hand".
De Brouwer is one of the people behind the Scanadu Scout, a clever handheld sensor that measures your temperature, heart rate, and other vital signs just by touching your forehead, similar to the tricorder scanners used by Mr Spock and Bones McCoy of the Starship Enterprise.
The Scanadu -- and its spin-offs, including the urine-sampling ScanaFlo -- have soared past crowdfunding targets on IndieGogo, and are in the running to scoop the $10m Qualcomm X-Prize to develop a medical scanner. World-changing it just may be, but Scanadu has its roots in a very personal disaster that threw De Brouwer headfirst into the medical system.
Tragedy to tricorder
De Brouwer's background is in formal linguistics, the branch of data and algorithm study where mathematics meets linguistics -- which he describes as "search before there was anything to search". He found himself applying his understanding of numbers to medicine in 2005, when his 5-year-old son fell 11 metres from a window, leaving the boy in a coma.
"On the Glasgow scale -- a coma scale, a very interesting scale," remembers De Brouwer, "he was at the lowest, at which normally the chances of recovery are zero.
"We were in hospital a year. After two months we knew everything about that hospital; when you're there 24/7 there is nothing to do but wait, so you try to understand your environment." For a data analyst, that meant looking at the numbers: "In any environment, I see a text and when there are numbers in it, I see something I at least understand -- the structure of that text. It's a bit like a puzzle. It's a game.
"I realised that the most important part of our lives, medicine, is where love meets death at a certain moment."
Love meets death... and data
As he studied the numbers, it became clear to De Brouwer that data is crucial to the future of medicine. "As Marshall Macluhan says, 'We eventually become the tools we use.' In the 19th century we looked at our body as a machine because of the industrial revolution; after the PC we looked at our body as the hard disc and so on; but in the 21st century what is the tool that we use? Data itself. It's no longer atoms, it is data.
"That means we can think of our body as a river of data. And now comes the good news: data you can change. If you know the state of the data today, and you know where you have to go to be better, you can make a plan."
But in today's medical world, data is only gathered at certain times. "You only get data when you're dying!" Fortunately his son managed to beat the odds. "He was in such a bad state… But now he is a very happy kid."
"After three months they told us he's better now; the recuperation will take a long time, but he can go to paediatrics. So that was good -- but all my monitors were gone. I was in a panic -- it was number withdrawal syndrome. So what can you buy? A thermometer? I bought a blood pressure cuff -- but where's the ECG, the oximetry? All gone!"
Inventing the tricorder
De Brouwer was frustrated at the lack of a way to collect data, even though he didn't at first think he'd be the one to come up with it. "I needed an input modality. I was only interested in the algorithms. But I cannot have structured input if I don't make a structured device, so I had to make hardware.
"This was not the intention from the beginning; we wanted to make a website with numbers. We wanted to make the Bloomberg of health. We thought somebody was going to build it but nobody did."
So De Brouwer began to recruit. "Luckily, close to Stanford it's very easy to find scientists, electrical engineers, physicists. The problem is mathematicians, because they all work for Facebook and Google. They predict 'the next click'. But it's a big world, and for me it was an opportunity to get mathematicians from Europe. All my best mathematicians are from the UK. The filter of Oxford is so big in the beginning, they're not making their students dumber, you know?"
The road to Scanadu wasn't an easy one. "We had several problems. We had so many iterations and dead ends in the beginning, because look around -- no-one has ever done several medical parameters in one device. And certainly not in a device that can meet our target, which was that it must produce the result in 10 seconds.
"That's because we did surveys, and people were giving us on average 8 seconds. Which is a very strange number because it's the same number that is also dominant in sitting on a bull during a rodeo, and Twitter. It's 8 seconds after reality."
Sensors indicate life signs, Captain
You measure your wellbeing with the Scanadu by touching the small handheld device to your temple for a few seconds, almost like a salute. "We had to make a way to use the body itself as much as possible, almost as a battery," De Brouwer tells me.
The Scanadu measures all this data from outside your body by measuring electrical changes. "We are electrical beings. We are the body electric!"
It's designed to be easy to use, by anybody, anywhere, recording your data to an iOS or Android app on your phone. The potential of the Scanadu could be life-changing for the developing world, something De Brouwer learnt from his previous involvement in the One Laptop Per Child project. "You only need one smart phone for a complete village, and you don't even need healthcare workers because the intelligence is in the device."
The 8 second limit did mean some compromises, though. "For instance, heart rate variability, you can't do in 10 seconds. We need at least 3 minutes for that. But if you really want that, you just have to hold it there."
Smart phone smarts
Fortunately, the rise of the smart phone proves an incalculable boost to the next generation of medical devices. "We are standing on the shoulders of a giant, this little box. The problem is we can't get into the box, unless you can prove to the device-maker that there are 30 million people out there that want to buy this, before they'll change anything in that box.
"People ask us, 'Why wouldn't you make a smart phone yourself?' Because it costs a lot of money!"
But the biggest challenge is ensuring that the device, and the development that went into it, complied with guidelines and certification from US medical watchdog the FDA. "The main challenge for us is the FDA process. Where normally you might work one week on an app, we work for a month on a small part of the app because you have to document everything, with timestamped documents, in FDA-certified systems."
This knowledge is ripe to be shared, thanks to the Internet. "I think there is a part of us -- and I saw it in hospital -- that is full of empathy, that wants to help other people. We just don't know how.
"I believe in empathy networks rather than bulls*** networks, people who tweet, 'I just opened a bottle of wine.' Who gives a s***? But if you could say, 'My son just had this medicine, and that medicine didn't work,' and then you get tips and tricks from the crowd… and it's up to you to accept them or not, or to share them with your doctor."
Ultimately, the collection of these vast amounts of data can benefit the whole of society as well as the individual. Although Scanadu doesn't harvest your data -- for reasons of practicality as well as privacy -- there is potential for you to add your results to an unprecedented corpus of knowledge. It's fitting then, if data is the new body, that De Brouwer says, "I sincerely believe people should donate their data the way they donate organs."
It's not just attitudes that De Brouwer sees changing in coming years. The "entrenched medical-industrial complex" needs to change. "Nobody in this system is satisfied. The doctors are not happy. The hospitals are not happy. The government are not happy. Who is happy?"
He predicts the health US system is about to collapse "very soon", heralding a future of branded hospitals, robot surgeons, and data-driven doctor-patient relationships.
Dare to know
It'll be fascinating to see how Scanadu and other devices change the way we view our health. "The map that we have put on the human body is made by doctors. If you give all these instruments into the hands of the crowd they're going to rewrite the map."
Each Scanadu comes with its own tiny acknowledgement of the potential of taking responsibility for our health. The Latin Sapere aude, Dare to Know, is micro-engraved in each scanner. Dare to know your body, dare to take responsibility for your own health, and dare to do something with that knowledge -- like Walter De Brouwer, who turned tragedy into a potentially life-saving innovation.