How Consumers Are Defining Healthcare's Future w/ Dr. Daniel Kraft, Founder, NextMed Health

Welcome to Care Talk, America's home for incisive debate for healthcare, business, and politics. Today, we have one of my older friends in healthcare, Dr. Daniel Kraft, uh, who has been a public servant, um, in the military, in medicine, and I first got to know Dr. Kraft in future conversations.

But what's fascinating about Dr. Dan Kraft is that he's as relevant to now as he is to the future. Welcome to the podcast, Dan. Thanks.

It's great to be with you. I haven't known you that long. I mean, you know, sort of older colleagues, it's all relative, right? So time's accelerating.

I think it was TEDMED may have been the first time we met. Um, and, you know, TEDMED at the time, Jay Walker was very, very focused on, uh, the future and all these new interesting things. And it was close to 20 years ago. But what was fascinating, Dan, is that, you know, it seems like you took that and built your own conference, an even more future-facing conference around it.

Do you wanna talk a little bit about the conference you've been running and with sort of a view towards the future that where kind of the future is now conformed to kind of get to a lot of the points that you laid out 15 years ago? Yeah. I mean, things we talked about back then are now becoming reality. And, uh, I, I never called myself a conference organizer or a futurist.

I've sort of accidentally converged into that realm. I did this traditional, you know, academic path, Stanford for medical school, Harvard for residency, fellowships in hematology, oncology, bone marrow transplant. My world sort of opened up as a fellow. I started going to the TED Conference before there were TED Talks and before anyone knew about it particularly, and that sort of opened my ideas to this sort of super convergence of technologies and people from multiple worlds coming together to solve big challenges.

Um, I reconnected with, uh, Ray Kurzweil and Peter Diamandis, who I knew from going to International Space University when I was a medical student and, and had a whole path looking to be an astronaut. And, uh, became founding ch- uh, chair of medicine for faculty at Singularity University thematically about exponential technologies and where things were heading. And everyone there, when we would run smaller executive programs, um, was interested in their own health and the health of their community and technology, and thought, "There's a real unmet need here to look at the future of healthcare from all these different angles."

So I built a program initially called FutureMed with about 80 participants from 20 countries, where we looked at everything from early AI to wearables to big data to genomics to CRISPR to 3D printing, uh, and bringing in multiple parties to sort of reimagine and cross-fertilize. And that grew into something called Exponential Medicine, which we held for 10 plus years at the Hotel Del and then has evolved to Next Med Health. Um, which the idea is to really, again, cross-fertilize and get people… I'm a hematologist oncologist.

I'll go to ASH and ASCO. Cardiologists go to TCT and, and cardiology conferences. Psychologists go to others. How do you bring them together to go, "What's the state of the art today?

Where's the puck heading? How do you look at this convergence of all these fast-moving technologies, sometimes exponential technologies, and use that to reimagine the whole healthcare continuum?" So that's sort of a bit of the backstory. Yeah.

What I, what I found fascinating, though, is that, you know, healthcare is often a team sport that's undermined by individual incentives and structures, and you solve for that. You also solve for the fact that, you know, we're effectively creating the equivalent of the last 100 years of medicine every 24 months in terms of data, information, and insights. The, the kinds of the, the sources of data we have that could be relevant to healthcare. And the folks that were focused on the computational challenge there as well as the intellectual challenge, they all found a home and in, at your conference.

And but maybe step back a little bit and, and explain for those who may not be as, as, as well dialed into Ray Kurzweil and the super convergence, the singularity idea. Maybe, maybe that might be an interesting framework to sort of set up some of the rest of the conversation. But what, what was, what was Ray trying to define there? Well, stepping aside from the singularity which is near or, or arriving, um, the concept is really the power of exponentials, and the usual example is sort of Moore's law, the power of computing getting f- faster and cheaper and doubling in speed and price performance every 18 months.

