These are the collective tools that lay the groundwork for digitizing humans. This is a new era of medicine, in which each person can be near fully defined at the individual level, instead of how we practice medicine at a population level, with mass screening policies for such conditions as breast or prostate cancer and use of the same medication and dosage for a diagnosis rather than for a patient. We are each unique human beings, but up until now there was no way to establish one's biologic or physiologic individuality. There was no way to determine a relevant metric like blood pressure around the clock while a person is sleeping, or at work, or in the midst of an emotional upheaval. This represents the next frontier of the digital revolution, finally getting to the most important but heretofore insulated domain – preserving our health.
We have early indicators that this train has left the station. The first individual, a five-year-old boy who had his life saved by genome sequencing, was recently documented. But it's not just about finding the root molecular cause of why an individual is sick . We can now perform whole genome sequencing of a fetus to determine what conditions should be watched for postnatally. At the other end of the continuum of life, we can do DNA sequencing to supplant a traditional physical autopsy, to determine the cause of death. We can dissect, decode and define individual granularity at the molecular level, from womb to tomb.
That's just the start of illuminating the human black box. Recognizing that we are walking event recorders and that we just need biosensors to capture the data, and algorithms to process it, sets up the ability to track virtually any metric. Today, these sensors are wearable, like Band-Aids or wristwatches. But soon enough they will also be embedded into our circulation in the form of nanosensors, the size of a grain of sand, providing continuous surveillance of our blood for the earliest possible detection of cancer, an impending heart attack or the likelihood of a forthcoming autoimmune attack.
Yes, this does ring in the sci-fi concept of cyborgs, the fusion of artificial and biological parts in humans. We've already been there with cochlear implants for hearing loss, a trachea transplant, and we're going there in the creation of embedded sensors that talk to our cellphones via wireless body area networks in the future. With it comes the familiar "check engine" capability that we are accustomed to in our cars but never had before for our bodies. Think true, real prevention for the first time in medical history.
We live in an extraordinary data-rich universe, a world that had only accumulated 1 billion gigabytes (109 or 1,000,000,000 bytes of data) from the dawn of civilization until 2003. But now, we are generating multiple zettabytes – each representing 1 trillion gigabytes – each year and will exceed 35 zettabytes by 2020, roughly equivalent to the amount of data on 250 billion DVDs. Sensors are now the dominant source of worldwide-generated data, with 1,250 billion gigabytes in 2010, representing more bits than all of the stars in the universe.
The term "massively parallel" is an important one that, in part, accounts for this explosion of data and brings together the computer, digital and life science domains. Note the convergence: from single chips that contain massively parallel processor arrays, to supercomputers with hundreds of thousands of central processing units, to whole-genome sequencing that is performed by breaking the genomes into tiny pieces and determining the life codes in a massively parallel fashion. In 2011, the Watson IBM computer system beat champion humans on the game show, "Jeopardy!" Watson is equipped with a 15-terabyte (1012) or 15,000,000,000,000-byte databank and massively parallel 2,880-processor cores.
So, beyond its television premiere and victory, where was Watson first deployed? At Columbia University and the University of Maryland medical centers to provide a cybernetic assistant service to doctors. David Gelernter's February 2011 op-ed in The Wall Street Journal, "Coming Next: A Supercomputer Saves Your Life," introduced the concept of a WikiWatson supercomputer that could bring together the whole world's medical literature and clinical expertise. Putting a massive databank to use to improve health care is emblematic of the overlay of the digital and medical worlds.