A temporary tattoo that brings hospital care to the home | Todd Coleman

Translator: Jone Aliri Lazcano Reviewer: Nagore Salaberria

Please meet Jane.

Hemen duzue Jane.

She has a high-risk pregnancy.

Arrisku altuko haurdunaldia du.

Within 24 weeks,

24 aste ostean

she's on bed rest at the hospital,

ospitaleratuta dago

being monitored for her preterm contractions.

kontrakzio goiztiarrak monitarizatuak izateko.

She doesn't look the happiest.

Ez dirudi oso zoriontsu.

That's in part because it requires technicians and experts

Teknikoek eta adituek uteroko kontrakzioak

to apply these clunky belts on her to monitor her uterine contractions.

monitorizatzeko gerriko pisutsu horiek jartzen dizkiotelako.

Another reason Jane is not so happy is because she's worried.

Eta, arduratuta dagoelako.

In particular, she's worried about what happens

Zehazki ospitalean 10 egun pasa ostean

after her 10-day stay on bed rest at the hospital.

gertatuko denak arduratzen du.

What happens when she's home?

Zer gertatuko da etxera itzultzean?

If she were to give birth this early it would be devastating.

Hain goiz erditzea, suntsitzailea litzateke.

As an African-American woman,

Afroamerikar emakumea denez,

she's twice as likely to have a premature birth

aukera bikoitza du erditze goiztiarra edo

or to have a stillbirth.

fetuaren heriotza izateko.

So Jane basically has one of two options:

Beraz Janek bi aukera ditu:

stay at the hospital on bed rest,

ospitaleko ohean geratu,

a prisoner to the technology until she gives birth,

teknologiaren mende, erditu arte

and then spend the rest of her life paying for the bill;

eta bizitza osoa faktura ordaintzen pasa;

or head home after her 10-day stay and hope for the best.

edo 10 egun ostean etxera joan eta dena ondo ateratzea espero.

Neither of these two options seems appealing.

Bi aukera horietako ezein ez da oso erakargarria.

As I began to think about stories like this

Horrelako istorioetan pentsatzen dudanean,

and hear about stories like this,

eta horrelakoak entzutean,

I began to ask myself and imagine:

neure buruari galdetzen diot:

Is there an alternative?

Ba ote dago alternatibarik?

Is there a way we could have the benefits of high-fidelity monitoring

Posible ote da ospitalean dugun bezalako

that we get with our trusted partners in the hospital

kalitatezko monitarizazio baten onurak izatea

while someone is at home living their daily life?

etxean eguneroko bizitza egiten dugun bitartean?

With that in mind,

Ideia honi bueltaka,

I encouraged people in my research group

nire ikerketa taldea zientzialari

to partner with some clever material scientists,

batzuekin elkartzera animatu nuen,

and all of us came together and brainstormed.

eta guztiok bildu eta idea-jasa bat egin genuen.

And after a long process,

Prozesu luze baten ostean,

we came up with a vision, an idea,

bisio bat, ideia bat, izan genuen:

of a wearable system that perhaps you could wear like a piece of jewelry

soinean eraman zitekeen zerbait, bitxi baten modukoa, edo

or you could apply to yourself like a Band-Aid.

tirita bat bezala jar daitekeena.

And after many trials and tribulations and years of endeavors,

Eta estuasun eta ahaleginez beteriko urteen ostean,

we were able to come up with this flexible electronic patch

txaplata elektroniko malgu honetara heldu ginen.

that was manufactured using the same processes

Konputagailuetako txipak sortzeko erabiltzen den

that they use to build computer chips,

prozesu berarekin fabrikatzen dira, baina, kasu honetan,

except the electronics are transferred from a semiconductor wafer

osagaiak olata erdieroale batetik giza gorputzarekin

onto a flexible material that can interface with the human body.

komunikatu daitekeen materiale malgu batera pasatzen dira.

These systems are about the thickness of a human hair.

Sistema hauek ile baten lodiera dute.

They can measure the types of information that we want,

Guk nahi dugun informazioa bil dezakete.

things such as:

Esaterako,

bodily movement,

gorputz mugimendua,

bodily temperature,

gorputzeko tenperatura,

electrical rhythms of the body

gorputzeko inpultso elektrikoak,

and so forth.

eta horrelakoak.