And that's continued through wars and recessions, now it might be supplanted by quantum computing. But, you know, it took a Cray supercomputer of compute, now it fits on your smartwatch. Uh, we've seen that exponentials in AI and, um, the internet and, uh, the fact that everything's become digitized, the world of digital health. What used to be, you know, uh, analog now can be conversion to an app or a wearable.

And so the concept that Ray popularized in that the theme of exponential medicine and now Exponent Health is you wanna, if you're kind of living the now and wanna build into what's next, you sort of need to appreciate the power of exponentials, the doubling, you know, two, four, eight, 16, 32. You know, 15 steps of exponentials gets you to 30,000, but 30 steps gets you to a billion. And so that's sometimes hard for people to sort of grok, and healthcare is often very linear and incremental.

And so there's a balance between taking these incredible exponential technologies, which are sometimes, of course, moving faster than policy, regulatory reimbursement, workflow, and figuring out how do we see where things are going? How do we leverage that into everything prev- from prevention to diagnostics to therapy to public and global health? And that takes sort of a new way of thinking and maybe even rewiring our healthcare systems in new ways, uh, 'cause we're still using fax machines and DVDs and, uh, paper forms.

Well, just on that, that, that, that painful part of healthcare, and, uh, you, you did have a very conventional background as a doctor, although very few doctors are finalists to become astronauts, let's be honest. You always were looking, looking l- you're l- looking a little bit beyond the horizon line. Uh, but how, how do you, um, you know, how do we solve for that, uh, the sort of the, the backward-looking structures we have when the y- the sort of the future is now? And all of the… I mean, you've gotta - We, we - The, the, the greatest use of fax machines in the world is probably the US healthcare system.

At the same time, you know, 60 to 70% of doctors are using OpenEvidence, which is an AI assistant to help them do research for relevant treatment modalities. Right. And they're using OpenEvidence without waiting for their IT department to say it's okay. Uh, and that's a good example of, you know, often our, our institutional structures are based on sometimes well-meaning rules that were sometimes built well before the digital age.

HIPAA is my favorite thing to pick on, right? I've had patients almost die with their privacy intact 'cause you couldn't get them to sign something and get their medical records faxed over while they're in extreme duress in the emergency room. And by the way, that's not a cartoonish example. That's actually a real, uh, uh… Dr.

Kraft, you know, is, is a clinician. Like, that's a real problem. Yeah, the idea of data transportality and, you know, there's definitely a lot of interest and focus on privacy, but, you know, there's also the opportunity when you can be a data donor, and I'm in the oncology field, almost every pediatric patient I manage is on a clinical trial, that when you become a data donor with the right privacy things intact, you can build a better future for other patients like you or with similar conditions.

And I think the example I always use is, you know, one thing that's transformed our world is Google Maps and Waze. You know, you can't imagine driving in New York or San Francisco without those kind of platforms, but that's crowdsourcing your driving data, and that's some private information actually, where you are, what speed you're at. If we can think more globally about sharing our meta healthcare data and building better healthcare journeys for patients like you on similar journeys with similar CARs or genomics or other meta, uh, multimodal data, I think that could really open up the art of the possible.

But our structures are still based on sometimes fear, uh, need to be rewired. One small example is you need to bring the regulators with us. We had, uh, at the time, Bakul Patel, who was the FDA lead for digital health, come to Next Med Health. We helped the FDA sort of future scope a bit, and that helped evolve their thinking for what's now become, you know, software as a medical device and their pre-check platform.

So you can reimagine elements of, of the FDA process. You need the, the policymakers. There's like one PhD in all of, uh, Congress and a couple wackadoodle MDs in the Senate. Um, they're not educated on the art of the possible.

So I think whatever part of health and medicine you're in, and the policymakers and lawmakers need to sort of get a bit of an exponential mindset and think about what could we do when we kind of not just leverage the technology, but the new, uh, workflows and incentive models and ability to have agentic health and, you know, self-health now that really could open up the aperture for better outcomes and lower costs, which are so critical as well. So is, is the, is the challenge more the regulatory structures or the kind of the mindset of the clinicians and the clinical leaders that are currently kind of the arbiters of what, what, what gets, what gets adopted and what gets implemented?

