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

Translator: Natalia Outerelo Reviewer: Serv. de Norm. Lingüística U. de Santiago de Compostela

Please meet Jane.

Preséntovos a Jane.

She has a high-risk pregnancy.

O seu é un embarazo de alto risco.

Within 24 weeks,

Ás 24 semanas de xestación

she's on bed rest at the hospital,

ingrésana en repouso no hospital,

being monitored for her preterm contractions.

para monitorizar as súas contraccións prematuras.

Non parece moi leda.

She doesn't look the happiest.

That's in part because it requires technicians and experts

Iso é, en parte, porque require que o persoal técnico e experto

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

lle poña eses cintos pesados para monitorizar as contraccións uterinas.

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

Outra razón pola que Jane non está leda é porque está preocupada.

In particular, she's worried about what happens

En concreto, está preocupada polo que pasará

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

despois de estar dez días hospitalizada.

What happens when she's home?

Que ocorrerá cando estea na casa?

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

Se tivese que dar a luz tan cedo sería devastador.

As an African-American woman,

Como muller afroamericana que é

she's twice as likely to have a premature birth

ten o dobre de posibilidades de dar a luz prematuramente

or to have a stillbirth.

ou de que o neno naza morto.

So Jane basically has one of two options:

Así que Jane ten dúas opcións:

stay at the hospital on bed rest,

permanecer en repouso no hospital,

a prisoner to the technology until she gives birth,

prisioneira da tecnoloxía ata dar a luz,

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

e pasar o resto da vida pagando a factura

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

ou volver á casa despois de dez días e agardar que todo vaia ben.

Neither of these two options seems appealing.

Ningunha das dúas opcións é tentadora.

Cando dei en pensar en historias así

As I began to think about stories like this

e comecei a escoitar historias coma esta,

and hear about stories like this,

I began to ask myself and imagine:

empecei a preguntarme a a min mesmo:

Is there an alternative?

Hai algunha alternativa?

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

Hai forma de ter os beneficios dunha monitorización de calidade

that we get with our trusted partners in the hospital

coma a que temos nos hospitais

while someone is at home living their daily life?

mentres estamos na casa facendo vida normal?

With that in mind,

Con isto na cabeza,

I encouraged people in my research group

animei ao meu grupo de investigación

to partner with some clever material scientists,

a asociarnos con algúns científicos enxeñosos

and all of us came together and brainstormed.

xuntarnos con eles e facer chuvias de ideas.

And after a long process,

Despois dun longo proceso,

we came up with a vision, an idea,

xurdiu unha visión, unha idea

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

dun dispositivo que se puidese levar como se fose unha xoia

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

ou que se puidese poñer coma un apósito.

And after many trials and tribulations and years of endeavors,

Despois de moitos intentos e tribulacións, e anos de esforzo,

we were able to come up with this flexible electronic patch

fomos quen de chegar a este parche electrónico flexible

that was manufactured using the same processes

elaborado seguindo o mesmo proceso

that they use to build computer chips,

ca os chips dos ordenadores;

except the electronics are transferred from a semiconductor wafer

salvo que a electrónica transfírese dunha oblea semicondutora

a un material flexible que pode comunicarse co corpo humano.

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

These systems are about the thickness of a human hair.

Estes sistemas teñen o grosor dun pelo humano.

Poden recoller o tipo de información que queiramos,

They can measure the types of information that we want,

things such as:

cousas como

o movemento corporal,

bodily movement,

bodily temperature,

a temperatura corporal,

os ritmos eléctricos do corpo

electrical rhythms of the body

and so forth.

e máis cousas.

We can also engineer these systems,

Tamén podemos deseñar estes sistemas

so they can integrate energy sources,

para que integren fontes de enerxía

and can have wireless transmission capabilities.

e poidan ter capacidade de transmisión sen fíos.

So as we began to build these types of systems,

Ao empezar a construír este tipo de sistemas,

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

comezamos a probalos en nós mesmos no noso grupo de investigación.

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

Contactamos tamén con algúns socios clínicos

in San Diego,

de San Diego

and test these on different patients in different clinical conditions,

e probámolos en diferentes pacientes e en diferentes condicións clínicas,

including moms-to-be like Jane.

incluíndo futuras mamás coma Jane.

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

Velaquí unha foto dunha muller a piques de dar a luz no hospital,

being monitored for her uterine contractions with the conventional belt.

co cinto convencional para monitorizar as contraccións uterinas.