We can also engineer these systems,

Sistema hauek energia iturriak

so they can integrate energy sources,

barne hartzeko ere diseina ditzakegu,

and can have wireless transmission capabilities.

eta haririk gabe igortzeko gaitasuna eman.

So as we began to build these types of systems,

Honelako sistemak eratzen hasi ginenean,

we began to test them on ourselves in our research group.

guregan eta gure ikerketa taldean probatzen hasi ginen.

But in addition, we began to reach out to some of our clinical partners

Baina gure bazkide ziren kliniko batzuekin ere kontaktatu genuen

in San Diego,

San Diegon,

and test these on different patients in different clinical conditions,

eta egoera kliniko desberdinetan zeuden gaixoekin probatu genituen,

including moms-to-be like Jane.

Jane bezalako etorkizuneko amekin ere bai.

Here is a picture of a pregnant woman in labor at our university hospital

Hau unibertsitateko ospitalean erditzera doan emakume bat da,

being monitored for her uterine contractions with the conventional belt.

eta uteroko kontrakzioak ohiko gerriko baten bidez monitarizatzen ari zaizkie.

In addition,

Horrez gain,

our flexible electronic patches are there.

gure txaplata elektronikoak ere hor daude.

This picture demonstrates waveforms pertaining to the fetal heart rate,

Irudi honetan fetoaren bihotz taupaden uhinak ikus daitezke,

where the red corresponds to what was acquired

marra gorria ohiko gerrikoaren bidez

with the conventional belts,

lortutako datuek sortzen dute,

and the blue corresponds to our estimates

eta urdina, gure sistema elektroniko

using our flexible electronic systems and our algorithms.

malgua eta gure algoritmoak erabiliz egindako estimazioek.

At this moment,

Une horretan,

we gave ourselves a big mental high five.

bosteko handi bat eman genion geure buruari.

Some of the things we had imagined were beginning to come to fruition,

Imajinatu genituen gauzetako batzuk fruituak ematen hasi ziren,

and we were actually seeing this in a clinical context.

eta hori testuinguru klinikoan ari ginen ikusten.

But there was still a problem.

Baina artean bazen arazo bat.

The problem was, the way we manufactured these systems

Sistema hauek fabrikatzeko modua

was very inefficient,

ez zen batere eraginkorra,

had low yield

errendimendu baxua zuen

and was very error-prone.

eta erroreak sortzen zituen.

In addition,

Gainera,

as we talked to some of the nurses in the hospital,

ospitaleko erizainekin hitz egitean,

they encouraged us to make sure

aholkatu ziguten

that our electronics worked with typical medical adhesives

gure elektronikak ospitalean erabiltzen ziren itsasgarri medikoekin

that are used in a hospital.

funtziona zezatela.

We had an epiphany and said, "Wait a minute.

Epifania bat izan genuen, "Itxaron une bat.

Rather than just making them work with adhesives,

Itsasgarri horiekin ongi lan egiteaz gain,

let's integrate them into adhesives,

goazen itsasgarri horietan barneratzera,

and that could solve our manufacturing problem."

eta horrela gure fabrikatze arazoa konpontzera."

This picture that you see here

Hemen ikus dezakezue

is our ability to embed these censors inside of a piece of Scotch tape

sentsore horiek zinta itsasgarrian barneratzeko dugun gaitasuna

by simply peeling it off of a wafer.

olata batetik askatuz.

Ongoing work in our research group allows us to, in addition,

Ikerketa lan gehiagok, gainera,

embed integrated circuits into the flexible adhesives

seinalea anplifikatzeko eta digitalizatzeko

to do things like amplifying signals and digitizing them,

itsasgarri malguetan zirkuituak barneratzea, ahalbideratzen digu,

processing them

seinalea prozesatuz

and encoding for wireless transmission.

eta haririk gabeko transmisiorako kodifikatuz.

All of this integrated into the same medical adhesives

Guzti hau, ospitalean erabiltzen diren

that are used in the hospital.

itsasgarri berdinetan barneratuta.

