before we get started I want to share with you the fact that there are incredible breakthroughs coming on the health span and Longevity front these Technologies are enabling us to extend how long we live how long we’re healthy the truth is a lot of the approaches are in fact cheap or even free and I want to share this with you I just wrote a book called Longevity guide book that outlines what I’ve been doing to reverse my biological age what I’ve been doing to increase my health my strength my energy and I want to make this available to my community at C so longevity guidebook.com you can get information or check out the link below all right let’s jump into this episode our panel here today is titled how can AI democratize health for the next billion and um to contextualize this I’ll simply say that given the development of AI and weable sensor
[00:01:02] technology uh there is no excuse for a world 10 years from now without a massive increase in health uh there is no greater wealth than our health every mother wants one thing for her children to be healthy and I think that’s a world that’s more peaceful and more prosperous what I’d like to do is uh ask each of our panelists to just take one minute and introduce themselves from the perspective in which they’re here to speak about this each of them is bringing a very different unique perspective on global democratization will would you kick us off yeah absolutely uh very happy to be here uh will Ahmed I’m the founder and CEO of whooop uh we build wearable technology to unlock Human Performance and improve health a combination of metrics like sleep and Recovery and
[00:02:00] exercise and stress a bunch of physiological measurements like heart rate and um V2 Max and pulse socks skin temperature these are all the things that whoop is measuring and as I think about the potential of continuous Health monitoring and AI you can imagine a future in which you have this 247 coach that’s able to look at all of your data and really understand for you what you need right now and that include lifestyle decisions that’ll include diet that’ll include when you need to see a doctor or not uh and I I’m pretty optimistic that the future of Health monitoring uh will make the world a much healthier place when coupled with AI thank you will I could agree more Dr Oz uh what perspective do you come to us with I am I’m a fan of Peter diamandes if you follow what he’s doing you’ll probably do well in life but along the way I realized that a heart surger by
[00:03:00] training and much of what we knew was causing chronic illnesses amongst the people I was doing open heart surgery on could be avoided if they took some prophylactic measures so to try to tell folks outside the Ivory Towers of Columbia University where I’m on the faculty how to do that I started doing more media so I hosted the drage show which aired here in Saudi Arabia for its entire course of 13 seasons and in 120 other countries and I learned a lot about people around the world saw the challenges to health early in this process I launched a show with my partner opro wirey we started a company called share care uh that was run by Jeff Arnold uh who is the founder of WebMD and it was the biggest digital Health platform in the United States um and we began to learn a lot about how to give people digital tools uh the the big lesson we learned is you want to give them rewards which we’ll talk about a bit more as we come along some of the rewards are informational but often times you just literally want to give them something and it’s especially of
[00:04:00] evident with people in the working place so Muhammed please stand Mohammed is a pediatric surgeon our partner here but we launched uh just agreed with this with the National Council on Occupational Health to bring this Sharecare platform to all 1.2 million businesses in this uh the the kingdom and the effort to get to more than 10 million workers and many more coming from other countries over the next few years is projected is to get them to be healthier and I’ll just give you one fact that might highlight why that matters financially we ranom numbers in the United States if you can get the average person to retire not at 61 which is the average but the 64 that three-year difference in that one age cohort is worth a trillion dollars to the US economy that’s enough to close the US debt which is onethird of all the debt we have in the world it’s also enough to to make our social programs like Medicare and Social Security solv it the same would be true here in Saudi Arabia and this monograph which the FI published if you turn to page 60 this’s a list of attendees and what everyone is
[00:05:01] doing to stay healthy so you can pick these up you know in different places but in this list you’ll notice two things there’s com common products like probiotics that are being used by a lot of people but but 20% of the attendees are asking and taking maybe taking but asking for metformin which is a prescription drug it’s a linked with longevity so it’s a very sophisticated group here that are looking for ways to biohack and even spa hack 30 40% are doing cold plunges and when sauna so there’s a lot of awareness of prevention how do we activate that AI would be the best way to customize amazing Dr tanal please introduce yourself and your perspective on this thank you Peter another huge fan of yours and thank you for having me I’m Jim tabom I run foresight Capital uh we’re a three and a half billion dollar Healthcare focused Venture fund um have a great interest in the intersection of AI uh and Healthcare uh in general we believe that over the next decade there’s going to be a