In addition,

Ademais,

poden verse aí os nosos parches.

our flexible electronic patches are there.

This picture demonstrates waveforms pertaining to the fetal heart rate,

Esta foto amosa as ondas pertencentes ao pulso fetal

where the red corresponds to what was acquired

onde as vermellas son as que rexistran

with the conventional belts,

os cintos convencionais

e as azuis corresponden coa estimacións

and the blue corresponds to our estimates

using our flexible electronic systems and our algorithms.

dos nosos sistemas electrónicos flexibles e os nosos algoritmos.

At this moment,

Nese intre

we gave ourselves a big mental high five.

chocamos os cinco mentalmente.

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

Algunhas das cousas que imaxinabamos, comezaban a concretarse

and we were actually seeing this in a clinical context.

e estabamos véndoo alí nun contexto clínico.

Mais había un problema:

But there was still a problem.

The problem was, the way we manufactured these systems

a maneira de fabricar estes sistemas.

was very inefficient,

Era moi ineficiente,

had low yield

cun rendemento baixo

e moi proclive a erros.

and was very error-prone.

Ademais,

In addition,

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

falando co persoal de enfermaría do hospital,

they encouraged us to make sure

animáronnos a asegurarnos

that our electronics worked with typical medical adhesives

de que funcionaban cos adhesivos médicos

que se empregan no hospital.

that are used in a hospital.

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

Tivemos unha revelación e dixemos: “Un momento.

Rather than just making them work with adhesives,

Mellor ca facelos funcionar con adhesivos

let's integrate them into adhesives,

imos ver se os podemos integrar neles

and that could solve our manufacturing problem."

e resolver así o problema da fabricación”.

This picture that you see here

Nesta foto vese

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

como puidemos integrar os sensores nunha cinta adhesiva

by simply peeling it off of a wafer.

despegándoos dunha oblea.

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

Continuar co noso traballo de investigación permitiunos tamén

embed integrated circuits into the flexible adhesives

introducir circuítos integrados en adhesivos flexibles

to do things like amplifying signals and digitizing them,

para, por exemplo, amplificar e dixitalizar sinais,

procesándoos

processing them

and encoding for wireless transmission.

e codificándoos para a transmisión sen fíos.

Todo isto integrado nos mesmos adhesivos médicos

All of this integrated into the same medical adhesives

que se empregan no hospital.

that are used in the hospital.

So when we reached this point,

Cando chegamos a este punto

we had some other challenges,

presentáronsenos outros retos

from both an engineering as well as a usability perspective,

relacionados tanto coa enxeñaría coma coa usabilidade,

para estar seguros de que podiamos facelos sinxelos de usar.

to make sure that we could make it used practically.

In many digital health discussions,

En moitos debates sobre saúde dixital

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

crese e transmítese a idea de que podemos dixitalizar os datos,

wirelessly transmit it,

transmitilos sen fíos,

send it to the cloud,

envialos á nube

and in the cloud,

e unha vez alí

extraer información valiosa para interpretalos.

we can extract meaningful information for interpretation.

De feito pódese facer todo iso,

And indeed, you can do all of that,

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

se ignoramos os desafíos enerxéticos.

Think about Jane for a moment.

Pensemos en Jane un momento.

She doesn't live in Palo Alto,

Ela non vive en Palo Alto

nin en Beverly Hills.

nor does she live in Beverly Hills.

What that means is,

Isto significa

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

que temos que considerar a tarifa de datos e o custo

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

que supón para ela enviar datos continuamente.

There's another challenge

Hai outro desafío máis

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

que a moita xente do mundo médico non lle resulta doado de abordar.

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

É que Jane non confía plenamente

in the medical establishment.

no colectivo médico.

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

Ela e xente coma ela, os seus devanceiros, non tiveron boas experiencias

at the hands of doctors and the hospital

nas mans dos médicos e do hospital

ou das compañías de seguros.

or insurance companies.

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

Por iso temos que pensar na privacidade.

Jane might not feel that happy

Jane pode que non se sinta cómoda

about all that data being processed into the cloud.

cos seus datos procesándose na nube.

And Jane cannot be fooled;

Jane non é parva,

she reads the news.

le as novas.

She knows that if the federal government can be hacked,

Sabe que se o goberno federal pode ser hackeado

if the Fortune 500 can be hacked,

ou as empresas da «Fortune 500»,

so can her doctor.

tamén pode selo o seu médico.

