Darshan
Hey everyone, welcome to another episode of DarshanTalks. I'm your host Darshan Kulkarni. It's my mission to help patients trust the products they depend on. And as part of that, we're looking at what the future of medicine future health and future pharma looks like. As we continue, our guest today is is is a very well known globally known futures and we're gonna talk about that a little bit more. As you may know, I'm an attorney. I'm a pharmacist and I advise companies with FDA regulated products. So if you think what drugs wonder about devices, consider cannabis or ponder pharmacy, this the podcast for you. I'm a lawyer do i do FSA This is not legal advice, not clinical advice. Our guest is a physician, definitely not clinical advice either. So the other pieces again, I do these podcasts is that a lot of fun, I do these live streams, but a lot of fun. I find myself learning something new each time. So if you like what you're hearing, please like please subscribe. And if you find someone who might enjoy this talk, because I know I will, please share because they might like hearing about this, you can find me on Twitter DarshanTalks, or go to our website at DarshanTalks calm. Our guest today is someone I have interviewed a few times before. And each time I'm amazed by the knowledge he brings to the table. He is a a physician, but he is globally known as being a medical futurist. And he's currently in the middle of writing a book. And I want to ask him a little bit more about that. And he's doing research and, and the way he's doing research is the type of ways I want to do research as well, which is traveling all over the world, meeting new interesting people and changing the world as he does it. So our guest for today, Dr. Emmanuel fondue, man, how are you?
Emmanual
I'm doing great. Thanks for having me.
Darshan
Thank you for coming on. First question. When you talk about, about futurism, what does that mean to you? And why? Why is that something we need to consider?
Emmanual
For me, when I talk about features, and especially on healthcare, I'm not talking about what happened 2000 years from now, or 20 years from now, right? I think especially in healthcare, there are lots of technologies that are available today that could be formed the way we interact with a healthcare system that we're taking advantage of us. And I would say because the process of innovation, we have different stakeholders outside of a traditional clinical role, right? We have a compliance regulatory, we have legal people that all in and not everyone is up to date with what's happened with technology, the only challenge that I've faced in the industry and in clinical practice. And so I think being out there to educate the community about what technology is available, what the regulatory barriers are, and how we can overcome them, is the best way to go to make sure we have improved healthcare outcomes.
Darshan
So do you think that as a futurist, your your goal is to inform or to shape the future,
Emmanual
inform and shape a couple of ways? One is, if you look at something like telemedicine, right, like pre COVID, when I had conversations pre COVID, and I say telemedicine, people will say, oh, something in the past, we tried it did not work. So we're done. Right? When COVID came, and all of a sudden, you've seen companies like teladoc, right? These companies that they go public, they were billion dollar valuations, and everyone is excited about it. But at the end of the day, that's like innovation actually, for my site, right? Because if you look at who has a WhatsApp on your app phone, right? Yeah, FaceTime is like, okay with someone to video. Yeah, battery is illegal batteries or health information is what makes Tella Doc's extra special. In that sense, right? Is that open line of communication. But there are many countries in which people don't have dunnock, right where FaceTime works and WhatsApp works, the same kind of concept. And I think shaping that is one piece of it. But now what happens is how do you shape that, that the world where you have telemedicine The biggest challenge there obstacle is difficult to measure vital signs or other symptoms at home? Right? So how do we make that better? How do we improve that we have tons of startups now and greatest solutions that come in to measure remote blood pressure monitoring, right remote, you know, dermatologist visits, and different things we can measure at the whole and so that's how we ship it by bringing in that those innovative innovations and make people I can imagine what the future looks like if we can incorporate these solutions and then have that perfect kind of solution going forward. So it's to inform and then shape.
Darshan
So it's interesting you say that, but let me because one of the things that always stuck to me is are you a Starcraft guy? Oh, yeah. Okay. Um, so one of the things that really came up to me was We now routinely try to mimic what we see in sci fi. And we, Tesla, I think Ilan Musk, I think had the XPrize or someone else had the XPrize. And the goal was, how do you make sure that we can now mimic what we saw on TV 3040 years ago with the tricorder? And they're trying to do that I think we had a successful entry as well. Personally, I see you smiling. Do you know much about that one?
