 is Heidi Doze from Google. And I'll get to just pass you over to Heidi, who's been a presentation for you, and our children will be very interesting. All right, thank you very much. I'm really excited to be here at the Ivy Tech X. Thank you for inviting me. And today, I'm going to share a little bit about my 30-year journey as a professional heart patient and being an early adopter of wearable technologies and how that has also led to my day job at Google. I was fortunate to grow up playing a lot of sports. I started out as a swimmer and soccer player, ran track in high school, ended up being a competitive windsurfer on the World Cup Tour and was on the US national team for freestyle skiing. And during that whole time, it turns out I could never figure out how to take my pulse. All those kids in high school and the instructor would say, OK, let's count your pulse. I had no idea where they got those numbers. And so I would just make up a number that sounded like what they were saying. And I can tell you, some 30 years ago, if I had had a wearable heart rate monitor, my journey as a heart patient would have been much smoother. And a lot easier. Because as it turns out, I was 19 years old, and I had to go in for knee surgery to kind of clean up the mess I've been making through all these sports. And it was at this point that I had my first EKG as part of the surgery prep. And when that machine started to spit out the strip of paper and the nurses' eyes got really wide, I went from 19-year-old healthy athlete to heart patient head to the coronary care unit. Because as it turns out, 270 beats per minute is not good. And I ended up being diagnosed with a really rare heart arrhythmia. And of course, I had no idea this was going on. I'd been playing sports. I was healthy. I was happy. And it turns out I had this going on inside, which is why I couldn't count my pulse. And it's also one of the reasons that today we find athletes, especially school-age kids, that have issues and all through the cracks. Because no one ever thinks that if you're healthy, you've got a heart problem. So I was diagnosed with a rare heart arrhythmia. The treatment at that time in 1983 was an experimental procedure to go in using DC current to oblique my AV node, leaving me 100% fabric operated. Just as a side note, and one of my wish list items as a heart patient or just a patient in general, see all these wires and see this horrible hospital gown? Those have not changed in 30 years. All of this amazing technology, and we still have dumb hospital gowns. So under the smart fabrics and great sensors, let's get rid of the wires and let's make these more comfortable. But anyway, I ended up going in for this experimental procedure to have my AV ablated. That left me 100% pacemaker dependent, which was fine, except that being an early adopter of technology also comes with some complications. And over the years, I ended up with an infection in my pacemaker wires that led to a viral cardiomyopathy and heart failure. And then a little bit of scar tissue started to build up. And next thing you know, my vascular system was blocked. So we had to go in and do some open heart surgery or open chest surgery and go in and repair all that. But needless to say, all this time, all I really wanted was my life back, because I've been an athlete. I always had been an athlete. I wasn't very good at being a heart patient. So my goal to recover from all this was how do I get my life back? First, what I needed to do was I needed to have the desire, because it's hard. And it's scary to say, OK, I don't want to be a victim of heart disease. Instead, I want to go back to being a person with a life that I enjoy. So I had to set a goal. And for me, that meant getting back on my bike and cycling. And in order to do that and feel safe, I needed tools and data. Because that data was what was going to help me to understand, where am I? Am I safe? And can I give good information to my physician who probably thinks I'm crazy for the stuff I want to do? And then, having a community to support my goal. And it was like, how do I find other people like me? And up until just the last few years, there were communities of people on Facebook or social media that got together independently, grassroots, to create supportive ways to encourage one another to do great things. And so like I said, I'm on my seventh pacemaker now. So I've been testing the ultimate wearable, which is the implantable device. My first pacemaker back in 1983 looked like a giant pack of cigarettes in my chest. One of my biggest concerns when I first had that put in was my god, I'll never wear a swimsuit again. What am I going to tell my swimsuit sponsor? But over the years, the pacemakers have had more sensors implanted. It collects more data. The one I have today runs very smoothly. It has oxygen sensors, senses, muscle stimulation, electrical impulses, has a gyroscope, minute ventilation. And all of that can quickly determine whether I'm having a tachycardia or I'm exercising. And so I have my pacemaker. And then the device right there, my latitude communicator, that is a passive interrogator that's just at my home. It can interrogate my pacemaker, collect the information, send it to the cloud. It's available for my physician. And now I've reduced the number of times I have to go to the doctor for a pacemaker checkup. The more important tools are actually my heart rate monitor, which for me, because I'm a pacemaker and I'm on heart failure medication, chest straps don't work. So when they started to come out with the optical light heart rate monitors, that was amazing. I was super excited. And then when they came out with one, they connected to my Garmin. That was even better, because now all of my data was in one place for cycling. And this is actually my trainer device. And it has cadence, speed, and power sensors. So in my desire to go from, all right, I have to be a heart patient and a battery operated. And they collect the data. And I reduce the number of times I go to the doctor because I have all this cool stuff. But I can be an athlete. And I can set my goals of what I want to do next for training purposes, because I have a heart rate monitor and then I have the tools to collect the performance data. For me, this is probably the most important slide of why data for pacemaker or for heart patients and patients in general is so important. It's because these devices give us a window into our body. And that window inside, you used to only be able to find out what was going on. If you made an appointment or you were in the emergency room and you had to go to your physician, and they could tell you if you were OK. Now we can actually have that information on our wrist or on our phone. I can collect real data points instead of going to my physician. And for many years, when they never diagnosed my condition as when I was