[00:06:01] profound uh impact and change that comes through the two coming together um there are two categories of things that we’re looking for things that are um more readily uh integrated on top of the existing Healthcare infrastructure and uh one way of thinking about this is that we have right now A Health Care delivery system in the United States and globally which uh has a very wide variation of standard of care and um and AI methods are going to be able to to narrow that variation so that we’re able to deliver more uniform um best practices across patient population and we think that those are the types of things that are going to roll out um over the the course of the next five years uh and then there are larger questions about given what we know now how do we redesign uh Healthcare delivery uh and uh it’s interesting here in Saudi uh in fact uh the government has been uh embarking on that exercise and um and in the United States it’s uh very hard um to uh to change a system
[00:07:02] that’s so uh uh encumbered uh and uh and um has been around for so long so um but nonetheless we have an interest in looking at a very long-term project of re recreating uh and reimagining healthare delivery in the United States and hopefully over the next few years we’ll get involved with something um substantial that focuses on that so those are in our interests thank you thank you Jim uh Amir Rubin please introduce yourself and your perspective here well thank you great to be here I’m in the fan club of this entire row of people so it’s a privilege to be here so uh my background is in healthc care Innovation and delivery I used to be the CEO at Stanford University’s health system and then I was Executive Vice President at United Health Group big Fortune 5 company and then went to a startup one medical that reimagined the doctor’s office and combined digital Health and inperson Care we took it public and then we sold to Amazon last year so if you’re a us Amazon Prime
[00:08:00] member you could add one medical for nine bucks a month you could get all you can eat on demand digital health and then in 31 markets across the US inperson care and what I’ve seen kind of across my experience is how do you take this great Innovation uh that all the these amazing people have shared and how do you fit it into workflows of both kind of the demand side the problem statements for consumers and employers and payers and the supply side Physicians clinicians nurses care coordinators and so right now I run a venture firm called healthier capital and we’re investing in health Tech this intersection of how do we take these great exciting Technologies but yet fit them into the workflow of clinicians and I I’ll use an example from one medical as the kind of things we’re looking for so in one medical a consumer within a minute can have 247 access to digital health no co-pay no deductible no claims
[00:09:00] and we charged a membership fee n bucks month so how did we not overwhelm our providers with unlimited demand so we built our own technology and we first use natural language processing now some generative AI approaches that reads the emails based on the content pulled it out of the physician inbox we then staff a national 247 team not all of them have to be Physicians or even clinicians based on the content then we had a human in the loop but then generative AI now helps draft the response so we can take 50% of the tasks off of a physician yet then have one to two minute response for the consumer so it’s an example of how do you blend technology into services but Peter I want to throw it back to you uh so I’ll play moderator on this end okay you have an unbelievable background and been a student and fan uh of you and and x prise and I know you’re a thought leader please share a little bit about how you’re thinking about this in healthcare uh sure um I like studying
[00:10:01] how Industries get massively disrupted right so the pts the telephone lines around the world got disrupted when a service that was not 10 times 100 times better came in and made getting a landline irrelevant right and so we see India with uh you know gash Amani’s 5G Network just amazing um we saw Google come in and make libraries irrelevant I’m interested in completely crushing destroying obliterating and Reinventing the healthcare industry and I do think that we’re going to get there relatively quickly there’s a point at which why would you ever go there is a point which AI is the best
[00:11:00] physician period right where it’s malpractice to diagnose without AI in the loop there is a point at which the most of your data is collected on your body in your clothes in your car in your bed in your urinal all the time and that data is fed up to your AI That’s monitoring you not once a year for a checkup but continuously through your day and finding things at the very beginning so I’m interested in where what countries are going to like reinvent healthare and make us Healthcare super jealous that we don’t have that yeah so I’m not interested in incrementalism so I going to start with you m um you have some fascinating data how do you think about the the rise R ing billion I’m going to not call it you know the
