The future of digital health | Stanford University School of Engineering

The future of digital health | Stanford University School of Engineering unknown

Transcript

[00:00:00] Eleni Linos: I think the future of digital health is health. I think we will reach a point in the future where we won't need to necessarily differentiate digital health or digital anything. I think we're moving in this direction where digital health really covers all of health.

[00:00:26] Russ Altman: This is Stanford Engineering's The Future of Everything, and I'm your host, Russ Altman. Please remember to follow the podcast if you're not already doing so. And if you're listening on Spotify, please hit the bell icon. It'll help us grow and it'll make sure that you never miss an episode. 

[00:00:41] Today, Professor Eleni Linos will tell us how digital technologies are transforming how we deliver medicine. In her specialty of dermatology, it's having a particularly early and profound effect on how she sees her patients and how she evaluates their skin. It's The Future of Digital Health. 

[00:00:58] Before we jump into this episode, I'd like to ask you to rate and review the podcast. It'll help others figure out if they're interested in The Future of Everything.

[00:01:13] You know, the pandemic accelerated our use of digital technologies. Many of us had the experience of seeing our doctors on Zoom or on a secure video line, and there was things that were nice about it. We, uh, had more convenience, uh, it was easier to set up the appointments, and you could even see your doctor on your cell phone. Well, that's just one example of how digital technologies are transforming medicine. We're starting to see AI being used in patient communications and physician communications. We're seeing AI used to make diagnoses, especially in dermatology, where you can take a picture of a lesion and ask your dermatologist, hey, should I be worried about this spot? 

[00:01:50] Well, Eleni Linos is a professor of dermatology, medicine, epidemiology, and public health at Stanford University. She's an expert in digital technologies and digital health, and she leads the Stanford Center for Digital Health, which is doing research on ways to ensure that this technology gets used in the best way for patients. 

[00:02:10] Eleni, you do digital health, that's a big part of your research program. How do we define digital health and what do you see are the big opportunities and challenges? 

[00:02:19] Eleni Linos: So that's a great question, Russ, um, and it's one I get asked a lot. Um, and my answer at the moment is, um, to try and avoid defining it. And the reason for this is because I really think, you know, your podcast is, you know, The Future of Everything, I think the future of digital health is health. I think we will reach a point in the future where we won't need to necessarily differentiate digital health or digital anything. I think we're moving in this direction, um, where digital health really covers all of health. Um, and so, you know, really, the question is, what isn't digital health?

[00:03:01] Um, we play this game with my kids where, uh, you know, we think about, like, even, you know, even riding your bike, if it has some sort of meter measuring things, well, is that digital health? It's a healthy activity, and there's a digital metric. If you're playing pickleball outdoors and you're wearing an Apple watch, is that digital health? 

[00:03:20] Russ Altman: Right.

[00:03:20] Eleni Linos: So, I think it's an intentionally very broad, um, but it is a really good question because defining the questions we work on initially is a priority. But deliberately avoiding defining digital health for now. 

[00:03:33] Russ Altman: Okay, good. I like that answer, um, have you considered politics? No. Okay. So, uh, but you're a dermatologist and I think it would be fun for it to hear how a dermatologist gets interested in digital health. Is this a big thing in dermatology? And tell us a little bit about, I guess, the roots of your interest in this area. 

[00:03:51] Eleni Linos: Yeah, so dermatology is a, you know, a really wonderful clinical field, partly because, you know, the skin is the largest organ in the body. It affects all of us, people really care about their skin, uh, both in terms of beauty, but also, you know, if you have a rash or an itch, that really affects your quality of life. And so, um, so it's a wonderful field also because it's visual, we, um, can very easily capture images of skin disease. And actually, dermatology was one of the first, um, fields or disciplines where computer vision and AI became, you know, almost the landmark study of looking at diagnosis of skin cancer using AI came out of dermatology.

[00:04:35] So, it's always been really at the forefront of people's minds, but also innovation. The reason I became interested in digital health as a dermatologist was really trying to understand how do we use digital images, digital tools for home monitoring to try and be able to collect data from patients at home, um, and save them the trip to the doctor, uh, you know, the visit to the dermatologist. And this was, you know, before the pandemic really, um, brought the, uh, the everyone's focus to telemedicine. So, that's how I became interested. 

