Walter De Brouwer has the mad scientist thing down: curly rumpled hair, lots of talking with his hands – the whole nine yards. After spending decades in the tech industry working on everything from publishing to telecom, time travel and interstellar flight, De Brouwer decided to jump into the health care industry after his son spent a year in the hospital after falling out of a window.
The much-publicized Scanadu Scout, which is slated to ship in the first quarter of 2014, is the result of his last two years of work. The puck-like device is a sleek vital-signs recorder – tracking everything from blood pressure, body temperature and heart rhythm via myriad sensors. The gizmo then beams your vital signs to an app loaded on your phone or tablet, where it’s yours to keep forever. De Brouwer designed the Scanadu Scout to be a DIY doctor’s office, minus the frustration, endless waiting, and lack of empowerment that’s often associated with the health care system.
Wired sat down with De Brouwer in our offices in San Francisco to discuss what it’s been like to delve into the health care space and how the Quantified Self movement will change medicine forever.
Wired: The Scout has obvious tie-ins to Star Trek. Is that why you set up shop at the NASA Ames Research Center?
Walter De Brouwer: It became clear our consumer was a bit like an astronaut because he’s also isolated from the system. When something is wrong, they will not come to save him. It was a little bit like, “Hey! That’s how we consumers get into the health care system.”
We also had this concept of the “tricorder,” and I thought I’m going to talk to NASA to see if we can use their resources for space medicine. Space medicine is the combination of the two coolest words in the world. We met them and they liked the concept because it was Star Trek. They also liked that we would look at their space-medicine assets to see if we could consumerize them. You have this enormous opportunity. You’re in the heart of Silicon Valley. There’s all these smart people around. The NASA connection is really great. The campus is also really great. I used to live there.
'Space medicine' is the combination of the two coolest words in the world.
Wired: What was that like? De Brouwer: In the weekends it’s existentially lonely. It’s like being in the desert because everyone is gone. I didn’t have a car so I got stuck on that campus. But there’s military guards. You feel very safe.
Wired: What’s your mission with Scanadu?
De Brouwer: The whole diagnostic part we wanted to recreate. We started with the emergency room. They do the vital signs: respiratory rate, heart rate, diastolic and systolic blood pressure, your temperature, oxygenation. You also have a heart monitor with your ECG. Then they take your blood samples. You get a little container to take your urine and then they take it away to the lab. Another nurse comes then you have to go for imaging.
Scout is sort of the mothership. There’s a complete emergency room in there. Every sensor you can think of we’ve put in there – blood pressure, ECG, infrared, three accelerometers, gyroscope, Bluetooth module, 32-bit microprocessor. This is a product that helps the doctor, partially replaces the doctor, or makes you into a citizen doctor.
The Tricorder. Photo: Alex Washburn / Wired
Wired: So what do you think of Vinod Khosla’s prediction that 80 percent of doctors will be replaced by machines?
De Brouwer: Everything is going to be replaced one day. This debate between carbon and silicon has long been lost. Khosla is right. In telecom, a lot of people were fired in the ’90s. We replaced them with switches. Because, you see, a switch does not make mistakes. The introduction of a human being is an opportunity to make a mistake, so the more little machines you put in your network of course the less you’re going to make mistakes. A machine doesn’t have a hangover.
Machines are going to replace anything and everything. This debate between carbon and silicon has long been lost.
But this is going to be a very long process. Wired: But that depends on how well you design your machines in the first place.
De Brouwer: Sure, that depends on how well a machine is programmed. It took us a long time to find the right way to go about it. The recipe is very important. You have to make the machine learn. The machine can only learn if every time it does something wrong, you tell it. And you make sure it doesn’t happen again. So you measure, and if it’s completely wrong, you figure out how it can be better. You must make the machine learn the environment of the things it’s looking for.
Humans are really good in synthetic knowledge and synthetic emotions. Why wouldn’t computers be? I want my tricorder or my phone to be proud of me. To say, you did well. I think that’s the kind of thing we’re looking for.
Wired: Can you share your data with other Scanadu users so maybe they can be proud of you too?
De Brouwer: We really believe in that. We asked people – just suppose you have something – would you like to see and share with others who have the same? More than 80 percent said “yes.” And you know why? If I have the flu, I want to know who is this patient zero. I want to see where it comes from, or I want to keep my kids away from them. You can do calculations on propagation or incubation of the virus. The people can do population scanning. But now with these things (like Scout), the people are going to rewrite the (medicine) map, like they have done with Wikipedia, and all sorts of great stuff will come out of that.
Wired: How do you analyze and store all that data?
De Brouwer: We don’t store the data. Everybody has to store it for themselves. It’s your data. Every time you check yourself, (the data) goes through our algorithms but we don’t keep it. They’ll become more precise. You’re making the machine learn, but once it learns, it gives it back to its owner. There’s a big debate now about who owns the data and I don’t understand the debate. It comes out of our bodies. We should own it.
Quantification is very important. This is what I learned when I spent nearly a year with my son in the hospital. When you know your readings today, you can make a plan so you can change the future. That’s like wow. It’s no longer about moments. It’s about calculus.
There is this interesting site, where you can calculate how much your body is worth based on the tests that your body has gone through and your age and gender. I was worth $3.
Wired: Will this make us worth more money?
De Brouwer: I think so because if you keep all that data, people will be able to sell themselves, especially if you have a rare disease because there will be a market for clinical trial testing. It will be a bit like the eBay for bodies.
The ScanaFlo. Photo: Alex Washburn / Wired Wired: You were on your way to a Ph.D. in economics, which would have been your second. What happened with that?
De Brouwer: I gave it up actually. It was a great project. I wanted to find an equilibrium in development aid. I was working on One Laptop Per Child. I thought you could convince the minister of finance that he should talk to the minister of education because by doing more education you’re actually feeding your tax base for the future. If your citizens are uneducated, there’s no way you’re going to tax them because they won’t make any money. You have to pay them. If you take that into account, and you calculate back and make government bonds for 20 years and put it into education, after 10 years, the tax base will repay the bonds. But nobody wanted to listen. It would have been a great model. Social capitalism.
Wired: How do technologies like Scanadu help in the developing world?
De Brouwer: Anything helps in the developing world because if I say education is bad, health care is worse. It’s pretty binary there. When you’re very sick, they cover you up. They keep you warm until you die. That’s basically how it is. But there’s also a third world in the first world. In all our cities, there are people without health insurance, and the great thing with these devices is you only need a smartphone. Everyone has a phone. Not necessarily a smartphone, but a lot are in the transition from cellphone to a smartphone. A smartphone has a lot of sensors, and one of them is for instance the camera. Our algorithm doesn’t cost anything so you can do urine analysis with these paddles for a couple of dollars. It’s very affordable.
Wired: What’s next for you?
De Brouwer: I want to see this to the end. I see people sitting in hospitals – they are waiting for stuff to happen. They’re not making it happen. They’re just waiting because they don’t have any tools. Nobody helps them. Everyone is alone in this little depressive cocoon. The end is that disease will be social. You will not be solitary anymore. There will be empathy. Perhaps we’ll even look at death as the next great adventure. I hope this revolution in health care is not going to kill me!