[00:12:01] bottom billion the rising billion and how this will support them you mentioned Ai and I share your belief that’s J by the way in your panel when Jack hit was describing sandbox eq’s large quantitative model thank you for that yeah opportunity and you should moderate uh I’ve watched from the best Through The Years Dr Oz so I’m trying to learn but well done then M awardwinning uh quality work uh I the big the big opportunity with AI I think is it’s honest honest now I asked say I’m sorry not not judgmental yeah no it can be it can make mistakes obviously it can hallucinate but there’s give you I’ll give you two examples the one classic example that Jack hit shared with me years ago when I was first trying to understand what this was was pathology slides so if I get a pathology slide in a western country for prostate cancer the pathologist will overread cancer they’ll say there’s more cancer than there really is why would they do
[00:13:01] that they they do it because they’re humans They Don’t Want to Miss a cancer so they’ll say something is a more advanced tumor than it really is just in case because they’re not sure pathology slides read by AI don’t make that mistake because they’re just bluntly telling you what it is so the great number of people have their prostates taken out that’s true in the west it’s also true in the East but the more pervasive issue today is we have a little bit of a illness industrial complex there’s a lot of money spent to make us sick making foods that aren’t good for us subsidizing those Foods sometimes they’re addictive Foods you know we support I I think we probably put as much money in tobacco subsidies in America as fruits and vegetables you know it’s just not done in a way that objectively honest person would want but these are historical realities why these were done I’m not blaming the people just is true that we’re not doing our best AI generated advice will have to tell you the truth it doesn’t fall prey to human fail ability because it’s kind
[00:14:01] to be kind and an effort to be kind hurts you like a parent who loves you but does the wrong thing by enabling behaviors it also will take on special interest groups that maybe don’t want you to do the right thing and I think if you put those together we have an opportunity not just in the west but also in the rising billion to say honorably your water is so poor that you can’t be healthy as healthy as you could because you have arsenic levels you know 100 times more than they should be so as a country you need to do better job with water supply I mean basic stuff it’s not just curing polio which would be nice also but it actually starts to get into these issues that expose pathology that otherwise we would ignore well how many excuse me I’ll ask it yeah how many Loops are in circulation and what you mentioned what you’re measuring today what what would be your the next three or four things that you would love love to be
[00:15:00] able to measure physiologically on in the body where are you going well when we first started woop we looked at what were some of the the sort of more capable medical Technologies out there and how could we put those in a smaller form factor and so initially it was the PSG machine which is like the gold standard for Sleep monitoring um it was the electrocardiogram but in particular to be able to measure heart rate variability which is this fascinating lens into how your body’s recovering and it was actually the chest strap which is the heart rate monitor from the 80s that athletes wear to train and being able to measure heart rate accurately during all sorts of different activities now the good news is we’ve now been able to take those Technologies and put them in a small form factor that has the same level of efficacy and if I think about um going forwards all the new capabilities we’ll probably go back to a similar place which is just saying what are all the different pieces of technology that you find in a hospital room or that are off the shelf um you know more cumbersome pieces of
[00:16:01] technology that you’ll be able to put in a much smaller form factor much more affordable form factor and democratize I mean just think about the fact less than 1% of humanity measured their sleep last night yet we know that sleep is essentially one of the most important things you can do for longevity for performance for really reversing all sorts of disease States and everything that that could go wrong and yet such a small percentage of society today is measuring it so it’s often asked well what more can we measure what more can we measure I think a good starting point is just getting a lot more people to be measuring their bodies because you can only really manage what you measure sure I I’m curious um both of you have been in the medical system uh investing in the medical arena is it do we start from from clean sheet and work up or do you
[00:17:03] try and take the existing systems and and improve them Jim how do you think about that I mean I like your categorization to simplify but do you do you want to live are you gonna live long enough to see changes made no no I mean I I i’ i’ hope Hope Springs Eternal you know and uh I think you know what uh you know venture capital start off with with um macro themes uh the macro themes bring you to entrepreneurs uh and the entrepreneurs bring you to investment opportunities um so the macro theme is to use AI to you know make uh care of delivery more uniform then the entrepreneurs underground that are delivering that um have a spread of ways of going about it I would say um ironically uh there’s not a tight correlation between revenue growth and techn techology Excellence uh can can I