Yeah. One of my favorite quotes, uh, is from an old economist, John Maynard Keynes, that the challenge isn't the new ideas, it's escaping from the old ones. And the current guard, the old guard, you know, often, you know, chairs of departments and deans of medical schools still trained, you know, in the '80s and '90s, often in the pre-digital age. It's generationally changing.

But, um, sort of what's needed is sort of a bit of a, of a reboot and reimagining how we can do almost every element of care. But thus often comes with, as you know better than me, aligning the incentives, because we don't practice evidence-based medicine, we practice reimbursement-based medicine. The incentives are for sick care, not for proactive anytime, anywhere, uh, healthcare. And what I think is interesting today in 2026 is now we're seeing this emergence of self-care, right?

You can go online and go to Lily Direct and get your GLP-1s for better or for worse. You can sign up for Function Health and get hundreds of labs interpreted with AI. You can buy an over-the-counter wearable. I've got four of them on that now have agents on them that will interpret not just your digital biomarkers, but your lab markers in context.

People are now opening up and ChatGPT Health is launched, and other examples now where each of us is, can be much more engaged. That's somewhat disruptive to old models, but it's, it's not just about what's now, near, next, it's also what's needed to sort of reshape our healthcare for the next generation so it becomes sustainable and much, much more, um, impactful. You've opened up the, the personal side. Should everybody have a, some sort of device on them?

Uh, uh, not everybody wants to have four. But should everybody have a, a, a, a, a, a, a personal healthcare device that's feeding the, some of their vitals into a, into a, a database? I don't think it's for everybody. Um, and it's not just about the device.

These are all supposed to becoming commoditized. They all sort of measure some of the same things. It's what do you do with the, not just the data, 'cause no one wants raw data. You can have all sorts of data about your sleep, and maybe you want a bit of a sleep score.

What does that mean for John or for Daniel or so Sally about starting to optimize their sleep? And then what gets most interesting about these sort of wearables and otherables, as they can do more and more, um, is the contextual information and the change from baseline. What's getting interesting, even the Apple Watch has a platform most people don't know, know about called Vitals, which will see your normal heart rate, sleep, O2 sat, temperature, and go, "Wow, you're out of sorts.

Maybe you're developing the flu or an early case of COVID or some cardiovascular conditions creeping up." And so I think a big opportunity is to not just think about quantified self, which has been around for a while. The first Fitbit launched in 2009. But quantified health, how do we connect the data and the insights from our wearables and our smart homes and the microphones that can pick up sounds of biomarkers of health into our workflows for your health agents or back to your primary care doctor or specialist?

And I think what's exciting now is no matter what wearable or otherable, other data you can feed, you now have the power to go for free and build your own database and have that be sniffed continuously and look for those changes that are relevant to John, or know that you're traveling and jet lagged and maybe your vitals are off that day, or know that you have certain genomic risk factors and put that in context. So this idea of multimodal contextual health, which can almost be free, and hopefully get paid for by Medicare and our payers, can really change the game.

Should the average person who's got a, a monitor on somehow feed that back to their primary care doctor? Do you think there's a way that the, as, as we empower the consumer with more, more, more gadgets and toys, that we can then l- th- th- that it's on the consumer because obviously the doctor doesn't necessarily know that they've got them, to then integrate it back into their healthcare, and how do you recommend they do that? Yeah, we had a, a really fascinating session at the last Next Med Health with Larry Smarr, who is a amazing astrophysicist, and, and his son Ben Smarr, who's a professor at UCSD as well, who's been studying wearables.

And I had their prim- their own primary care doctor on stage with him who's been pioneering, 'cause they're the most quantified guys on the planet almost. How do you think about that in the future of continuous primary care? So I think what gets interesting is it's not any one day of data or one spot check or pushing all that data to your clinician, 'cause no one wants to look at your raw steps or sleep or now blood pressure and blood sugar. Um, but giving that context and allowing the AI to sift through that, and so the future of your physical exam for the year is continuous.