Emmanual
Or? Yes, I actually spent time there's a conference that takes place in Scotts Valley, California annually for future is called augmented intelligence conference. To attend a conference and it's, you have the wind is about 30. People, just select people, high school kid, there's an entire pilot, this filmmaker, a couple of celebrity actors, you have a couple of Nobel Prize winners can make for people. And what we do is we sit together for three days. And we imagine what the world looks like in 2030. From is how the cities look like and where people's healthcare look like. And you can see figures for any group, and boundaries where you can imagine financial regulations. But the principle one of the exercises is you need to have universal basic income as a rule. And we imagine a world and we spent three days hashing things out Max Tegmark, someone I really admire from MIT, they wrote a book like to do point out, I put together this conference, and I love spending time with him. He's an adviser to Elon Musk as well. Right? omega took great revelations, but he's a brilliant conference. You have nuclear physicists around and it's like 30, intimate chats about marshmallows, right? In three days together. It's fantastic. And that's exactly what we do. And I think in healthcare, that's because you asked that these visa secret a framework, which is what is used in Hollywood, that you design your Star Trek movies, right? Well, yeah, let's imagine the possibilities of healthcare. We got all these regulations around and then backtrack and say, how do we make it happen? I think that's the best way to do it.
Darshan
I think that's awesome. But here's, here's my question that comes out of that. When you see Star Trek, it talks about this unified world where we all have the same opportunities. And he talks about universal basic income a little bit here. So I'm going to layer that into the conversation. But I guess my question is, is it fair to see what 2030 looks like, but not consider what happens? What I mean by that is 2030 in New York, is going to be very different from 2030 in rural India. So So how do you visualize 2030? Where do you visualize 2030?
Emmanual
That's a good point. I always say that the future is here now, but not for everyone. Right? I live in the future today. Right? Waiting, distant future. And it's quite evident. Like I mentioned, like, I just came back from a tour, like traveling to Europe, you know, look at different countries to deal with COVID. And you realize that things are completely different, right? Way to us, we have access to vaccines. I've been in Europe where people are waiting months didn't get access to vaccines, right? So future for us is here. Now look at Japan and the Olympics are happening right now we're another, like 22% of population actually is vaccinated. Right? The features are there for everyone. And so that's a unique piece of it. And it comes down to this personalized experience, shall we say, personalized medicine, personalized experience, if you look at health care in the Western world, US has advanced in certain units. But if you look at an NHS, for example, in the UK, because they have a more complete database that complete different compared to Israel, they also have better University and database centralized compared to us, the US will have different kind of pieces. So clearly, people more advanced, but the journey stays the same. If you look at healthcare in India, compared to Cameron, but my family's from India is definitely way advanced that then we can run it sort of so what is the best example would be an example of India. But that's just one example data. For example, the media is big in Rwanda and getting health care down, right? It's not Google, Africa. My book is OpenOffice. But data. So I think for every part of the world, whether you're developing country or you develop country, there is a leader in that environment and you follow that path, because the infrastructure fits your needs much better. We can't have just one size fits all kind of technologies, just to have one size fits all kind of medicine.
Darshan
It's a great, so it's a great point, you can have one size fits all medicine because it has to be personalized to where you are. So does that create a dichotomy? a break of rough 2030 looks like and the result of that is therefore should you aim? Should innovation be aimed at the lowest common denominator? Or should it be aimed at the highest common denominator?
Emmanual
I think innovation should be aimed at access. And I'll tell you the reason why. If you look at Facebook today, Google, you could be anywhere in the world. You'd have access to Google or Facebook, right? What prevents someone in the rural part of India or Africa to connect with a commissioner in the United States if they're willing to pay the price? We assume that it can pay. So we create these different silos for things and between different markets. If you look at what happened in India recently, we look at COVID. And the dead rates that in COVID, oxygen became like a commodity. Right? People, railways are dying. But air conditioners of experts in California in New York that I'm dealing with these patients, why can't they have direct access to them to technology is a barrier for them to use Facebook and connect with someone like drift messenger piece and talk to clinician and the different models like to do that, I think we need to break silos and scale realize where humans and their expertise around the world, and we create those kind of connections that is not driven by insurance companies are driven by these things, because people are willing to pay for something, or doctors are willing to do for free. Right? So let's like quiz boundaries and prevent people talking to each other, I think eventually open up access, and people connect to the best this the ability to pay, and whatever people want for free or pay. I think that's the best way of doing it.
