Telehealth Secrets Conference 2018 by VSee Speaker: Ted Driscoll, Ph.D. (DigitalDx Ventures) More info here: vsee.com/conference

1. How Medicine is becoming
a changing Big-Data Field
Ted Driscoll, Ph.D.
Managing Partner
DigitalDx Ventures

2. In the last 60 years…
• Doctors used to make diagnoses based on
inferences from limited data
• Now they have too much data to absorb
– My grandson was BORN two years ago with more
than a gigabyte already in his EMR!

3. What really makes us different?

4. A Human Being
Weight is ~150 lbs
What is he made of (by mass)?
Oxygen = 97.5 lbs
Carbon = 27.75 lbs
Hydrogen = 14.25 lbs
Nitrogen = 4.8 lbs
Calcium = 2.25 lbs
The rest = ~ 2 lbs
Phosphorus = 1.5 lbs

5. A Dog (Great Dane)
Weight is ~150 lbs
What is he made of (by mass)?
Oxygen = 97.5 lbs
Carbon = 27.75 lbs
Hydrogen = 14.25 lbs
Nitrogen = 4.8 lbs
Calcium = 2.25 lbs
The rest = ~ 2 lbs
Phosphorus = 1.5 lbs

6. So what makes mammals
different?
• How those atoms are organized.
• What is attached to what.
• How they pass around energy.
• How our bodies change each day
• This is INFORMATION

7. Molecular Informational Differences
Cells in Human Body ~100 Trillion Grows as we mature
Genome in each cell ~3.1 Billion Base Pairs Mostly stable
Epigenome Millions (?) Changes slowly
Microbiome Up to 1 Quadrillion Changes daily
Immune Cells ~1-5 Billion Cells Changes slowly
Virome Billions (?) Changes daily
Communicome Millions (?) Changes slowly
Proteome Millions (?) Changes daily

8. It’s all code
• Computer code is binary. (0s and 1s)
• Genetics code is quaternary. (As, Cs, Ts & Gs)

9. Today
• A doctor has less time per patient
– Gigantic EMRs for each patient
– Soon a whole genome for each patient
– And epigenomes, microbiomes, nucleomes,
immunicomes, communicomes, proteomes, …
– And we are being exposed to many chemicals in
our food, toothpaste, shampoo, etc.
• Every patient is now recognized as unique

10. Personalized Medicine
• Big Realization: We are all slightly different!
• Every individual needs a custom drug or
treatment now.
• Determining that targeting is a big data
problem.
• Vast data mining is coming to medicine.
• Doctors will need help from AI.

11. Where is this going?
• Today the doctor is swamped with
information.
• Inevitably, Artificial Intelligence will become
involved.
– Help the doctor see what is important
– And advise the doctor on best courses of action

12. Steering Evolution
• For millennia, humans have been leveraging
selection to slowly optimize genetics
– Corn
– Grains
– Dairy
– Pets

13. Reading
• In the past two decades, we’ve been ”reading”
our genomes and life’s genomes.
• Seeing defects and predispositions
• Identifying mutations
• Detecting pathogens
• Identifying susceptibilities

14. Now we are “Seizing The Steering
Wheel of Evolution”
• We can now write the genome.
• Writing the code of life is enormously powerful
• Four ways to do it:
– Zinc finger nucleases (ZFNs)
– Transcription Activator-Like Effector-based
Nucleases (TALEN)
– CRISPR-Cas9 system
– Mega-nucleases

15. This raises Ethical Issues
• Designer Babies?
• Gene Drives That Disrupt Ecosystems?
• The Law of Unforeseen Consequences

16. Impact Areas
• Where will these technologies make an impact?
– Human Germline (correcting genetic birth defects)
– Mutations during life (cancer, aging, neurodegenerative &
auto immune diseases)
– Food-related Products (plants, animals, etc.)
– Bacterial/Viral organisms (microbiomes, pathogens)
• And soon we will be monitoring our bodies
continuously with wearables
– Our EMR will become a live dashboard