It'll maybe give you a little nudge when something seems to be off, but also maybe alert your clinical team. Let's say I'm a primary care doctor managing 2,000 patients, 500 of them have hypertension. You know, today you might be lucky if they check with a home-based blood pressure cuff. Maybe it's even digitally enabled and might send something to the cloud, but that's not in my workflow.

I'm not paid to look at that. What I might want from my 500 patients is to know which 10 of them are running 20 or 30 points too high over the last week, and might need to nudge them with an AI agent or a call from the nurse to adjust their beta blocker or their ACE inhibitor. And if they get incentivized to drive better outcomes with better hypertension control or, or pick your condition, using that and it becomes more seamless and not, um, over-datafied, but into the workflow and using AI machine learning to make that contextual, I think that could really be a game changer.

But that takes changing medical education, uh, payment models. I was gonna say, that's where I was leaning on the consumer, Dan. Do you think that, that we are better off if we wanna drive positive change in healthcare, continuing to push devices, protocols, and ideas through, um Instagram and device world or, or, or can we really rely on the institutional healthcare system to reform at the speed of technology and, you know, and data? Because I, I, I kinda think, you know, his - Well, I'd love your perspective on it, then I'd give you sort of a more, uh, uh, that maybe sh- maybe have you react to mine.

Yeah. I, I think the institutions and the, from the big, big pharma to big payers to big healthcare systems are slow to adopt these things. The consumer often drives the adoption, and I think folks aren't waiting. You know, uh, from the e-patient Dave movement with, uh, give me my damn data to now give me my insights, and that's becoming table stakes.

And it's super early days, right? I mean, ChatGPT only launched in the world about three and a half years ago. What'll it look like in three and a half years or five years from now? Today already, and just launched, what, in July of a month ago, in July of 2026, you can go to ChatGPT Health now and connect your wearable data and your MyChart and your, upload your genomics if you have that, or your 23andMe, or your last set of Quest labs, um, and it'll have some context.

It also might look at your mindset. You might wanna say, "I wanna live to 100," but, but why? What's your sense of purpose and, um, mindset around healthy longevity, if that's an interest? So I think the consumer is gonna be pushing a lot of this, and now that they can get their full body exams done in labs and have their own AI chatbot for mental health, it's gonna really change the game, uh, and healthcare systems will need to adapt.

And so we're, we're kind of putting it all back on the consumer then. I think it's not about putting it back on the consumer. Often there's no choice. I mean, even here I am in San Francisco Bay Area to see a specialist or, uh, even get a good primary care doc can take weeks or months.

And so, you know, folks aren't going to Dr. Google anymore, they're going to Dr. GPT, sometimes getting good bi-guidance, sometimes not. I think there's some data about 44 million Americans earlier this year had gone to GPT agents of some sort and avoided a physician visit or self-triaged for good or for bad.

Um, and again, it's still early days. We, we can study how relevant these are, but, um, or how safe they are. But in many cases, it's not about, you know, replacing a doctor or a clinical interaction, it's there just isn't one available or it's gonna be delayed. And so we know that so much of healthcare, um, costs is because we pick things up late at stage two or three or four.

We can start to be much more upstream, you know, proactive, personalized, and participatory, engaging every human, you know, with these agentic health platforms that know their age, their culture, their language, their personality, their zip code, their goals, um, and, uh, can really help tune that interaction with them. Not to replace their clinician, but to help augment elements of care. Because you've got this wonderful platform of all the different forms that are next med and you're, because you're pulled into this futurist stuff on a pretty regular basis, regardless of whether you think of yourself as a futurist, every Google search I do suggests that Daniel Kraft in 2011 in Maastricht predicted this.