[00:05:09] Russ Altman: Great. Yeah. So let me just ask, I think everybody would want to know, I think in general patients like the idea of not always having to go into the clinic to see their physician. And I recently had an experience during the pandemic where I was talking to my dermatologist, and she saw something on my head that she didn't like. And she said, come in today, I want to do a biopsy. And so that just leads to a very natural question, which is, how good are like iPhones and Zoom cameras to allow you as a dermatologist to actually make accurate diagnoses?

[00:05:40] Eleni Linos: Yeah, so that's a, that's a great question. And I think, um, we found that photos, sending, uploading photos is actually very useful because you can zoom in, you can adjust the lighting. Um, the, the you know, the zoom, the live video is harder. 

[00:05:56] Russ Altman: Ah. 

[00:05:57] Eleni Linos: And you know, during the pandemic, obviously we had to do it, but it's hard to examine all of someone's skin that way. Um, and so you need it, you do need a combination of in person visits and remote. But what, what the home portion adds is you can really very quickly send a photo, we do, we do tons of work with photos. As your dermatologist found, you know, if you can submit a photo and she's worried, then that helps triage and prioritize who can be seen sooner, um, which is, which is a [00:06:30] big, uh, help for fields where appointment times may take three or four months to schedule. As a specialty, we know who to prioritize, whose care is urgent.

[00:06:41] Russ Altman: Great. And I know you've done some work in the fact that we all don't have the same color skin. It ranges from very pale to very dark, and that can lead to some challenges, is my understanding. So, tell me about how do dermatologists manage that, um, in terms of being able to do the best exam possible, uh, for people of different backgrounds and different skin colors?

[00:07:01] Eleni Linos: Yeah. So, this is, um, again, a really important topic, uh, probably across medicine, is ensuring people from diverse backgrounds and diverse skin types are included in research, in educational materials, in our publications. Um, and I, you know, would have to mention my colleague, Jenna Lester at UCSF, who has led a lot of this work, who you should invite on your podcast next time, um, uh, who's, who has a phenomenal approach and has given a TED talk on this topic as well.

[00:07:31] And, you know, the uh, the thing that's important here, and we've, we've published a lot of work together is, is to make sure that not only, um, does the research include people of, of all different skin types because a rash looks different on, um, on white skin than it does on darker skin. And, but also our educational materials, our residents, um, who train to become dermatologists, need to be trained on, uh, on all skin types, because how can you, how can you recognize and treat a patient unless you have seen that condition?

[00:08:08] And the same is true for all of the image libraries, all of these, you know, AI algorithms, um, are trained on data sets from real patients. So, unless those data sets represent the full spectrum of, of uh, human skin colors, they really won't be um, as good at diagnosing or predicting, uh, for darker skin types. And so, that's been a huge priority for our team, our university, our department, um, and I think for many, uh, many researchers nationally and internationally. So, it's now at the forefront of everyone's attention, which is great. 

[00:08:48] Russ Altman: Yes, and, and that raises the issue, uh, in general is I said Somewhat flippantly before that, patients like not going to the doctor, but I'm sure you, you, you care about this more than that and you've studied it. What is the reaction of patients to these distant interactions, either with dermatologists or with other doctors?

[00:09:05] Eleni Linos: Well, I think, you know, practically, um, this does add a lot of convenience in people's lives, and what we have always been interested in is not just studying how tools help people, but what happens in terms of health disparities. So, who is it, who are these tools helping and who might they be leaving behind? And I had a particular interest in figuring out, are [00:09:30] there differences in terms of age? Like, you know, are older adults, for example, if you're 70 or 80 or, you know, or 90, are you able to benefit from these telemedicine tools as well? Um, if you come from a different racial or ethnic background, you know, whose benefit. And we did actually do this analysis and look at the data, and what was interesting is that we found that actually a substantial amount of older adults do prefer using tele dermatologists. But obviously the tools aren't there yet, aren't designed well enough to facilitate optimal care for older adult.

[00:10:09] And what do I mean by that? You know, the getting the, um, the, the technology literacy of an older person may not be at the same level as a younger person, and it's our responsibility to make these tools user friendly, easy, you know, accessible, big font, just easy to use so that everyone can use it. [00:10:30] Um, that said, the convenience of being able to reach your doctor, you know, if you work, you can call from work if you can find a private space, that you don't have to leave work, that Facilitates a lot better access for certain populations. And so, we have found that actually there are some big advantages to using, uh, digital tools for medical care in terms of health equity. 