Darshan
So it raises this interesting question, you asked this. So let's explore that a little bit. You said, well, let's break down those boundaries. Let's Let's allow people to access the care, which I think is great, as a concept sounds awesome to me. But the implication of that is things like who provides that access? And what I mean by that is, let's say Google, or Facebook, or someone else, one of the big tech companies providing it not a teladoc is the point of making but whether it's valid or not, doesn't matter. Who owns the data of what was transmitted? And does it matter? What how that how that information gets access. So is it okay, to create a safe provide access to these patients in exchange for holding their data? And they don't know any better? Or is that exploited?
Emmanual
That's a big challenge. piece around data ownership piece, right? If you look at there's a quote about if you're not paying for it, then you are the product. Yeah, right. And we know that there are lots of interest in patient data around the world. For example, we know today that in clinical studies conducted the question that minorities, you know, African Americans, Africans, Indians or women have in places like Sri Lanka, how many people from Sri Lanka represent in a typical clinical study right as to be complete? I mean, Nigerians? I mean, come on, Mister Africans. And I think an industry needs data, these access to these data sets as you make more decisions open up access, Isn't that better in exchange for that isn't what is not worth the price to say? Well, current expense for the $150 tele visit was over Nigerian, in exchange for your datasets? That's a fair thing to consider. Right? And so is it a monetary issue of what's I think this kind of framework, I think, is I think that we need to discuss as a community, but this will not be done by governments. If we wait for the FDA and everyone else to come up with this rules, it will never happen. Right? When we look at Facebook trying to create like Internet in Africa, that is true, the telecommunication agencies to figure out what to do, right? Only in our industry, do wait for the for the for the federal government to give us guidelines on what we should do. I think we should create a path carbon is a great framework we all agree on, and then propose that path, and then move forward with it.
Darshan
I think that sounds great. And concept because I think your point is that we are more innovative than what what the agencies can do because the agencies react, as opposed to our be proactive, if you will. And that's fair. But my question is, in many ways, we've sort of done that though, right now, haven't we, where we basically said, we'll let industry do what they want. And what industry did was create personalized versions of each one of us that we barely have access to decide what they're going to sell to us, and then weaponize that knowledge. And now we're trying to play trying to catch up with things like these different privacy laws and the different biometric laws. I mean, there's a great example of let industry do what it will and then we'll catch up. And that's Henrietta Lacks, where we basically said, I know I'm sort of doing soliloquy, so I'll give it to you in a second. But where we basically will take all the data, and we'll use it and then look, let FDA and stuff come back and make rules later on. Sorry, many.
Emmanual
We say industry as a better point, which industry? Are you talking about the healthcare industry or the ck industry? To find it, right? I think and the reason why I say that is this, there isn't the problem we have is that healthcare today is driven by what I call the sick care industry. If you look at anyone that's interested in digital health, right? If you hear Google do Amazon do something, you have all the cheerleaders coming behind them right? Here, this company raised $100 million or $20 million, everyone was coming behind them. The companies behind that I still have great innovative solution. They have not raised on demand, but have a great solution but no one here about them, right? So and most of these things are driven by disease driven medicine. So you're saying these and the solution behind it. But if you look at a tech companies like the Amazons, if you look at, you know, Facebook, or you look at Google, and Fitbit, it's coming into the space, they're coming from a healthcare perspective, okay? healthcare does not mean that you are healthy, and you're not sick. But you have to look at someone as a holistic piece. If you are sick, what is the best version of you living your life with your disease, if you are healthy, what is the best version of you preventing disease, and that's what the consumer driven kind of market that we're going into, and I think that will transform healthcare to watch if you look at every pharma company today, the payers will look after the tech companies, because they bypass these rules that we are talking about the mercy care, because when you do see care, no one trust you see care, because you have an agenda behind it. And it doesn't matter how much evidence look at the COVID vaccine is a great example. They're amazing evidence that the drug works, but because they haven't debated by the by the vaccine, still, because of the evidence, right? It's the challenge to get people to get vaccinated. So it's much better for us to say if you're in a business of healthcare, then you have solutions that beyond an agenda with selling your drug is a universal solution. That's the way I think pharma companies need to think in the future, the idea of beyond the pill is kind of solution will be something that should be established and every drug come into the market, you have a solution around it, that comes with datasets. That is that that also helps a company does have Lifecycle Management, you understand your patient population more. If I'm in the business of diabetes, I want to understand the long term repercussions of patients with diabetes. So no sugar beet into the market.
Darshan
I think that sounds great, and concept, but realistically, how would that work? And what I mean by that is, you'd have to be doing a clinical trial of such a ridiculously large patient population to look at longitudinal studies. How, at a realistic level, how do you propose just observational studies? Or what would you think might be a way to achieve that goal?