So when we reached this point,

Une horretan,

we had some other challenges,

beste erronka batzuk agertu ziren,

from both an engineering as well as a usability perspective,

ingenieritzaren eta erabilgarritasunaren ingurukoak,

to make sure that we could make it used practically.

erabiltzeko praktikoak zirela ziurtatzeko.

In many digital health discussions,

Osasun digitalari buruzko eztabaida askotan

people believe in and embrace the idea that we can simply digitize the data,

jendeak sinisten eta onartzen du datuak digitaliza ditzakegula,

wirelessly transmit it,

haririk gabeko moduan transmititu ditzakegula,

send it to the cloud,

hodeira bidali,

and in the cloud,

eta bertan,

we can extract meaningful information for interpretation.

berau interpretatzeko beharrezko informazioa atera.

And indeed, you can do all of that,

Eta, izatez, guzti hori posible da,

if you're not worried about some of the energy challenges.

energiaren arazoa alde batera uzten badugu.

Think about Jane for a moment.

Oroi gaitezen Janetaz.

She doesn't live in Palo Alto,

Ez da Palo Alton bizi,

nor does she live in Beverly Hills.

ez eta Beverly Hillsen ere.

What that means is,

Beraz,

we have to be mindful about her data plan and how much it would cost

kontuan izan behar dugu zein datu tarifa duen,

for her to be sending out a continuous stream of data.

eta zein den beretzat uneoro datuak bidaltzearen kostua.

There's another challenge

Beste erronka bat ere badago,

that not everyone in the medical profession is comfortable talking about.

medikuntza arloan lantzea erosoa ez den bat.

And that is, that Jane does not have the most trust

Izan ere, Janek ez du erabateko konfidantza

in the medical establishment.

medikuengan.

She, people like her, her ancestors, have not had the best experiences

Berak, bera bezalakoek, bere arbasoek, ez dituzte esperientzia atseginenak izan

at the hands of doctors and the hospital

ospitaleetan eta medikuen eskuetan,

or insurance companies.

edo aseguru konpainietan.

That means that we have to be mindful of questions of privacy.

Beraz, pribatutasunari buruz pentsatu behar dugu.

Jane might not feel that happy

Posible da Jane eroso ez sentitzea

about all that data being processed into the cloud.

bere datu guztiak hodeian prozesatzearekin.

And Jane cannot be fooled;

Eta Jane ez da tuntuna;

she reads the news.

berriak irakurtzen ditu.

She knows that if the federal government can be hacked,

Badaki gobernua hackeatua izan badaiteke,

if the Fortune 500 can be hacked,

edo Fortune 500-eko konpainiak,

so can her doctor.

baita bere medikua ere.

And so with that in mind,

Eta hori kontuan hartuta,

we had an epiphany.

ideia bat izan genuen.

We cannot outsmart all the hackers in the world,

Ez gara munduko hacker guztiak baino azkarragoak izango,

but perhaps we can present them a smaller target.

baina helburu txikiago bat aurkez diezaiekegu.

What if we could actually,

Zer gertatuko litzateke,

rather than have those algorithms that do data interpretation

datuen interpretazio egiteko algoritmo horiek

run in the cloud,

hodeian burutu beharrean

what if we have those algorithms run on those small integrated circuits

itsasgarrietan integratutako zirkuitu txikietan

embedded into those adhesives?

burutuko bagenitu?

And so when we integrate these things together,

Horrela, gauza hauek guztiak bateratzean,

what this means is that now we can think about the future

ondorioa da orain pentsa dezakegula etorkizunean

where someone like Jane can still go about living her normal daily life,

Jane bezalako pertsona batek, bizitza normal bat izaten jarraitu eta

she can be monitored,

monitorizatua izan daitekela.

it can be done in a way where she doesn't have to get another job

Bere datu-tarifa ordaintzeko beste lan bat

to pay her data plan,

bilatu beharrik gabe,

and we can also address some of her concerns about privacy.

eta pribatutasunari buruzko ardurak ere kontuan izanez.

So at this point,

Une honetan,

we're feeling very good about ourselves.

geure buruarekin oso gustura gaude.