You, you have, you're, you have access to all of the, um A lot of the talking heads that people are listening to. The current most interesting topic or s- appears to be the, the arguments for longevity. Everybody is for improving their health span. You know, who would you be listening to right now to help consumers sort of cons - What should consumers be thinking about as the most authoritative sources of either people or information around how to live a, a, a better, healthier life and increase their health span?

I think the answer is it's not about any one person or influencer. I mean, too many folks got their health advice from Joe Rogan, and that didn't go very well for getting vaccines, for example. A lot of people, uh, take advice depending on how many, you know, followers someone has on Instagram. That's not a good measure.

There's cer- certainly some great clinicians out there spreading good gospel, but there's also some charlatans or snake oil up the wazoo, particularly around longevity, and I think you framed it well. N- we wanna extend our healthy healthspans and shrink our sickspans, and today there is no magic bullet. I mean, we can argue whether metformin or rapamycin or, uh, you know, uh, you know, intermittent fasting might be helpful. Uh, the trials are underway, but, you know, it's all still about lifestyle.

Exercise is the best drug, good sleep, sense of purpose, connection, uh, diet. All those lifestyle ones that aren't sexy are probably the, the most, um, healthspan longevity inducing agents. Of course, that combines with your genetics and environment and mindset. Um, so I'd be careful about tracking any one person.

I, I think the future of healthspan longevity will be personalized, you know. I've been building a platform called digital.health, that's the website, given that there's so many solutions out there from wearables and digital and AI and, uh, sensors both for clinicians, patients, consumers. I think the future will be one where you can say, "I'm John," "I'm Daniel, here's my attributes, here are my goals, here might be my genome, here's, here's my digitome.

What might be best for me to improve my healthspan?" And you can do that today with these agents. The trick is how do you build that healthcare journey, kind of the Uberization, that easy button that can help match to you and not give you the same, um, you know, rote user interface that a lot of these platforms have. So I don't think it's one person, it's about how you hyper-personalize that and help the solutions match you.

You know, Dan, one of the things I find inspiring about you is your conferences and your talks. They're, they're always kinda upbeat and positive, and yet I talk to so many young doctors who are depressed or overwhelmed. What's your advice to a, a younger version of yourself that, that might be, uh, in, in a, in a similar state about what they can look forward to in a career in medicine? That's hopefully positive.

Yeah. I mean, this is the most exciting time, I think, to be alive. I mean, it's a challenging time with everything. You know, AI can be used to build a, a bioterrorism weapon or a new mRNA vaccine that can help cure cancer.

So all these things have pluses and minuses. It - and, and the future is accelerating. It's hard to keep up. But I say it's an exciting time to be in healthcare 'cause change is what used to take 20 years or 10 years can, is happening in two or sometimes, you know, six months.

And so the lens I would put on it, if you're a clinician, is it's easy to get, become a cog in the wheel, but you now have the opportunity to see pain points, challenges that you have as a clinician, as a patient, as a caregiver, and to see how might I solve that, sometimes using convergent exponential technologies, whether it's the $10 genome that's on the way or the next generation wearables that will do blood pressure and hemoglobin A1C. Uh, it, it's an opportunity to think about where gene editing is gonna go to be proactive also, um, and to then solve them yourself.

You can vibe code an app now and get it out into the world without any coding experience. You can, uh, work with collaborators. I went through Stanford Biodesign, uh, when I was a fellow. It's all about finding a pain point and solving for that.

And now, as a clinician, you don't have to have the MBA or a bioengineering des- d- degree to sort of come up with a solution, build a team, and get that out into the world faster and more impactfully. So, you know, um, whether you're a day-to-day clinician or you're a clinician who wants to be innovating, you know, we can help reimagine healthcare together. Well, I think that's a great place to wrap, Dan. And with that, um, if you liked what you heard or you didn't, we'd love you to subscribe on your favorite service.

I'm John Driscoll, the chairman of UConn Health, and I am delighted to wrap up my first of hopefully many conversations with a person I always find interesting, Dr. Daniel Kraft. Dan, thanks for joining. Thanks, John.