younger, it's because I would feel something. I knew I didn't feel right. And I would go to the doctor and I would tell him, this is how I feel. And of course, my arrhythmia would never show up when I was at the doctor's office. So they'd say, it's probably not you're not getting enough salt in your diet. It wasn't until I went in for that knee surgery that they finally actually had the data points to be able to determine a diagnosis. And not all health care comes from the clinic. So now we're in a place where we can actually get peer to peer support. Nobody understands what you're going through, like somebody who's been there before. So we can start to share with one another. And at the end of the day, what my devices and what the wearables give me is they allow me to feel safe. There was a period of time when I used to have the worst panic and anxiety attacks because I was counting every heartbeat in my head. And that just takes a lot of energy. And every time I get a little extra heartbeat because you're hypersensitive to everything, next thing you know, you feel like, oh, it's happening again. It's not working as intended. And now I have to go to the doctor and you spin yourself up into a panic attack. Now I can just look down and say, oh, everything's working as intended, so I'm still safe. And when I'm safe, I'm more confident. And when I'm more confident, I can do more. And you start to do that and you repeat that and being safe and confident becomes your default as a patient and you're able to let go of the fear. And so from that point, I really was able to get my life back. So I'm a competitive cyclist. I race mountain bikes all over the world. And I wouldn't have been able to do that. I wouldn't be able to put in the training hours and do the things I do if I didn't have that data, if I didn't have that information, if I worked safe, and if I couldn't communicate that to my physician when I tell him I'm gonna go do a 200 mile single day gravel race and his eyes glazed over and he says, yes, riding your bike is healthy. You know, this helps make sure that we're all on the same page. So I was able to successfully make my life better using wearables, using data. I wanted to be able to help other people take this journey and be successful also. On the steering committee of a project called the Healthy Heart Study, this is out of the University of California, San Francisco. It is their goal is to get a million participants, healthy people, heart patients, to provide their patient-generated data from wearable devices, blood pressure cuffs, things like that, e-visits that they do online, and also clinical data to put all that data up into the cloud so that we can start to do, you know, use big data to diagnose and treat patients differently. One of the things that this is offering is it's offering individuals to have a voice. It's giving patients the opportunity to have a voice at the table, to become a patient researcher, to have their input heard as to what's important. And it's changing how we deliver healthcare. And this is made possible because the individual is valued because they're coming to the table with their patient-generated data. I'm always asked right about now how I feel about data privacy and healthcare data privacy. And in the U.S., every time you go to the doctor's office, you're given the HIPAA consent form. And the HIPAA consent form has all kinds of scary language that basically tells you bad things will happen if anybody ever has any kind of look at your healthcare data. And then typically we go home and we post what we did at the doctor on Facebook. So there's a, you know, we need to get to a balance where healthcare data and privacy and security are taken very seriously. But that it's also balanced with the fact that sometimes the value in the healthcare can be useful to solve big problems. And that's my personal opinion is that when the length of and the quality of your life is dependent on the advancements in innovation and healthcare, it really, I want to help share my data because I know I will value, I will be the recipient of those innovations in my life. And then I hope that when I contribute, it will also help to provide new innovation and helpful resources for someone else. But the thing is, is I do wanna make sure that I have control over who uses my data and how they use it. And I wanna make sure that I get to give consent and that I'm valued for the data that I'm providing to the big bucket. I had an opportunity this last year to attend Harvard Medical School and an executive MVP program that they put together. And what that really means is that I got to be immersed in all aspects of healthcare. And it was really interesting. I found out that I know where all the pagers have gone. They're still at the hospital and they're still using fax machines and the healthcare industry doesn't move very quickly. You know, we as Googlers, we went thinking, aha, we can come like do all this great stuff. And then you realize that, okay, legacy healthcare, that, you know, when you look at your payer and your provider ecosystem, their biggest challenge right now is figuring out EHR interoperability. How do they get the meaningful use metrics to make data portable? They adopted EHRs, but the electronic health record systems are mostly walled gardens of digital data. The really exciting place, and this is where many of you are working, is in the future of healthcare, the disruptors. How are we really going to get to that place of patient-centered healthcare, customized healthcare, enabling the individual to have control over their data? And like I said, having the tools to be accountable for their healthcare and participate and talk with their physicians. And this is where the internet of connected medical things and sensors and wearables are very important. And then that third big bucket is the research side of things. We now have the ability with like cloud computing to ingest huge data sets, munch those data sets to find the interesting bits and find that needle in a haystack to start to identify and treat diseases differently. But the key to this is that the data has to be interoperable, and it needs to be able to flow across all these segments because in order to make the disruptor technologies and the data generated there useful, at some point it needs to, a component of that needs to go back to the EHR. So how do we get that data to flow back and forth? And I think as an industry, this is a place where we come together and look at what are those standards, what are those that we can agree upon, how do we make that happen? And this is the next thing that I wanna talk about is we have tool makers, solution builders and the solution users. And this is where my day job comes into play. Google Cloud Platform as a tool maker. We're an enabling platform with lots of services and features and functionality that