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 ...

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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.

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Editorial Reviews

From the Publisher

Arnold S. Relman, New York Review of Books
“As an introduction for the lay reader to the sophisticated digital technology now being applied to medical care, and as an explanation of the rapidly advancing science of medical genetics and the new revelations from the sequencing of the human genome, Topol’s book is a tour de force.”

Siddhartha Mukherjee, author of The Emperor of All Maladies: A Biography of Cancer

“What happens when you combine cellular phone technology with the cellular aberrations in disease? Or create a bridge between the digital revolution with the medical revolution? How will minute biological sensors alter the way we treat lethal illnesses, such as heart attacks or cancer? This marvelous book by Eric Topol, a leading cardiologist, gene hunter and medical thinker, answers not just these questions, but many many more. Topol’s analysis draws us to the very frontlines of medicine, and leaves us with a view of a landscape that is both foreign and daunting. He manages to recount this story in simple, lucid language—resulting in an enthralling and important book.” 

Atul Gawande, M.D., author of The Checklist Manifesto
“Dr. Eric Topol is an extraordinary doctor. He’s started a leading medical school, identified the first genes to underlie development of heart disease, led major medical centers, and been a pioneer of wireless medicine. But he is also a remarkable communicator—one of the few top-flight scientists in medicine to be able to genuinely connect with the public. He was, for example, the first physician researcher to question the safety of Vioxx—and unlike most who raise safety questions, actually succeed in bringing the concerns to public attention. I have known and admired Dr. Topol for a long time. I recommend him highly.”
 
A. J. Jacobs, author of My Life as an Experiment and The Year of Living Biblically
“It may sound like hyperbole, but it’s true: Medicine is undergoing its biggest revolution since the invention of the germ theory. As Eric Topol writes, thirty years ago, ‘digital medicine’ referred to rectal examinations. Dr. Topol is both a leader of and perfect guide to this brave new health world. His book should be prescribed for doctors and patients alike.”
 
Steve Case, co-founder, AOL, and founder of Revolution LLC
“Health care is poised to be revolutionized by two forces—technology and consumerism—and Dr. Eric Topol explains why. One-size-fits-all medicine will soon be overtaken by highly personalized, customized solutions that are enabled by breakthroughs in genomics and mobile devices and propelled by empowered consumers looking to live longer, healthier lives. Fasten your seat belts and get ready for the ride—and learn what steps you can take to begin to take control of your health.”
 
James Fowler, Professor of Medical Genetics and Political Science, UC San Diego, and author of Connected
“Eric Topol is uniquely positioned to write such a timely and important book. He leads two institutions—one in genomics and one in wireless health—that will each play a huge role in transforming medicine in the twenty-first century. From this vantage point, he can see unifying themes that will underlie the coming revolution in population and personal health, and he communicates his vision with vibrant energy. Everyone will want to read this book.”
 
Clayton M. Christensen, Robert and Jane Cizik Professor of Business Administration, Harvard Business School, and author of The Innovator’s Dilemma “Eric Topol gives us an eye-opening look at what’s possible in healthcare if people can mobilize to charge the status quo. The Creative Destruction of Medicine is simply remarkable.”
 
Mehmet Oz, M.D., Professor and Vice-Chair of Surgery, NY Presbyterian/Columbia University
“Eric Topol outlines the creative destruction of medicine that must be led by informed consumers. Smart patients will push the many stakeholders in health to accelerate change as medicine adapts to a new world of information and technology.”
 
Jeffrey Immelt, Chairman and CEO of General Electric
“Eric Topol has been a longtime innovator in healthcare. In The Creative Destruction of Medicine, he citesthe big waves of innovation that will save healthcare for the future. Real healthcare reform has not yet begun, but it will.  The Creative Destruction of Medicine lays out the path.”
 
Brook Byers, Partner, Kleiner Perkins Caufield & Byers
“This is the one book to read for a complete and clear view of our medical future, as enabled by the convergence of digital, mobile, genomic, and life science breakthroughs. Dr. Topol explains how iPhones, cloud computing, gene sequencing, wireless sensors, modernized clinical trials, internet connectivity, advanced diagnostics, targeted therapies and other science will enable the individualization of medicine—and force overdue radical change in how medicine is delivered, regulated, and reimbursed. This book should be read by patients, doctors, scientists, entrepreneurs, insurers, regulators, digital engineers—anyone who wants better health, lower costs, and participation in this revolution.”
 
Misha Angrist, Assistant Professor, Duke Institute for Genome Sciences & Policy, and author of Here is a Human Being
“Eric Topol is that rare physician willing to challenge the orthodoxies of his guild. He recognizes that in the U.S., health care business-as-usual is unsustainable.  But he does not despair. He bears witness to the rise of Homo digitus and the promise it holds to upend the inefficiencies and dysfunction so entrenched in clinical medicine. The Creative Destruction of Medicine is a timely tour de force. It is a necessary heresy.”
 
George Church, Professor of Genetics, Harvard Medical School
“What happens when the super-convergence of smart phones further combines with million-fold lower-cost genomics and diverse wearable sensors? The riveting answer leads compellingly to a call to activism—not only for medical care providers, but all patients and everyone looking for the next ‘disruptive’ economic revolution. This future is closer than most of us would have imagined before seeing it laid out so clearly. A must-read.”
 
