Reflecting on the Great Challenges at TEDMED

Oct 6, 2014, 11:19 AM, Posted by Paul Tarini

Here at RWJF, we are working to build a Culture of Health for all. This is an audacious goal, and one that we clearly cannot accomplish alone. We need to collaborate with thinkers and tinkerers and doers from all sectors–which is why we sponsored TEDMED’s exploration of the Great Challenges of Health and Medicine at its 2014 events.

Specifically, RWJF representatives helped facilitate conversations around six Great Challenges: childhood obesity, engaging patients, medical innovation, health care costs, the impact that poverty has on health, and prevention. We spoke with hundreds of people in person and online (Get a glimpse of the conversation here).

We asked three TEDMED speakers from RWJF's network to reflect on their experience at TEDMED and share some of the stimulating ideas they heard. We hope you'll add your ideas in the comments. 

Ramanan Laxminarayan, of the Center for Disease Dynamics, Economics & Policy

Several of the TEDMED talks offered solutions for patients to play a more informed and active role in their care. Dr. Leana Wen’s work at whosmydoctor.com and Elizabeth Holmes’ company Theranos both focus on getting patients the information that they want to inform their personal care decisions. Empowering patients to make decisions based on accurate information can also play a role in reducing hospital-associated infections (HAIs). Patients need better information on the risks of HAIs, and they need to feel comfortable asking questions.

Thomas Goetz, former RWJF entrepreneur in residence

I came away from the Great Challenges and TEDMED event with a sense that there is yet another challenge: How to turn data into something more useful. There’s a persistent gulf between the promise of data to address these challenges and the real-life, logistically complicated, compatibility-challenged, resource-starved, doing of it. In previous years I think many people in the TEDMED constellation expected the data gods to come along and make it happen. This year I think there was an epiphany that the promise of data won’t be fulfilled by IT departments but by those at the top, and those in the trenches.

Consider Ted Kaptchuk’s presentation about research into placebos: On the face of it, he’s not a typical big data acolyte but a philosopher, an expert in Eastern medicine. But by recognizing that placebos can have clinical value, he’s applied statistical rigor toward a new paradigm of understanding. Or look at the audacious vision of Marc Koska, who wants to attack the status quo by re-designing the way we immunize people, , and leverage data in a relentless pursuit of that vision. Or Carl Hart’s data-driven debunking of the conventional wisdom around drug abuse. Or Jill Vialet, founder of Playworks, and the way she took a pragmatic idea about improving recess and brought it to community after community, armed with evidence and passion in equal measure.

My takeaway from TEDMED 2014: that passion and pragmatism mesh, and that data and dedication can be equal allies. I witnessed a new way to tackle the Great Challenges, an inspired approach that doesn’t accept the way things are, and that makes a compelling argument for the way things must be. Data is part of that argument. It’s also part of the solution.

Ted Kaptchuk, of Harvard's Program in Placebo Studies and the Therapeutic Encounter

Innovation is critical, yet new ideas are disruptive–so understandably resisted. Intelligence requires a critical attitude, but it is difficult to know if one is too skeptical, or not enough. We need our previous knowledge to make judgments, yet these judgments can involve biases that resist valuable new ideas. Only hindsight can tell us whether we avoided ridiculous propositions, or obstructed positive innovations.

Many of the TEDMED speakers wrestled with this issue. Elizabeth Nabel, president of Brigham and Women’s Hospital in Boston, framed the issue in terms of humility. She understands that being “certain” about knowledge is not necessarily a positive for science, and instead can be a way to flatter ourselves. For her, humility means openness to the new and an awareness that today’s “truths” can become tomorrow’s discarded beliefs. She reminded me of Max Planck’s warning that “a new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”

We want to always reflect on what unexpected innovations the next generation will generate, and remember–they will be smarter than us.