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October 31, 2014

You’re right there, TED

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Fresh from the TEDMED conference in Washington DC, Dr Muiris Houston says the event is more about getting you to think in new ways, rather than providing ready-made solutions.

I’m not long back from what was the best conference I have ever attended. TEDMED was held in Washington DC and has no agenda and no policy prescriptions. Instead, it aims to create a safe place where people with very different ideas can come together to talk and to learn.

Unlike a regular medical conference where doctors, nurses and other health professionals come together, usually from a particular field, TEDMED invited a diverse group of people, many from outside the health arena, to inject some ‘outside the box’ thinking.

The result was an amazing experience of sometimes mind-bending sessions. Science and art mixed in a cocktail of creativity and it was the first time I saw a conference audience cry during a presentation.

Throughout the three-and-a-half day ‘TEDfest’, we were asked to consider and vote on the 20 greatest challenges facing medicine and health today. We were briefed on 50 potential challenges before voting in the top 20 of these. These are the ones that emerged:

  • Inventing wellness programmes;
  • The caregiver crisis;
  • The role of the patient;
  • The obesity crisis;
  • Achieving medical innovation;
  • Managing chronic diseases;
  • Medical communication;
  • Reducing childhood obesity;
  • Making prevention popular;
  • End-of-life care;
  • Causes of sleep deprivation;
  • Impact of poverty on health;
  • Faster adoption of best practices;
  • Impact of stress;
  • Future of personalised medicine;
  • Promoting active lifestyles;
  • Preparing for dementia;
  • Addressing healthcare costs;
  • Whole-patient care; and
  • Eliminating medical errors.

So just to get you thinking, here is the blurb from some of my favourites, starting with ‘Shaping the Future of Personalised Medicine’.

“Science is harvesting more and more information about the human population, and individual patients specifically. Medicine is understanding the roles of genomics and the environment in a patient’s medical history. Yet translating this data to practice has proved difficult. The fundamental question for a physician is still: Will this treatment work for my patient?

“How can the wealth of medical information be factored into patient medical records and into everyday care — more quickly, more usefully and more completely? How can insights into individual patients — gleaned from in vitro and in vivo diagnostic tests — allow us to zero in on targeted therapies?”

In ‘Coming to Grips with End-of-life Care’, its advocate noted how modern medicine has extended the life expectancies of many terminally-ill people.

“In turn, prolonging lives can mean incurring more intensive care and associated costs… Quality end-of-life care requires balancing the input of doctors, families and patients themselves. And making crucial end-of-life decisions can take physical and emotional tolls on patients and their loved ones. How should we help people manage end-of-life care choices to maximise individual well-being and minimise social cost?”

Then there was ‘Improving Medical Communication’: “Physicians are not typically trained in interpersonal communications and are not rewarded based on their communication skills.

Equally importantly, patients are often intimidated when talking to doctors and often feel they don’t have a receptive audience, especially when doctors are rushed. What can be done about this on both sides of the challenge (patients and doctors) — including possible initiatives in areas ranging from education to technology, to possible changes in the physical workspace? How do we make this issue a priority?”

On the topic of ‘The Role of the Patient’, it was stated: “Patient empowerment can be a double-edged sword. From hospitals and insurance companies to doctors and patients themselves, much of the medical system increasingly treats patients as ‘customers’ or ‘consumers’, terms that some people love and others hate. If patients are customers, does that mean ‘the customer is king’ or does it mean ‘buyer beware’ — or both? If patients retain their traditional role, does that mean doctors are in charge? Are both in charge somehow? How is ‘power’ shared among all stakeholders and how should it be shared?”

And finally, ‘Eliminating Medical Errors’: “All humans make mistakes. Doctors and nurses are human; they make mistakes. All systems are imperfect.

“Medical professionals use systems. Errors by medical professionals and systems are inevitable (unfortunately, in the US, they send 2.4 million patients to hospitals yearly and are directly linked to 200,000 annual fatalities). Regardless of methods used to detect, prove and compensate for medical errors, how much better can we do in reducing or eliminating medical errors and what areas should we focus on to get the best improvements?”

As you can see, and this is very much in keeping with the TEDMED modus operandi, the challenges are about getting you to think, rather than providing answers.

On reflection, it is this that is the key to the success of the entire TED project: It seems to free your mind to think laterally, unconfined by the boundaries of having to find immediate solutions.

In the next few months, I hope to write a number of columns around ideas that emerged from TEDMED 2012.