We've accomplished this,

Hori lortu dugu,

we've begun to address some of these questions about privacy

pribatutasunari dagozkion hainbat gai konpondu ditugu

and we feel like, pretty much the chapter is closed now.

eta uste dugu atal hori ia itxita dugula.

Everyone lived happily ever after, right?

Aurrerantzean denak pozik bizi izan ziren, ezta?

Well, not so fast.

Ez hain azkar.

(Laughter)

(Barreak)

One of the things we have to remember, as I mentioned earlier,

Oroitu beharreko gauzetako bat lehenago esan bezala, zera da,

is that Jane does not have the most trust in the medical establishment.

Jane ez dela asko fio medikuetaz.

We have to remember

Gogoan izan

that there are increasing and widening health disparities,

osasunaren inguruan aldeak handitzen ari direla,

and there's inequity in terms of proper care management.

eta ezberdinatsunak daudela mediku zaintza egokien inguruan.

And so what that means is that this simple picture

Horrek esan nahi du irudi arrunt hori,

of Jane and her data --

Jane eta bere datuen irudia,

even with her being comfortable being wirelessly transmitted to the cloud,

haririk gabe datuak hodeira igortzearekin eroso egon arren,

letting a doctor intervene if necessary --

beharrezkoa denean medikuaren eskuhartzea onartu arren,

is not the whole story.

ez dela istorio osoa.

So what we're beginning to do

Beraz, orain egiten ari garena

is to think about ways to have trusted parties serve as intermediaries

bide barriak lantzea da Jane eta bere medikua bezalako pertsonen

between people like Jane and her health care providers.

artean konfiantzazko bitartekariak eduki ahal izateko.

For example, we've begun to partner with churches

Adibidez, elizekin elkartzen hasi gara,

and to think about nurses that are church members,

elizako kide diren erizainak bilatzen,

that come from that trusted community,

konfiantzazko komunitateetatik datozenak,

as patient advocates and health coaches to people like Jane.

eta gaixoaren babesle eta aholkulari bihurtzen ditugu.

Another thing we have going for us

Alde dugun beste gauza bat

is that insurance companies, increasingly,

aseguru etxeak horrelakoetan

are attracted to some of these ideas.

gero eta interes handiagoa dutela da.

They're increasingly realizing

Ohartzen ari dira, hobe dela

that perhaps it's better to pay one dollar now

orain dolar bat ordaintzea,

for a wearable device and a health coach,

soinean eraman daitekeen gailu bat eta osasun aholkulari batengatik,

rather than paying 10 dollars later,

gero 10 dolar ordaintzea baino,

when that baby is born prematurely

haurra modu goiztiarrean jaiotzean,

and ends up in the neonatal intensive care unit --

eta jaioberrien zaintza intentsiboen unitatean amaitzean;

one of the most expensive parts of a hospital.

ospitaleko unitate garestienetako batean.

This has been a long learning process for us.

Guretzat ikaskuntza prozesu luze bat izan da hau.

This iterative process of breaking through and attacking one problem

Aurrera egin eta arazoei aurre egiteko prozesu errepikakor honek,

and not feeling totally comfortable,

non ezeroso sentitzen ginen eta

and identifying the next problem,

hurrengo arazoa identifikatzen genuen,

has helped us go along this path

bide hau egiten lagundu digu,

of actually trying to not only innovate with this technology

teknologia honekin berrikuntzak egiteaz gain,

but make sure it can be used for people who perhaps need it the most.

gehien behar dutenek erabili ahal izatea ziurtatuz.

Another learning lesson we've taken from this process

Prozesu honetan ikasitako beste ikasgaia, oso apalgarria,

that is very humbling,

zera izan da:

is that as technology progresses and advances at an accelerating rate,

teknologiak exponentzialki aurrera egiten duen honetan

we have to remember that human beings are using this technology,

teknologia honen erabiltzaileak gizakiak direla kontuan izan behar dugula,

and we have to be mindful

eta jakin behar dugula

that these human beings -- they have a face,

pertsona horiek aurpegi bat dutela,

they have a name

eta izen bat,

and a life.

eta bizitza bat.

And in the case of Jane,

Eta Jane-en kasuan,

hopefully, two.

espero dezagun bi bizitza.

Thank you.

Mila esker.

(Applause)

(Txaloak)