Emmanual
observational studies, I think in the age of machine learning, the idea of retrospective studies is over again, because you could do a disparity study just to get a baseline. But God prospectively, that's what we do. For example, if you look at all, like the FDA preset program for all the digital solutions, right, where companies get a pre certification, the idea is going forward is through machine learning. Your continuous learn by a patient population is not a one time thing, right? You have a baseline piece where people can deplete the value, or the probability or likelihood of someone having a disease initially could be 50% 60%, in terms of the Apple Watch, for example, right? But you go over time, and you have more information about people, you learn more, everyone gets better over time, and you don't do great. So look at Apple Watch, for example, they have tons of data, right? I ran a study, once I shall go we had about 160 patients found in about six months, we had about 41 years of longitudinal data sets, massive data sets, right? We found out we could predict the risk of people having strokes, just activity and sleeping patterns, right. And so these things will happen. And tons of data being collected every day, everyone with a Fitbit, or an Apple Watch has massive data sets. So that is as pharmaceutical industry, are they going to evolve to actually incorporate these tech solutions in house, find partners, because the future is data driven, right? It's not just a thing of like, oh, vendors hold the data. I'm doing my study. And I have no idea what happens. That's why you hear about big discussions about things like real world evidence. Evidence, it's exactly what Apple is doing the real world like I can datasets, that means no inclusion, extra criteria, how does my drug work in the real world? And that's what patients want to see also. And so it's inevitable that that's the future, right? Because access to payers will be to that will evidence?
Darshan
I think you're 100%? Right? I think that parents definitely want to see that type of data, it definitely helps them to know where to put their money. But But I guess let's go back to the point you raised, which is really interesting point, which is we have so much data, I believe that the last time I heard something like two, two exabytes of data every single day, or sometimes it's a ridiculous number of amount of data that's being created. My question is, number one, one of the big issues with data, as you know, is garbage in garbage out. And the data is unstructured, which means that it's and I know you know, this man really explained to the audience who may not but the it's not like the data is in a column and you can go back number, that number, that number, that number, it's in the middle of notes, which are saying different things in different contexts. It's hard to understand what all that means. So my question to you is that that tremendous amount of data number one, how do you avoid the garbage in garbage out problem? Number two, if you can avoid that, how do you make sure that the information is is actually meaningful, and what I mean by that is, I can trust my Fitbit and I'm wearing one right now. I can't trust my Fitbit Give me the number of steps I take every single day. But now I'm suddenly expecting it to tell me if my drug works. And that seems unfair. So what's your thought process around that? I agree
Emmanual
with you on big data. I'm not a fan of big data. I mean, kind of smart.
Darshan
I like that.
Emmanual
What are you measuring? I suppose they just like every single thing that you like. And so the question becomes, because it starts with this central point of why, what what, why, why are you doing this? First question, right? If you have a Fitbit, what is the goal of you wearing a Fitbit? Is it for activity counting to burn calories? is monitoring oxygen saturation? In that particular case, then you know exactly what you're measuring for your particular outcomes? What is the why I think that's, that's what everything starts with. The challenge here is a lot of conditions. Have no idea what 1000s of solutions out there, right? And then understand who's doing what and what is the why behind this solution? What why Fitbit? And why Apple Watch and why whatever, right? Why not just want to wait, what is that each one has a unique thing that is measuring. And you have the same things that could be for heart failure, different companies working on heart failure is somewhat of a mental health measure. There's actually things right, but something's relevant to them. What is the relevant to the other? So that's a big challenge. So if you're doing like a Fitbit kind of thing, you actually have structured data. Because you've got two specific things right? oxygen saturation activity. But I was interested in Duchesne is I once worked on a study with the former FDA Commissioner, and we discussed the idea of what activity means, right? You know, activity does not mean the same thing for Fitbit and Apple Watch and everything else. Like they're different. Yes, complete different. And it's certainly public. No one knows what it means. Right? Step count for Apple is very different than Steph council Fitbit. And those are all proprietary definitions, right? Yeah, this activity is also different. So step count is the step count is nothing. Just the idea, and everyone defines it different. Right? So it's very difficult to do a study where people live in devices. And you are looking at all of them in the same way. They don't define it the same way. Yeah, put it on your arm, and then put it on Apple watch or you walk, I bet you have two different readings. Right? So because of that, people don't trust these things. Because break just exactly because the What does this mean? How do you? And that's a big challenge. And no one has to find a piece right now in healthcare. And so the goal becomes what is what do you measure? What actually counts becomes a difference? Yeah. And that's the biggest challenge of adoption of healthcare solutions. So the first thing I would say is, what is your why. And so I'm working with some colleagues to create a platform called Moshi health, like em, er, CH e health, where basically what we do is bring in all the solutions on board and comparing them side by side, think of it like a price line for digital health solutions. Yeah, which are why we're looking for, and you can literally query and search companies and find the best ones that feature. So I think something like that is, is needed to actually help people feel confident to adopt solutions.