[00:18:01] can I ask on top of that do you think that doctors will change or medical systems will change I I I don’t believe so I I think it’s they’re they’re so ingrained in how they do what they do that to get people to actually change is almost impossible well I think there’s small change and large change okay and there and there’s and there’s um who’s at risk and who can benefit from change um and in places where people go at risk uh and they can deliver we’re we’re involved in a cancer uh care delivery company that’s making some changes to the way that the way the Cancer Care is delivered um originally we were hoping that they would be really heavy on the tech front they’ve just been really heavy on the figuring out how to get doctors to accept various changes that are uh and you know that are easy for them to accept I mean how long did it take for cardiologists to accept using AI to read an
[00:19:01] EKG right I mean stethoscope stethoscope just now just now we’re getting doctors to allow AI to analyze acoustic sounds which we’re so bad at objectively we’re bad at hearing Austin Flint murmurs please well and I think it’s a it’s a great question Peter I think the answer is both and meaning I think we’re going to have Innovation and continuous improvement from within the ecosystem and sometimes we’ll have disrup from without but if one is naive to how the ecosystem works I like to say big healthare always wins and so uh but I think also understanding the stakeholder needs uh I I actually was just with a kind of cancer uh almost customer relationship management software company that’s helping manage patients longitudinally and a lot of practices in community practices they don’t have a the knowledge base and then the staff to manage kind of the symptoms and followup
[00:20:00] on on these immunotherapies so they’re not using the latest generation so part of the answer there is okay and by the way they’re not getting paid for that time and but this panel is about the next billion so let’s take it let’s take it there so I think then the end on the next billion is however then there are some approaches that can leap frog these things and we’re seeing this now in a lot of this generative AI so I’ve looked at a number of companies now where a doctor and a patient can sit across from each other and not only have the system do transcription document what the doctor’s saying but also say kind of do the differential diagnosis I think it’s this I think it’s that it could be this consider ordering these exams and I think back to your other point Peter I think this could be an area like we saw cell phones in some parts of the world Lea frog landlines we could see the same here we may have more regulatory burdens and more stuck in our current ways in the
[00:21:01] US um actually I’ve been spending some time with the Ministry of Health these last couple days here in in the kingdom and it’s good to be the king it is and it’s also however good to have a a national Viewpoint of Regulation we have pros and cons in the US from cities and counties and States but in terms of having a uniform digital Highway in terms of for having consistent standards it’s very hard to innovate in that can I put forward the thesis and get your feedback which is the I’m going to compare the us against Africa in health the US has such regulatory burden and such a disease based industry a sick care industry that shifting the battleship will be extraordinarily difficult but pick your favorite African nation where there is little but there’s 5G there’s
[00:22:02] smartphones and with the proper creation of sensor Technologies we can have a groundup revolution using AI to democratize health just like in Africa we saw um uh the first cell phone based currency exchanges using minutes right which is innovation I still would love to have in the US so do you imagine that we might see in five years time and I’ll remind you guys five years from now I said this that we have standards of Health Care improving in the rising billion um at the mass level not at the wealthiest but at the the general populace level well I think I think the I I think the place that has the most likely scen for that type of scenario is actually here or the U is Saudi or UAE yeah uh and they’re already starting and they’re doing planning and they’re they’re making an
[00:23:00] Earnest effort meu has just spent the last couple days U banging around the healthcare Authority here and he can make more comments but um I mean you need a lot of factors you need um uh you need uh government um that that can actually be empowered to make change um alignment uh long-term thinking money um and a lot of the factors are here and and I think one needs the right Financial incentives we can do it also in the US I mean the system is responding exactly as the financial incentives are absolutely you get what you incentivize so Ai and Healthcare we all know where it’s applied revenue cycle billing collections claims that’s where all the first money is to be made in Ai and Healthcare and you know everything that Dr Oz was talking about of digital pathology and digital Radiology it’s there but it’s much much slower why is it FDA approval is it through CMS can you get build for it how