Con isto en mente

And so with that in mind,

we had an epiphany.

tivemos unha revelación.

We cannot outsmart all the hackers in the world,

Non podemos ser máis listos ca todos os hackers do mundo

but perhaps we can present them a smaller target.

pero si podemos presentarlles un albo máis pequeno.

What if we could actually,

Que pasaría se no canto de ter

rather than have those algorithms that do data interpretation

eses algoritmos de interpretación

funcionando na nube,

run in the cloud,

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

os fixésemos funcionar neses pequenos circuítos integrados

embedded into those adhesives?

incorporados nos adhesivos?

And so when we integrate these things together,

Cando integremos todas esas ideas

significará que podemos pensar nun futuro,

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

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

onde alguén coma Jane poderá facer unha vida normal,

she can be monitored,

estar controlada

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

sen que teña que ter outro traballo

to pay her data plan,

para pagar o plan de datos.

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

Tamén poderemos responder algunhas das súas preocupacións pola privacidade.

So at this point,

Neste punto

sentiámonos realizados.

we're feeling very good about ourselves.

Logramos isto,

We've accomplished this,

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

comezamos a atallar o tema da privacidade,

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

e cremos que este capítulo está case pechado.

Everyone lived happily ever after, right?

Todos felices para sempre, non si?

Well, not so fast.

Pois non tan rápido.

(Laughter)

(Risos)

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

Unha das cousas que temos que lembrar

é que Jane non confía moito no colectivo médico.

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

Cómpre lembrar

We have to remember

that there are increasing and widening health disparities,

que hai crecentes disparidades en materia de saúde

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

e hai desigualdades na xestión adecuada da atención médica.

And so what that means is that this simple picture

Iso significa que a simple imaxe

de Jane e os seus datos,

of Jane and her data --

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

--incluso se ela está cómoda deixando que se transmitan á nube,

letting a doctor intervene if necessary --

deixando que un médico interveña, se cómpre--

non é toda a historia.

is not the whole story.

Así que comezamos a cavilar

So what we're beginning to do

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

en ter intermediarios de confianza

between people like Jane and her health care providers.

entre persoas como Jane e os profesionais da saúde.

For example, we've begun to partner with churches

Por exemplo: comezamos a asociarnos con igrexas

and to think about nurses that are church members,

e procuramos persoal de enfermaría que sexa membro delas,

that come from that trusted community,

que veñan desas comunidades de confianza,

as patient advocates and health coaches to people like Jane.

para que actúen como defensores e asesores de saúde de xente coma Jane.

Another thing we have going for us

Outro elemento ao noso favor

is that insurance companies, increasingly,

son as compañías de seguros,

are attracted to some of these ideas.

cada vez máis interesadas nestas ideas.

They're increasingly realizing

Estanse dando conta de que

that perhaps it's better to pay one dollar now

quizais é mellor pagar un dólar agora

for a wearable device and a health coach,

por un dispositivo poñible e un asesor de saúde

rather than paying 10 dollars later,

que pagar dez despois

when that baby is born prematurely

cando o bebé naza prematuro

and ends up in the neonatal intensive care unit --

e remate na unidade de coidados intensivos neonatais,

one of the most expensive parts of a hospital.

unha zona das máis caras do hospital.

This has been a long learning process for us.

Este foi un longo proceso de aprendizaxe.

This iterative process of breaking through and attacking one problem

Este proceso repetitivo de avanzar e atacar un problema,

and not feeling totally comfortable,

non estar cómodos de todo co resultado,

and identifying the next problem,

e identificar o seguinte problema,

axudounos a seguir neste camiño

has helped us go along this path

de tentar non só innovar coa tecnoloxía

of actually trying to not only innovate with this technology

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

senón asegurarnos de que a poida usar quen máis a precisa

Another learning lesson we've taken from this process

Outra cousa que aprendemos neste proceso,

that is very humbling,

que obriga ter moita humildade,

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

é que a tecnoloxía avanza cada vez máis rápido

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

e temos que pensar que quen usa esta tecnoloxía son persoas,

and we have to be mindful

e darnos conta

that these human beings -- they have a face,

de que teñen unha cara,

they have a name

un nome

and a life.

e unha vida.

And in the case of Jane,

No caso de Jane,

hopefully, two.

afortunadamente, dúas.

Grazas.

Thank you.

(Applause)

(Aplausos)