[00:10:56] Russ Altman: So that, that sounds great. And, and speaking of patients and, uh, and communications. I know that you've recently written a paper on the impact of things like, uh, chat GPT, these so-called large language models, uh, specifically in dermatology. And I was intrigued by that because as you said, it's a very visual, um, uh, practice of dermatology. But, and yet these LLMs, I think have opportunities. So, can you tell me what are your thoughts about these, uh, kind of amazing language models and where they might fit into, to digital health? 

[00:11:28] Eleni Linos: Yeah, I mean, this is just an amazing time, um, in terms of how the technology and how these models will change. I mean, six months ago, you know, people weren't using ChatGPT the way they are now, and who knows what will happen six months from now. And so it's hard to predict, I think ultimately, you know, not just as a dermatologist, but as a leader of the Center for Digital Health at Stanford, my priority is making sure whatever we study, we um, [00:12:00] we, we think about, okay, who is this helping? Who might this be leaving behind? And how do we partner with not just other scientists, but the tech companies to make sure these tools are fair, are, um, helpful to everyone.

[00:12:15] We, as you mentioned, we recently published a study looking at how these large language models perform compared to actual doctors uh, in terms of reducing bias. And, you know, the, the interesting finding is that basically the, you know, doctors also have bias in their medical decision making and as do these large language models, um, and the question is, how do we optimize the technology to reduce doctor's bias. 

[00:12:45] Russ Altman: Yeah.

[00:12:45] Eleni Linos: So how do we essentially have them add to our work and help physicians deliver better care? And I think we're very close to doing that. 

[00:12:57] Russ Altman: So that's fascinating. And if I could, could I ask you to dive in a little bit? Like, what kinds of biases are you seeing either in the doctors or the LLMs that you think are kind of we're shedding light on? Because it's very interesting and I'd like to just put a little bit of a more meat on that. 

[00:13:11] Eleni Linos: Sure. Um, you know, just a simple example of the types of scenarios we analyzed. So, in this one very simple study, we took published clinical vignettes. So, it describes a patient, patient comes into the ER, these are their symptoms, and, you know, what would you recommend? And those questions have already been asked to hundreds and thousands of doctors, so we know what the doctors would reply. We plugged in that same question into BARD and into CHAT GPT to see what the algorithm would reply. 

[00:13:44] Russ Altman: Right. 

[00:13:44] Eleni Linos: And we varied the race and the gender of the patient. 

[00:13:49] Russ Altman: Ah.

[00:13:49] Eleni Linos: So, in one situation, we said, this is, you know, a Latina woman, or this is a White man, or this is a Black man. And then we saw with the same exact symptoms, same story, same history, and we saw what the algorithm would recommend and diagnose. And we found, you know, it changed what it would recommend based on those characteristics, those gender and, uh, race and ethnicity characteristics.

[00:14:17] And that's where I think, you know, there's a problem, but actually I see it as an opportunity. This is, so easy to fix and I know that the tech companies and the researchers are aligned, everyone wants to improve these models to provide better recommendations. And of course, you know, they clearly have disclaimers that they're not to be used for medical care. 

[00:14:39] Russ Altman: Right. 

[00:14:40] Eleni Linos: But people use them, so.

[00:14:41] Russ Altman: Absolutely. 

[00:14:42] Eleni Linos: So, we can't avoid that. And so, it's an, it's an easy fix. And, you know, since then, we've done a similar study where we've plugged in um, psychiatric symptoms and we've I've looked at, uh, descriptions of psychiatric conditions and compared again what the, you know, these large language models will say compared to, um, you know, uh, residents, psychiatrists, and other groups. And in some cases, they do a lot better than, you know, there's a lot of published examples of um, of how people respond. So, I do think this is an opportunity, I think it's something we can only improve on from here. 

[00:15:24] Russ Altman: Yes. There was a great study, I'm sure you're familiar with it, where they compared the empathy of chat GPT with the empathy of pediatricians. And at least in some cases, the patients liked and that liked the chat GPT better than pediatricians. Which is a real warning to all of us because we all know that pediatricians are among the most lovable doctors. And so, if they're losing, we're all in big trouble. 

