The Creative Destruction of Medicine, How the Digital Revolution Will Create Better Healthcare, by Dr. Eric Topol, Basic Books 2012, 2013

Like I said, I didn’t care about healthcare – how much it costs, how long it takes, who’s going to fix it – until I tripped into the system.  Then full tilt the contrast between good care and bad information appeared at my gurney when one specialist after another asked the same three questions – what was my date of birth, was I currently taking any medications – no,  and how much alcohol did I drink – none .   Could not all these disconnected factoids be stored on a chip embedded in my arm?

But Topol has brave and detailed predictions, some of which may already be here, that change the way information is stored and carried through the healthcare “experience.”  Although he describes this as a digital revolution, in many ways it’s a simple systems architecture problem – where to get the data, how to manipulate it, when and how to make it available, etc., questions not unfamiliar to manufacturing survivors of the quality crusades.

Topol sees this revolution at least partly driven by consumers – “The consumer use of and reliance on online health social networks is steadily increasing, despite the fact that most physicians don’t even know they exist! “  Topol’s observations about digitizing everything, as well as genome accessibility, Population Medicine, and finally the squeezed role of our expert doctors are great leaps in a landscape where it is now so easy to get lost.  The author compares our current position to “entering the Gutenberg era,” what the scribes must have surely felt as they saw their hold on the written word slipping away.  Although lead type created bigger markets with more variety, the scribes could not have seen the natural result being less work, less eye strain, and a different life.  

Topol was named the number one "Most Influential Physician Executive in Healthcare, 2012,"  by Modern Healthcare.  Instead of burying us in the changing details of government healthcare, Topol paints us a picture of the convergence of the Internet, increased bandwith and storage capacities, and miniaturization that inevitably moves from transformation of consumer lifestyles, to transformation of consumer healthcare - life and death!  And in fact Topol says that personalization, or customization of healthcare is "the next big thing."  Where healthcare statisticians may have studied and drawn conclusions from review of entire populations - looking at cancer risks, for example, or recurrence of specific threats, Topol highlights the individualization of healthcare.  As a pioneering geneticist and cardiologist he predicts that Big Data and analytics carried by the Internet, will bring individual health histories and requirements into the laboratory, the clinic, and the hospital.  If each patient history is continually updated - the same way his buying patterns are captured and studied - along with the imaging and 3D printing technologies to support it, what Topol envisions will in 3 - 5 years make mass production healthcare obsolete - and very unpopular.  We'll have to see what government and the cost curves do to his vision - it's hard to see ahead clearly when we're in the midst of a tsunami.

Modern medicine is designed for groups. The interactions of drugs, patients, and diseases are unpredictable—clinical trials are population based and do not account for personal idiosyncrasies, much less medical histories. In The Creative Destruction of Medicine, pioneering geneticist and cardiologist Eric Topol introduces a radical new approach—by bringing the era of big data to the clinic, laboratory, and hospital. With personal technology, doctors can see a full, continuously updated picture of each patient and treat each individually. Powerful new tools can sequence one’s genome to predict the effects of any drugs, and improved imaging and printing technology are beginning to enable us to print organs on demand. Topol offers a glimpse of the medicine of the future—one he is deeply involved in shaping.

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The San Diego Union-Tribune: Eric Topol's tough prescription for improving medicine

Read Dr. Topol's Q&A in the Wall Street Journal: "The Wireless Revolution Hits Medicine"

"The Creative Destruction of Medicine....offers an illuminating perspective on the coming digitization of health care."—Ron Winslow