I want to share some personal friends and stories with you

that I've actually never talked about in public before

to help illustrate the idea

and the need and the hope

for us to reinvent our health care system around the world.

Twenty-four years ago, I had -- a sophomore in college,

I had a series of fainting spells. No alcohol was involved.

And I ended up in student health,

and they ran some labwork and came back right away,

and said, "Kidney problems."

And before I knew it, I was involved and thrown into

this six months of tests and trials and tribulations

with six doctors across two hospitals

in this clash of medical titans

to figure out which one of them was right

about what was wrong with me.

And I'm sitting in a waiting room some time later for an ultrasound,

and all six of these doctors actually show up in the room at once,

and I'm like, "Uh oh, this is bad news."

And their diagnosis was this:

They said, "You have two rare kidney diseases

that are going to actually destroy your kidneys eventually,

you have cancer-like cells in your immune system

that we need to start treatment right away,

and you'll never be eligible for a kidney transplant,

and you're not likely to live more than two or three years."

Now, with the gravity of this doomsday diagnosis,

it just sucked me in immediately,

as if I began preparing myself as a patient

to die according to the schedule that they had just given to me,

until I met a patient named Verna in a waiting room,

who became a dear friend, and she grabbed me one day

and took me off to the medical library

and did a bunch of research on these diagnoses and these diseases,

and said, "Eric, these people who get this

are normally in their '70s and '80s.

They don't know anything about you. Wake up.

Take control of your health and get on with your life."

And I did.

Now, these people making these proclamations to me

were not bad people.

In fact, these professionals were miracle workers,

but they're working in a flawed, expensive system that's set up the wrong way.

It's dependent on hospitals and clinics for our every care need.

It's dependent on specialists who just look at parts of us.

It's dependent on guesswork of diagnoses and drug cocktails,

and so something either works or you die.

And it's dependent on passive patients

who just take it and don't ask any questions.

Now the problem with this model

is that it's unsustainable globally.

It's unaffordable globally.

We need to invent what I call a personal health system.

So what does this personal health system look like,

and what new technologies and roles is it going to entail?

Now, I'm going to start by actually sharing with you

a new friend of mine, Libby,

somebody I've become quite attached to over the last six months.

This is Libby, or actually, this is an ultrasound image of Libby.

This is the kidney transplant I was never supposed to have.

Now, this is an image that we shot a couple of weeks ago for today,

and you'll notice, on the edge of this image,

there's some dark spots there, which was really concerning to me.

So we're going to actually do a live exam

to sort of see how Libby's doing.

This is not a wardrobe malfunction. I have to take my belt off here.

Don't you in the front row worry or anything.

(Laughter)

I'm going to use a device from a company called Mobisante.

This is a portable ultrasound.

It can plug into a smartphone. It can plug into a tablet.

Mobisante is up in Redmond, Washington,

and they kindly trained me to actually do this on myself.

They're not approved to do this. Patients are not approved to do this.

This is a concept demo, so I want to make that clear.

All right, I gotta gel up.

Now the people in the front row are very nervous. (Laughter)

And I want to actually introduce you to Dr. Batiuk,

who's another friend of mine.

He's up in Legacy Good Samaritan Hospital in Portland, Oregon.

So let me just make sure. Hey, Dr. Batiuk. Can you hear me okay?

And actually, can you see Libby?

Thomas Batuik: Hi there, Eric.

You look busy. How are you?

Eric Dishman: I'm good. I'm just taking my clothes off

in front of a few hundred people. It's wonderful.

So I just wanted to see, is this the image you need to get?

And I know you want to look and see if those spots are still there.

TB: Okay. Well let's scan around a little bit here,

give me a lay of the land.

ED: All right.TB: Okay. Turn it a little bit inside,

a little bit toward the middle for me.

Okay, that's good. How about up a little bit?

Okay, freeze that image. That's a good one for me.

ED: All right. Now last week, when I did this,

you had me measure that spot to the right.

Should I do that again?

TB: Yeah, let's do that.

ED: All right. This is kind of hard to do

with one hand on your belly and one hand on measuring,

but I've got it, I think,

and I'll save that image and send it to you.

So tell me a little bit about what this dark spot means.

It's not something I was very happy about.

TB: Many people after a kidney transplant

will develop a little fluid collection around the kidney.

Most of the time it doesn't create any kind of mischief,

but it does warrant looking at,

so I'm happy we've got an opportunity to look at it today,

make sure that it's not growing, it's not creating any problems.

Based on the other images we have,

I'm really happy how it looks today.

ED: All right. Well, I guess we'll double check it when I come in.

I've got my six month biopsy in a couple of weeks,

and I'm going to let you do that in the clinic,

because I don't think I can do that one on myself.

TB: Good choice.ED: All right, thanks, Dr. Batiuk.

All right. So what you're sort of seeing here

is an example of disruptive technologies,

of mobile, social and analytic technologies.

These are the foundations of what's going to make personal health possible.

Now there's really three pillars

of this personal health I want to talk to you about now,

and it's care anywhere, care networking and care customization.

And you just saw a little bit of the first two

with my interaction with Dr. Batiuk.

So let's start with care anywhere.

Humans invented the idea of hospitals and clinics

in the 1780s. It is time to update our thinking.

We have got to untether clinicians and patients

from the notion of traveling to a special

bricks-and-mortar place for all of our care,

because these places are often the wrong tool,

and the most expensive tool, for the job.

And these are sometimes unsafe places to send our sickest patients,

especially in an era of superbugs

and hospital-acquired infections.

And many countries are going to go brickless from the start

because they're never going to be able to afford

the mega-medicalplexes that a lot of the rest of the world has built.

Now I personally learned that hospitals

can be a very dangerous place at a young age.

This was me in third grade.

I broke my elbow very seriously, had to have surgery,

worried that they were going to actually lose the arm.

Recovering from the surgery in the hospital, I get bedsores.

Those bedsores become infected,

and they give me an antibiotic which I end up being allergic to,

and now my whole body breaks out,

and now all of those become infected.

The longer I stayed in the hospital, the sicker I became,

and the more expensive it became,

and this happens to millions of people around the world every year.

The future of personal health that I'm talking about

says care must occur at home as the default model,

not in a hospital or clinic.

You have to earn your way into those places

by being sick enough to use that tool for the job.

Now the smartphones that we're already carrying

can clearly have diagnostic devices like ultrasounds plugged into them,

and a whole array of others, today,

and as sensing is built into these,

we'll be able to do vital signs monitor

and behavioral monitoring like we've never had before.

Many of us will have implantables that will actually look

real-time at what's going on with our blood chemistry

and in our proteins right now.

Now the software is also getting smarter, right?

Think about a coach, an agent online,

that's going to help me do safe self-care.

That same interaction that we just did with the ultrasound

will likely have real-time image processing,