[00:15:47] Eleni Linos: Well, I, I learned that, um, firsthand, Russ, when my kids went to sleepaway camp this summer and you're able to send an email, they print it out for your kids. So, I would every day, like a, you know, caring mother, I missed my children, I would type up these long, loving letters. And then after the first week, I kind of got tired and curious to see what chat GPT would do. Know this, by the way, when this goes live, this is the first they'll hear. But, uh, so then I, you know, I prompted Chat GPT, and I said, write a caring letter. 

[00:16:20] Russ Altman: Tell them I miss them, and I love them.

[00:16:22] Eleni Linos: And it came up with so many more thoughtful questions and parts that I didn't even think about. And so, that was the aha moment for me where I was like, oh, I am the, you know, I love my kids, the empathy is at the highest level it will ever be, but yet it's still better in some situations than I would be. Um, and it helped me. I edited the letter, so I didn't, uh, 

[00:16:43] Russ Altman: Of course. And, and, and, and, and I won't even ask you if you gave co authorship to ChatGPT, it sounds like you didn't. But, um, children, if you're listening, your mother loves you very much. And this was just her best effort to be a good mom with a diverse set of notes to you. Oh, that's a great, that's a great story. So not only are pediatricians in jeopardy, moms are now being threatened in terms of their levels of empathy. Oh, my goodness. 

[00:17:10] Eleni Linos: I think it's, you know, don't see it as a threat. I think that's my message. 

[00:17:14] Russ Altman: Yes. 

[00:17:14] Eleni Linos: And it's the same message to a dermatologist or a physician, you know, who, who may worry like, oh, will this technology replace them? It won't. It's, it's it's a help, it's an assistance, it will make your life easier, it will save you time, it will help you give better care, give more empathy. So, I see all of these innovations as a tool to help people and physicians deliver better care. So.... 

[00:17:44] Russ Altman: yes. 

[00:17:44] Eleni Linos: Not a threat. 

[00:17:45] Russ Altman: You and I have a colleague who had the greatest quote. He's a radiologist and somebody asked him if radiologists would be replaced. He said, AI won't replace radiologists, but radiologists who use AI will replace radiologists who don't. And I think that kind of summarizes some of what you were just saying. 

[00:18:01] Eleni Linos: Very true. Yeah. 

[00:18:03] Russ Altman: This is The Future of Everything with Russ Altman, more with Eleni Linos, next.

[00:18:19] Welcome back to The Future of Everything. I'm Russ Altman, and I'm speaking with my guest, Professor Eleni Linos from Stanford University. In the last segment, Eleni told us about digital health's impact on dermatology, how the patients are perceiving it, and what are some of the research challenges. 

[00:18:34] In this segment, she's going to tell us how social media is part of a public health portfolio of technologies, how we train future doctors to be savvy with these technologies, and a little bit about her new and exciting center.

[00:18:47] But Eleni, I know you've also done a lot of work with the use of social media, and I, I presume that falls under the General Umbrella of Digital Health. So, tell me, how do you think about social media and what are some of the projects you've done with it? 

[00:19:00] Eleni Linos: Of course, yeah, this work started, um, probably almost 10 years ago. So, you know, before 2016, one of the projects I worked on a lot as a dermatology researcher is how to convince young adults to stop using tanning beds, to stop using indoor tanning, because we had shown dangerous and caused melanoma.

[00:19:21] And we realized that, you know, no matter, how many scientific articles you published, um, showing the dangers of tanning, unless you reached, [00:19:30] you know, the teenage girls who were actually doing this, um, it wouldn't really have an impact. And that's when we started thinking about using social media and using targeted ads, uh, to reach the right person at the right time with the right message. Which is what, you know, online marketing tries to do as well. And so, our initial studies were really focused on that designing accessible, fun, engaging, um, ads to try and convince teenage, uh, and young adult women who are the most frequent users of indoor tanning to stop.

[00:20:05] Um, and, uh, then that, then the pandemic hit, and we realized we had the partnerships, the tools, the skills to apply this idea of reaching the right person with the right message at the right time to other public health challenges. 

[00:20:20] Russ Altman: Now, just to be clear, back in 2016, was this using traditional media or were you putting it out on early versions of Instagram and Twitter and those kinds of things?

[00:20:29] Eleni Linos: Yeah, this was on Facebook at the time. 

[00:20:31] Russ Altman: Facebook. 

[00:20:32] Eleni Linos: Facebook and Instagram, exactly. 

[00:20:36] Russ Altman: Wow. So, uh, and how did it work? 