[00:24:01] do you get reimbursed but we’ve seen for example in Medicare for seniors in the US we have 50% of seniors now in Medicare hmos Medicare Advantage well there was a financial incentives for the insurance companies for the groups uh and it’s not a perfect model far from it but I think to Jim’s point it takes leadership at the national level at the country level it then takes the right incentives the entrepreneurs will come up with the ideas but just to feed off that I’ve been to Saudi Arabia five times this year wow so and I as you have been talking to Miles baby sorry lot of f fly miles that we have not been able to use one day G donate him the will but I I what I’ve noticed here anyway is that the real winning game for health is going to come back down to the issues of making it easy to do the right thing sort of the blue zones approach and there’s probably a blue zones in the southern part of Saudi Arabia but know the other places where there are blue zones okanawa Sardinia they have done
[00:25:02] things that just every single day push you to walk a little more which by the way that by itself is probably the single biggest driver of longevity the average American walks 4,000 feet steps a day in Saudi Arabia it’s less because everyone’s indoors so often the optimal is you know well over 10 but let’s just say seven but that’s just a basic example that will can monitor and keep track of but I I think those are the kinds of things that ultimately will allow the extra billion people that we’re talking about uh to rise up and I spoke on Monday at the African Summit same basic idea the leap frogging that you mentioned is happening there already with Technologies and orbus is a company that looks at retinal images and does AI evaluation to diagnose everything inside your brain but a lot of other metabolic illnesses as well again we don’t do that in in in most parts of the world but they just can screen a lot of people but I think monitoring is a big part of it what I’d like to do in our final eight minutes is is give each of you two minutes to address that question how can
[00:26:02] AI democratize health for the next billion I want to bring us back there um will yeah and just reflecting on on the conversation here I a lot of how at least I’ve thought about building whoop is very uh customer first or like you know individual first and it strikes me that we’ve talked a lot about you know different regulations and you know what doctor’s offices are to do and we’ve almost looked at it more from the bureaucracy standpoint but I think that when you talk about a billion people it’s going to come from the users first and you know we might be able to learn something from the education system right now so it wasn’t like generative AI went to the education system and said hey we’re interested in rolling out you know large language models we’re interested in you know helping the students better understand how to write papers and answer questions it was just just like all of a sudden every school around the
[00:27:01] world woke up to the fact that their students can now write a paper entirely from a large language model and now every school is trying to figure out what the hell do we do with this new world and they’re changing way faster than they ever thought they would and I think what we’re going to see happen in healthc care is that level of disruption where all of a sudden answers are going to be at the fingertips of individuals around the world um you know there’ll be someone wearing a woop and the the AI layer that sits on top of that is going to tell them they’re about to have a heart attack in 30 minutes and guess what they’re not going to call their doctor and ask they’re just going to go to the ER right and all of a sudden when these things start to happen in real time the system is going to have to adapt rapidly and I think what’s so powerful about AI you talk about a billion people is that the cost of that level of intelligence is going to be so low that it’s going to be touching every individual and so that’s what’s going to push the system Amir going to you next yeah I think we
[00:28:01] can have a doctor in everybody’s pocket exactly and I think actually technology wise that’s here today at least kind of a triage and diagnostic I don’t a doctor or a much better doctor in everybody well I still believe we need humanity and compassion and also do you not think that AI can be more empathic than a human I I think for than most humans probably possibly I do think I think the data does show that right I think that’s right and there’s good good data on that but I I think the key here is today there’s a lot of barriers to access information and even if you have great insurance or great resources uh even if your name’s on a side of a building I just visited somebody at uh at Harvard whose name’s on the side of the building I said how long does it take you to get an appointment he said well I saw a nurse practitioner in 10 days and his name’s on on one of the buildings so you know everybody wants that immediate access and service and so those initial questions I think we could
[00:29:02] have assessed and I think to Will’s good point I was just V visiting with the red crescent team the ambulance EMS Services here and they’ve now got kind of remote Telemetry you can measure EEG in the fields or so you can get uh stroke protocol going or door to Balloon Time faster but if it was on your whoop yeah I could get that even faster so that’s I think all very doable the integration into the existing ecosystem is where it’ll fall all but I I agree with what will said if we could put it in the hands of consumers of people they’ll have that information um and I think the technology is here and it’s available and so I’m I’m very excited about that wonderful Dr tanal so um yeah I I agree with the line that everybody’s going down do doctorine a pocket concept is is already here and now and uh but the problem is uh it’s hard to get a person to trust uh an AI to deliver their care you know that the