Darshan
I'd say I take it one step further, I'm agreeing with everything you're saying. But I think you almost need the FDA or a government body or someone coming and saying, Let's define the what, what is activity. Once you know what activity is, then we can start saying we're all working off of the same same lists saying we're eating the same plate
Emmanual
activity? What is the relevance of that activity? What is the relevance of a 10,000 step count? And how does that relate? What What is the clinical benefit of a 10,000? Step count?
Darshan
Well, I would say that if you know what, what 10,000 steps is, then you can ask the question of why does it matter? But if we don't even agree on, on what a pound is, or what a step is, having 10,000 steps, it has no meaning. So right.
Emmanual
So an intensive activity is also different than you know, the intensive activity is different than if you had activity pattern for a long time. It was slow, but we all agreed activity helps improve care. But that correlation is relevant. And it matters. Right? And that's that we're learning.
Darshan
That's so interesting. I've never that that is mind blowing to me that it seems so obvious. But I've never asked that question. So thank you for that. So So we're now in a world where we're talking about innovation, we're talking real world evidence. My question for you is using things like machine learning, using things like artificial intelligence, we're going to potentially get to a place where we might be able to do better than what we've done before. So there's no need for retrospective studies to start doing prospective studies. Do you think that the way different countries are treating public surveillance and artificial intelligence and data is gonna play a huge role on what 2030 looks like? And what I mean by that is, Israel came out and they said that The data from COVID will happy to give it to whoever wants it. We're the startup nation, China came out and said that we want to use patient data, and we're going to use it for public surveillance. But you compare that to something like MMA, or technically Europe, and they're coming out and saying, We don't want people's individual data to be used to be used against people for a quick public surveillance. So that becomes a huge issue from a health data perspective. So do you see a future where Israel and China are running miles ahead of what the US and EU are doing?
Emmanual
Oh, yes, definitely. I was I was in the EU and GDPR stuff, you just use my phone. Every time I click on a website, I have to go to return policies. If you get annoying, I just click Yes. And I know anything. Right. So it becomes annoying and a piece of like, just let go of it. Yeah, I think the issue and he goes beyond countries Darshan, I think I make a prediction here, whether you see a company like Amazon, selling insurance on an open platform, right? If you look at the strategy in general, I think what's going to divide us in humans, much bigger than just income itself will be divided across income lines, and across healthcare. Let's look at what happened in COVID. Where people with comorbid conditions, you know, those are the highest dying rate, right, especially among African American communities, people diabetes, and heart disease, but they're dying faster. And those are the ones with the highest mortality rate we call it. What it tells you is that those are the same people that are more expensive to manage. In general, will you see a company like Amazon doing by acquiring like a whole foods? Getting like a peel back kind of company for generic drugs, get into activity pieces where they have activity monitoring pieces? Yeah, basically, what you're doing is, if you look at Amazon, customer base is like someone making over $100,000 a year. So your highest resale economics, that is the people that are most likely your guy, you know, Whole Foods exercise, that stuff. That's a low risk patient population. Yeah, literally deliver groceries for you healthy groceries, where you could take a new generic drugs, and I can literally sell insurance on the market, because you're low risk. Right? And so I could capture that market piece specifically, where are your employee employee, you could set on and get my employees insurance, I'll pay on Amazon and let Amazon Tell me what I need to do. Because I will find good things and exercise to pay lower premiums, that's what's gonna happen. There's, like there's a guaranteed piece of Amazon is gonna make that bold move, the more portable prediction, Google is gonna get into that, you will see private insurance in the public market. Now, if you look at countries, for example, like in England, for example, or Israel, where you have, like a social kind of health care kind of program, like right that cause everyone, they also want to cut down expenses and cut their wrists. So they literally could implement, like, apply that exact same kind of piece of mindset to say, hey, if you exercise, if you do this, then you have less pain. If you go to Europe, it's hard to find Burger Kings in places Wait, I mean, I just walked around. Silas was an option everywhere helping him it was more an option to find tasty fried chicken in places that you don't find that that's more healthy options there. Because the government is painful insurance. So you're going to eat healthy, right? It's more exercise places when parks and that's more common, that kind of community. So you'll see more of that happening because healthy populations means decrease costs. That's going to be a place where but I think US corporations will actually speed that up, though the low socioeconomic status or poor health will be later in society to be a big demarcation society. And that's the scary part.