[00:20:39] Eleni Linos: So, practically the way it worked is we realized that young adults or maybe everyone, don't always trust the establishment. So, me as a kind of boring physician professor may not really resonate the same way with, you know, an 18-year-old, 19-year-old, 20-year-old as a peer. Um, and so that we [00:21:00] started some early work with influencers, um, and trying to get messages that were really, you know, really fun, catchy, engaging. I learned a lot about, uh, online advertising during those early years uh, to really try and get people to shift behaviors, um, is hard. It's hard to get people to shift their actual, um, uh, behaviors. But, um, it's definitely possible. And, you know, people use these techniques all the time. 

[00:21:28] Russ Altman: Yes.

[00:21:28] Eleni Linos: To get people to buy a new pair of shoes or You know, uh, be finding a new brand more interesting. And so, that was, that was some of our early work, um, that we practically, you know, expanded when the pandemic hit to promote COVID vaccination as well.

[00:21:47] Russ Altman: Yeah, yeah, talk about that. Cause that's a little bit of a lateral shift. But I guess all of the same kind of ideas about fun, quick influencers. What did you kind of move the whole playbook over to COVID? 

[00:21:58] Eleni Linos: Yeah. So, what was interesting about COVID those early days was that the entire scientific and medical community It felt like we all rolled up our sleeves to work together and everyone, um, was engaged. We all had a common goal, especially, you know, because I have a public health background, you know, public health has always been, even though I'm also a dermatologist, my, you know, my background is in epidemiology and public health. 

[00:22:24] And so, all of us were like, okay, what do we do? How do we pivot our work to really help, um, uh, support people through this really difficult time. And so, what was remarkable about those early days of COVID was that we were able to very, very quickly bring together, um, physicians, public health advocates, again, I mentioned influencers, athletes, faith leaders, because I don't know if you remember early on in the pandemic, there were certain faith groups that were kind of opposed to vaccination. 

[00:22:57] Russ Altman: Yeah. 

[00:22:57] Eleni Linos: And we knew that, you know, as I said before, people trust their peers, people trust their community leaders, and we knew that if you needed to reach, you know, someone in the South, say, you know, a member of the Methodist Church, we had a Methodist, um, kind of church leader speaking to. We had rabbis speaking to Jewish communities. We had, you know, people from every faith, basically. 

[00:23:23] Russ Altman: Ya. 

[00:23:23] Eleni Linos: This video and then every, you know, ethnicity, racial group, age group. Um, and what was amazing was how quickly people volunteered their time, their videos, their messages, and their heartfelt encouragement. Um, and then we, you know, we were lucky enough to have the support in terms of free advertising from, uh, Meta, then Facebook, um, to disseminate this.

[00:23:50] So, we were able to take a specific message, and send it to a specific community very, very quickly. We reached over 30 million people. Um, and then another 10 million people internationally. And, you know, hopefully had an impact, there are some tools about measuring real world impact that we can get into but, but overall. 

[00:24:10] Russ Altman: But those numbers are very impressive. And you have to believe that even if a tiny fraction of those 30 million were impacted positively, that it made a big difference. 

[00:24:19] Eleni Linos: Yeah, that's our hope. And of course, we weren't the only team working on this. Um, as I said, you know, it was just an amazing time of seeing scientists, doctors, tech leaders all come together, um, for a common cause.

[00:24:33] Russ Altman: So, that's great, that's great. And that really clearly illustrates, especially given your earlier comments about digital health is going to be everywhere. A part of everywhere, for sure, is social media these days. Um, I wanted to pivot a little bit to training students because I know, you know, you're a professor, you're involved in training students, fellows, residents. Um, what are the challenges in preparing them for this digital medicine infused future? 

[00:25:01] Eleni Linos: Yeah, I mean, this is a big question for education in general, right? How, um, and it's, it's not just for medical students and postdocs, but also for, you know, high school and even younger college. How are all of these tools shifting the way we learn? What do we need to learn? And what do we not need to learn? I think ultimately, um, you know, and this may evolve, and you probably have educators can speak more, um, more not, with more knowledge on this. 

[00:25:31] But my experience is people need to know how to think. Um, they need to know how to ask the right questions. You need to really be able to know what is an important question. Um, and not just an important question to move the science forward, uh, you know, so you want to be able to ask really impactful questions that move us forward, not just incrementally, but can really answer the fundamental kind of research enigmas or dilemmas.

[00:26:01] Russ Altman: Yeah. 