[00:30:01] whole doctor you think that’s generational um over time it will be however um I I was going to a slightly different place which is that uh I think that the place where places where it will likely get adopted more readily is where the doctors are accepting of the AI um with the patient and I think there’s economic alignment uh in places that are capitated where you know for example you have six months of waiting and you can effectively make a much more streamlined system because now it’s augmented uh effectively but still doctors in Loop do you think Jim that uh uh Physicians will spend a quarter million or a half a million dollars going through medical school if they’re playing second fiddle to an AI that a nurse practitioner could easily well I don’t think there’s any I don’t think there’s any decrease in uh in uh uh
[00:31:00] acceptance you know rates at uh you know high top various medical schools is still in possible to get into medical school so there’s a a great deal of interest in it I think the role of a physician and this is actually something I’ve been interested in philanthropically uh you know is going to change uh and evolve it has to what’s your vision um my vision is more of a uh business a businessman uh woman you know sort of um uh objective what’s the best you know sort of processes for me to um adopt in order to be able to deliver measurably the best care the least expensively so more of a health coach and or consultant um could be could be although the AI could power up the doctor too I mean you’re talking about the last mile you know and The Last Mile could come in a bunch of different ways I mean it could be in your cell phone if that’s the way you like the last mile it could be delivered to you by a nurse practitioner you know as well if you want the human interaction but I I think that in general um Physicians that that
[00:32:03] adopt these tools are going to be advantaged and they’re going to be advantaged in uh various systems better than others but I think capitation is you know kind of one place where you know they there’s a fixed pot they can do something more efficient they can share more in that pot Dr Oz take us home please on on the topic I think you you teach people how to treat you that’s true in our personal lives it’s going to be true in the Medical Care System it has not historically been the case because there was a asymmetric advantage to Physicians because they had domain expertise the word doctor though mean doctor a teacher we’re supposed to be teachers not orderers and I do think the economics of medicine have always been driven to making more money for the people who are providing the care but the people who deserve more value who will ultimately use AI to drive it for the extra billion entering the system are the employers the governments the people who need the product ity of people just being very pragmatic about
[00:33:01] this if I’m running a business and my employees are present presentism they’re there but they’re not really at full speed or they’re not there because various Health ailments that’s a problem it’s why we focus so hard in the US on employee and occupational health that’s why we’re working with an National Council of Occupational Health here with this big program it’s Mission critical for the Saudis to have a Workforce that is healthy because they don’t have enough people to do the work and it’s going to be that way I think for the billion people as they come into the system they’re going to want to have jobs and stay in those jobs and earn money and build wealth for themselves and have a confidence for the future and therefore consume it runs the whole cycle we’ve never thought of healthc care as that Healthcare is always seen as a drain on the economy right four trillion dollars coming out of the economy as opposed to generating a lot of value for the Nations that have high quality health care so keeping clean water avoiding communicable diseases making sure that you’ve got folks that are able to get basic preventive care so they all can live with a health span that that’s you know the way they want to live until they’re at least 85 is
[00:34:01] something that’s valuable but I do have aspirations that will go even higher than that I think 120 which you’ve mentioned maybe longer but that think of how much value there is to someone who’s 75 years old who’s learned all that who can offer back because they’ve been kept healthy the only way to keep the system honest is a smarter arbitral and AI is the only thing in my lifetime that’s been close to doing that so it’s going to allow all these transformations to happen and without Ai and there’s a lot of arguments about the good or the bad AI not going to be the problem it’s people who use AI who aren’t good I’m going to we’re out of time do a survey of the four of you real quick here’s the question when will it be malpractice to diagnose a patient without AI in the loop your answer within five years within 10 years within 20 years or never I’m G to start with you I would say within five years within five years one year within one year within one year to be some of these complicated diagnosis why would you not just search it it’s right there amazing Jim I would say less than five for sure yeah I would
[00:35:02] say practically within five years when the legal system evolves is a different question Peter how would you answer it and how would you CL I’m like I’m gonna push as hard as I can as soon as I can 20 minutes yeah I think within five years is my answer let’s give it up for our amazing panel everybody thank get team photo