The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care

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Overview

What if your cell phone could detect cancer cells circulating in your blood or warn you of an imminent heart attack? Mobile wireless digital devices, including smartphones and tablets with seemingly limitless functionality, have brought about radical changes in our lives, providing hyper-connectivity to social networks and cloud computing. But the digital world has hardly pierced the medical cocoon.

 Until now. Beyond reading email and surfing the Web, we will soon be checking our vital signs on our phone. We can already continuously monitor our heart rhythm, blood glucose levels, and brain waves while we sleep. Miniature ultrasound imaging devices are replacing the icon of medicine—the stethoscope. DNA sequencing, Facebook, and the Watson supercomputer have already saved lives. For the first time we can capture all the relevant data from each individual to enable precision therapy, prevent major side effects of medications, and ultimately to prevent many diseases from ever occurring. And yet many of these digital medical innovations lie unused because of the medical community’s profound resistance to change.

 

In The Creative Destruction of Medicine, Eric Topol—one of the nation’s top physicians and a leading voice on the digital revolution in medicine—argues that radical innovation and a true democratization of medical care are within reach, but only if we consumers demand it. We can force medicine to undergo its biggest shakeup in history. This book shows us the stakes—and how to win them.

Editorial Reviews

Kirkus Reviews
The director of the Scripps Translational Science Institute suggests that in the not-too-distant future DNA testing and sequencing may become available on a smartphone. The former chairman of cardiovascular medicine at the Cleveland Clinic and founder of its cardiovascular gene bank, Topol looks to a future in which genomics will be one of the major tools of innovative, individualized medicine. "What constitutes evidence-based medicine today is what is good for a large population," he writes, "not for any particular individual." Not so in the future. The author is aware of instances in which pharmaceutical companies attempt to violate the principle of evidence-based medicine by suppressing negative results. In fact, Topol was the first to reveal "significant heart attack and stroke concerns for both Vioxx and Celebrex," information he published in the New England Journal of Medicine. As a result of his whistle-blowing, he was forced out of his position at the Clinic in 2004, when the two drugs were finally removed from the market. The author explains how "the large-scale randomized, double-blind, placebo-controlled clinical trial performed under the most rigorous conditions" will be superseded by individualized medicine. Sequencing the human genome opened up major new areas of preventative medicine; in the future these procedures will be able to identify medications that will benefit, or be injurious to, a small portion of the population who carry a specific genetic mutation, rather than the population at large. Topol weaves useful knowledge about how to evaluate the choices open to patients into this exciting account of the revolutionary changes we can expect.

Product Details

  • ISBN-13: 9780465025503
  • Publisher: Basic Books
  • Publication date: 1/31/2012
  • Pages: 320
  • Sales rank: 32,691
  • Product dimensions: 6.20 (w) x 9.30 (h) x 1.30 (d)

Meet the Author

Eric J. Topol, M.D., is professor of innovative medicine and the director of the Scripps Translational Science Institute in La Jolla, California. Trained at Johns Hopkins University, he conducted one of the first trials of a genetically engineered protein for treating heart attacks, and was the founder of the world’s first cardiovascular gene bank at the Cleveland Clinic. He lives with his family in La Jolla, California.

Interviews & Essays

Eric Topol, M.D. / Q&A for BN.com

In The Creative Destruction of Medicine, you argue that radical innovation and a true democratization of health care are within reach, but only if we consumers demand it. Why now?
Current medical practice is paternalistic, "Doctor Knows Best" because patients do not really have access to their own data. That is radically transformed in an era of wearable biosensors that connect to your smartphone, and rapid, affordable whole genome sequencing. The opportunity to know so much about the medical essence of oneself is going to be unprecedented...and we are well on our way now. No one has more vested interest in one's health than the individual. And finally each individual will have access to virtually everything that makes him or her tick!

What must consumers do now to make these changes happen?
Start by getting educated about the new options. About genomics and how each drug one takes interacts with your DNA—to avoid serious side effects or to make sure that the drug will actually work...and at the right dose. About which sensors can be used to track heart rhythm, sleep brain waves, glucose and virtually every physiologic metric. Moreover, start getting access to all of your office visit notes, lab tests, scans (including copies of the image and dose of radiation you were exposed to), and know that if you or a loved one develops cancer that only by request for some tissue to be frozen will proper DNA sequencing be possible. Most importantly engage with your social network to create and sustain a real consumer health revolution.

Why is the current medical community so resistant to change?
The medical profession is ultra-conservative. It took 20 years in the early 1800s for doctors to accept the use of a stethoscope, and not much has changed 200 years later. This will all happen eventually—it is inevitable—but we can't afford for individuals not to get optimal care and prevention NOW. And much of the innovations have the potential to markedly lower the costs of care, by making it much more precise, individualized, and ultimately preventive.

What other obstacles are there?
The regulatory agencies such as the FDA, which are especially risk-averse. The life science industry which has to reboot to develop therapies that are not for mass medicine, but now for highly select patients. That requires new models of clinical trials and new expectations for overwhelming effectiveness—now that we can digitize each human being. And a key caveat is that the doctor is involved as a partner, and does not treat the DNA, the scan, or the laboratory test—but treats the patient.

Would you expect such a transformation to dramatically lower insurance costs?
In the past, new technology has not lowered costs. But in the early going of this digital medical era (in its nascent phase) we are seeing exciting signs of frugal innovation, such as a portable high resolution pocket ultrasound device which should be part of the physical examination and could cut billions of dollars of unnecessary ultrasound scans each year. And wireless tracking of heart rhythm to avoid emergency room visits and hospitalizations.

How would patient privacy be assured in a world where every heartbeat is being recorded?
Once anything is digitized, there is a concern about hacking, leaking and a breach of privacy. The only approach that makes sense is that this has to be overwhelmingly positive and effective, while at the same time the risks of any leak of data be minimized to the nth degree.

What makes you so optimistic about this coming revolution?
This is unquestionably the most exciting time in medicine—as a physician and researcher for almost three decades—there has never been this potential for a radical change and upgrade of how we can render health care. And at the same time these incredible innovations are blossoming, the power of the people has soared to heights that were previously unimaginable. In parallel, and concurrently, a digital revolution that finally strikes medicine (it has hit virtually every other aspect of our lives) and a social revolution that has made things happen like the Arab Spring and Occupy Wall Street—we are well positioned for a creative destruction and rebooting of medicine going forward.

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Sort by: Showing all of 3 Customer Reviews

  • Anonymous

    Posted February 8, 2012

    Definitely worth sitting down with!

    Topol weaves a world that is feasible here and now in his (first!) book for consumers. He goes to great lengths to convince the reader that medicine needs to change and evolve to accommodate the evolution (or revolution!) of those who depend on it. Consumers are becoming ever more aware of their own vitals and this book explains why physicians need to keep up and more importantly...how!
    GREAT READ!!!

    Was this review helpful? Yes  NoThank you for your feedback.   Report this reviewThank you, this review has been flagged.

  • Anonymous

    Posted March 4, 2012

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    Posted April 9, 2012

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