[00:26:01] Eleni Linos: But also, how do you ask questions that are fair, that are based in these values of not leaving people behind, not forgetting the elderly, not forgetting, um, you know, children or infants, like, how do you include everyone? How do you ask questions that ultimately, um, benefit society? What are the impacts of your research questions, say, on sustainability, on climate, on society as a whole? So that deeper, more complex thought, is what I try and instill in trainees and students. 

[00:26:36] Russ Altman: Do you think that because they're growing up in this era and they're all plugged into social media, we see all young people, whether they're in training as clinicians or not using their phones, is that helping them be better at using these technologies? Or does it create blind spots that you have to kind of expose them to in their, in the way they think about how care should or could be delivered? 

[00:26:59] Eleni Linos: Yeah, I do think that, you know, one simple thing that is lacking, um, that we noticed with the pandemic when everyone turned, uh, to screens is just the ability to communicate in person, one on one, make eye contact. Also practically, you know, we're used to giving talks virtually like this. 

[00:27:18] Russ Altman: Right. 

[00:27:18] Eleni Linos: And so I still remember, uh, you know, a couple of students who we're invited to a scientific conference and had to give a talk in front of a podium and a live audience, you know, calling me in a panic and saying, I haven't, you know, I've never done this, like, how to. So, getting people used to talking to each other, having conversations, delivering a talk to a live audience is something we have to, we have to add. Um, but I think there, you know, there's so many advantages to learning right now through digital tools. 

[00:27:49] Russ Altman: Yes. 

[00:27:49] Eleni Linos: It's not about taking any of that away. It's just making sure the in person, the communication and the deep thought, the focused thought, um, still has a place. 

[00:28:01] Russ Altman: I, I love that example because when we do realize that the Zoom is not enough and we need to go in and actually interact with our physician, it would be really good if our physician knows how to make eye contact and be empathetic. And, and I know that there is data that this can be a challenge for young people because of the screen-oriented life. And we have to make sure that that is not lost. 

[00:28:20] Well, in the last couple of minutes, I wanted to ask you about the Center for Digital Health that you lead at Stanford. Um, why does it exist and what does it need to do? Um, and why are you excited to, to take it on? 

[00:28:31] Eleni Linos: Yeah, I'm so excited to take on leadership of the center, it's um, probably the, the best time in the world to be thinking about digital health, about the intersection of technology and health challenges. Um, and being at Stanford, being in Silicon Valley, um, really is just, is just such an honor and an opportunity.

[00:28:55] Um, I think what I'm most excited about as we build the center is how we are bringing together really the best and the brightest minds, not just from Stanford Medicine, but Stanford School of Engineering, the law school, so many other humanities. Um, but also Silicon Valley, we're in this incredible ecosystem of innovation and technology, um, but also the whole world.

[00:29:20] So as I, you know, as you know, Russ, I, you know, I'm, I grew up in Greece. I've lived in, uh, in the UK and have a [00:29:30] global perspective, and I think we all should. Um, so how do we bring together all of these pieces, build community, break down silos, in order to answer questions that we will face in the future? So, I think many of the questions That we need to answer with this new Center for Digital Health, we don't even know them yet. They probably aren't even; they don't even exist yet. But being prepared by building community, bringing people together, so that when those next challenges hit our world, we're ready. Um, that's my hope. 

[00:30:01] Russ Altman: Are the companies in Silicon Valley, are they excited about this? Uh, are they like, oh, we'll take care of it, you know, you can do whatever you want, but we know what we're doing. Or do they have questions and needs that you're perceiving? 

[00:30:12] Eleni Linos: Absolutely. I think, um, many people are incredibly thoughtful, wise and collaborative and see the need for an independent academic, um, uh, center, our group, which doesn't necessarily have the same pressures of, or motives for profit. You know, we're completely independent and I think that adds a lot of credibility and trust and it allows us to ask some of the harder questions, I think.

[00:30:39] Russ Altman: Right. 

[00:30:40] Thanks to Eleni Linos. That was the future of digital health. 

[00:30:44] You've been listening to The Future of Everything and I'm Russ Altman. We have a wide array of discussions in almost 250 episodes that are available to you with instant access. If you're enjoying the show, please leave a review and your comments about what you think of the show. Your feedback helps the show grow and it also gives us important information about how to make it better. You can connect with me on Twitter @rbaltman and with Stanford Engineering @stanfordeng.