Darshan
So interesting. We could keep going. But like I said, we try to aim for 1520 minutes, and we're almost a double back. So we could just have this conversation over and over and over again. Let me let me ask you four questions. Like I said, I'm gonna ask you the first question, based on what we've discussed, what would you like to ask the audience?
Emmanual
I would like to ask the audience more. We need to create a healthcare movement where we, we, as far as the digital healthcare solutions, where are you from legal background, or from a tech background for medical background piece, we need to come together to form our own guidelines, and the key challenges that we face in adopting a version of digital health and I would love for anyone that's interested in that movement to be new or being myself and let's bring the quarter cohort group together as this,
Darshan
well Sign me up. I mean, I'm definitely interested in something that sounds like a lot of fun. So that's patient number one, or whatever you want to call it. So there you go. Second question. What is something new you've learned over the last month?
Emmanual
I've learned that different countries treat the management of COVID differently. Right? I was. I was in Madrid, Spain. And on my way back to us, I had to go pay for testing cafe COVID this i 45 euros. I had Favorite out that I flew to Amsterdam. When I got to Amsterdam, they've given out free tasks. That's right. So one country, I'm paying the very next place three hours away. So Hey, everyone, and everyone has a free test test at home. of the airports in Europe right now look like medical clinics that people have that suits or clinics that really is very interesting. Some airports have like digital thermometers scanners in Ghana, for example, you come in and scan the temperature. us we don't have that yet. And people are using touchless credit cards now. I had one before I left, but I like to do that much the US or Europe is more like nope, non touch just actually. There's massive adoption of technology globally. And I love that trend. Because I think what is the solution going forward?
Darshan
A very cool. What is something that made you happy in the last month or last week?
Emmanual
Last week, what makes me happy I went to a concert in Madrid and it was great to sit outside in the garden and just watch replays of the music and people being happy to be out and be meeting each other again, I think it was fantastic is great to meet each other in person again. That's
Darshan
awesome. And the last question, how can people find you?
Emmanual
You could connect with me at Manny ma ny at mulshi dot health or send me a message on my LinkedIn.
Darshan
Let me put that into a banner. Manny at Mercy Mercy health mercy doc health. Hold on. Is this once you had mine?
Emmanual
Perfect. Yep, that's it. Excellent. And instead of the
Darshan
Oh, okay, hold on. Let me change that out. Oh, ma RC, he said. Yeah,
Emmanual
I mean, our machine is like marketing.
Darshan
Perfect. Yep. Okay, there we go. Um, and and just to do a quick recap, Manny, we land up talking a little bit about change, we talked about what innovation looks like we talked a little bit about telemedicine, we asked questions about should we aim for the lowest common denominator? Where What do you compare as the future of 2030? And we sort of talked a little bit about what 2030, New York would look like versus in Cameroon? And how those could be very different. We talked a little bit about Marvel, Marvel and Star Trek, and what that and their Futuristic Look, if you will, we talked a little about owning data. We talked about tech care versus sick care, sorry, care, versus health care, care, care. Thank you. And I thought that was fascinating. And then we got into real world evidence, what are the implications of that are, and we talked about artificial intelligence in that context. And then you use the word smart data, which I haven't. Maybe it's been used, but it hasn't hit me in the same way. But I just thought it was an interesting discussion we had that my biggest takeaway from our conversation is this idea of there's no centralized definition of activity. So the number of steps you take, may or may not register if they don't qualify for that activity. And each company defines that differently, which I think is mind blowing. And we've very briefly touched on this, but I think I'd love to have you back. And we can talk a little bit about the social determinants of health and the context of universal basic income and what that would mean. So
Emmanual
that'd be fun. Really good
Darshan
conversation. And again, Manny, thank you so much for coming on. This is going to be great. I can't wait to have you back on again. Same here.
Emmanual
This is the DarshanTalks podcast, regulatory guy, irregular podcast with hosts Dr. Shaun Kulkarni. You can find the show on twitter at DarshanTalks or the show's website at DarshanTalks.com