you guys as builders can assemble to be able to deliver the solutions that users need whether it's the patient individual level or it's a hospital level, but what are the issues you're trying to solve? And so under the pieces and parts, the tool makers, the industry standards, HL7 and their FHIR API, which is the standard for EHR interoperability. We've got the OpenM Health, which is working on the standards for mobile health and connected devices. And then SmartAPI, which is looking at how do we extend the data from an EHR across many applications? And of course the sensors and the internet of medical things and smart fabrics and how do we get battery power to last longer? And this is where I'm hoping we can make that smart hospital gown. But we've got the solution builders. So how do you wanna take these puzzle pieces, snap them together and what does that solution set look like? Because our users over here, they don't wanna be duct-taking individual features together. They want to look at a holistic solution that they can implement and then do what they do best, which is actually present and provide care to a patient. You guys probably all know this. The internet of connected medical things is growing. That's a huge market. And as we get more and more people from 3.4 million to 13.4 million connected healthcare things in the next three years. So that gets us to 2018. We need to put the data somewhere and we need to make that data interoperable and usable and across those segments. And that's where Cloud Platform is a really great place to put that. And these are some of our tools that we have that allow you to ingest the data, manage the devices that you're getting the data and keep them synced and then big queries where you can analyze and make that data usable. When we get to the patient-generated data, physicians are terrified of patient-generated data from wearable technologies right now. And part of that is because they don't know what to do with it. They're afraid if they open that door, it will just be drowned. So the big thing that we need to do here is make the data usable. How do we let the patient generate all the data that they want but distill it down so it's analyzed and just spitting out the anomalies or the actionable bits? And that's the piece that the physician can actually work with. It's also, there are lots of initiatives that are happening that are creating research opportunities for patient-generated data. So there's a movement happening. Now we just need to get the healthcare industry on board and make the data useful. And some of the things, again, ingest the data, analyze the data, cloud data flow allows you to process the data in flight. So a simple, how you connect it all. Right here, this is either my pacemaker or my smart watch. This is my, you know, an example here would be my smart phone connected to my smart watch. The latitude communicator connected to the pacemaker allows the data to be ingested up to the cloud. The processing through data flow and then you can either store the data or you can also perform the analytics and then spit it out to the stakeholders that you wanna share your data with. And then there's why Google. We're a data company. We wanna help give you all the tools and all the power of Google so that you can build the solutions that you wanna deliver at scale. Our Google Cloud Platform, we're working to create this as a healthcare optimized internet of things, internet of medical things platform for you to build on. And some of the things that we have, you know, basically management tools, each of these blue hexagons is a cloud service that you can assemble and build out the solutions. But we cover your big data storage, compute, networking, how to manage it, how to connect your mobile, so. And then interoperability, our cloud is fully supportive open standards and interoperability. Of course that is, we're very involved in the open source community and we focus on security at all the levels from the physical security of the data centers to data at rest and data in transit, data location. We focus on, we take security very, very seriously. And Google of course has been a leader in security for many, many years. And this would be kind of a reference architecture at a very high level that essentially you can pull in data from multiple different data sources and you can put it in a private data center or public cloud data. And then you can analyze it and then make it usable by your stakeholders. So giving it back to the patient to making data available for research or being able to share it with the providers. And we have some really interesting things for those of you that are interested in machine learning. We have our Google Cloud Platform Machine Learning tools which include our vision API, text API, translate. And one of the interesting things is we get to more and more vision and image related wearables doing the image analysis. So can you see a future where we're able to do things with healthcare imaging that will allow you to, you know, apply a context to it and categorize things and then be able to do machine learning and search on those things that today takes, you know, either isn't possible or takes too long and then we would be able to do much more quickly, you know, machine learning, Google Cloud Platform solution. So when we get to apply these things to healthcare, imagine what we'll be able to accomplish. So a couple of conclusions. Data interoperability is going to be key. We're gonna collect it from a lot of places from a lot of devices. And, you know, at some point, at least in the US, it has to also be compatible with the electronic health record because that's the record of the source of truth. But we wanna be able to get to this place where maybe that's just another input to a greater richer patient portal of information. We're gonna look to you as the industry experts. Google has worked with the genomics people for standards and things like that. We wanna work with all of you in wearable technologies to come up with standards. We wanna be a partner and we wanna be the platform that you build on. And personally, I've been at this for a long time, you know, 30 plus years as a heart patient and early adopter of wearable technologies, implantable technologies. And I'm really incredibly excited about where we are today because all of the pieces are coming together that we can truly deliver life-saving and life-changing solutions to people. And, you know, I'm hoping that great things come out of these conferences, people working together, and I look forward to being a part of the solution and helping to improve other people's lives. So with that, I thank you all and I will be around for the next couple of days if you have any questions on the Google stuff. And I'm certainly happy to answer anything from my personal experiences also. Thank you. That's great.