J. Craig Venter, Chairman and President, J. Craig Venter Institute
“Our sequencing of the human genome eleven years ago was the beginning of the individualized medicine revolution, a revolution that cannot happen without digitized personal phenotype information. Eric Topol provides a path forward using your digitized genome, remote sensing devices and social networking to place the educated at the center of medicine.”
 
Omar Ishrak, Chairman and CEO of Medtronic
“Eric Topol provides an excellent and pragmatic view of the U.S. healthcare system from a patient’s perspective. He then offers, through numerous examples, an exciting vision for the future ... when technology can be used to dramatically improve the quality of care and reduce cost at the same time. The Creative Destruction of Medicine is a highly informative and enjoyable book, which truly triggers the reader’s imagination as to what is possible”
 
Reed Tuckson, M.D., Executive Vice President and Chief of Medical Affairs, UnitedHealth Group
“Eric Topol has written an extraordinarily important book at just the right moment. Drawing upon a unique and impressive array of convergent expertise in medical research, clinical medicine, consumer and health technological advancements, and health policy, Dr. Topol opens the door for an essential discussion of old challenges viewed through an innovative lens. In the context of increasingly unaffordable health care costs, suboptimal quality of care delivery, a tsunami of preventable chronic illness, and new accountabilities for consumer’s health choices and behaviors, this book helps  all of us to think about solutions in new and exciting ways!”
 
Juan Enriquez, Managing Director, Excel Venture Management, and author As the Future Catches You
“Much of the wealth created over the last decades arose out of a brutal transition from ABC’s to digital code. While creating some of the world’s most valuable companies, this process also upended whole industries and even countries. Now medicine, health care, and life sciences are undergoing the same transition. And, again, enormous wealth will be created and destroyed. This book is a road map of what is about to happen.”
 
Elias Zerhouni, M.D., President, Global R&D, Sanofi and former director, National Institutes of Health
“If we keep practicing medicine as we know it today, healthcare will become an unbearable burden. We are in a real race between healthcare innovation and the resistance to change of the medical system. In a comprehensive and well researched tour de force, Eric Topol, always a clear and uncompromising thought leader of his generation, challenges us to imagine the revolutionary potential of a world where medical information no longer belongs to a few and can be automatically collected from the many to greatly improve healthcare for all. This is a must read!”

Kirkus Reviews

“Topol weaves useful knowledge about how to evaluate the choices open to patients into this exciting account of the revolutionary changes we can expect.”

William R. Brody, M.D., Ph.D., President, The Salk Institute for Biological Studies
The Creative Destruction of Medicine is an engaging look into how the discoveries in genetics and biology will change the landscape of medicine. Along the way, Dr. Topol provides a fascinating compendium of stories about the shortcomings of medicine as it is currently practiced and how the revolutionary discoveries coming since the first sequencing of the human genome a decade ago will shape the delivery of healthcare in the 21st century.”

Paul E. Jacobs, Ph.D., Chairman and CEO, Qualcomm Incorporated
“Dr. Topol believes that medicine, catalyzed by extraordinary innovation that exploits digital information, is about to go through its biggest shakeup in history. His newest book calls for a ‘jailbreak’ from the ideas of the past. In the next phase of medicine, powerful digital tools including mobile sensors and advanced processors will transform our understanding of the individual, enabling creative ‘mash-ups’ of data that will spark entirely new discoveries and spawn ultra-personalized health and fitness solutions. And with over 5.7 billion mobile connections worldwide, the mobile technology platform will have a major impact on that vision—leading to what Dr. Topol describes as nothing less than a ‘reboot’ of the health care system. Qualcomm, and its partners all around the world, are working to bring wireless innovations to market that will contribute to the solution. And we share Dr. Topol’s view that individual consumers have the opportunity, and the power, to increase the pace of the titanic change that’s coming.”
 
John Martin, Chairman and CEO, Gilead Sciences
“Eric Topol offers a new and intriguing perspective on how the intersections of medicine and technology could further transform the delivery of healthcare and the role of a patient. He advocates for a future world of medicine where informed consumers are in the driver seat and control their own healthcare based on genomic information and real-time data obtained through nanosensors and wireless technology.”
 
Eric Silfen, M.D., Senior Vice-President and Chief Medical Officer, Philips Healthcare
“In an upbeat, comprehensive volume, Dr. Topol has woven the prevailing technological undercurrents of the post-PC world—its power of many; its Gucci of gadgets; its cloud ecosystem; its ‘Arab Spring’ of apps; and its ubiquitous, calm computing—with the disruptive innovations of biomedicine, to create a compelling account of how this bio-digital transformation will hasten personalization of the highest quality of medical care.”
 
Greg Lucier, CEO, Life Technologies
“Dr. Topol is the top thought leader in medicine today, with exceptional vision for how its future can be rebooted. This book will create and catalyze a movement for the individualization and democratization of medicine—and undoubtedly promote better health care”
 
Dean Ornish, M.D., Founder and President, Preventive Medicine Research Institute, and author of The Spectrum
“Eric Topol is the perfect author for this book. He has a unique understanding of both genomics and wireless medicine and has a remarkable track record as a charismatic pioneer, visionary, and change agent in medicine. I’m sure this book will reach a very large number of people with information that can both empower and help transform their lives for the better.”
 


Nature
“The digital age opens up the possibility of a new type of medicine in which an individual’s health data are digitized using wearable sensors, smartphone apps and genome information, writes geneticist and cardiologist Eric Topol. With this wealth of data, medical interventions could be tailored to our uniqueness. Topol covers failures in patient information; what might happen if genomics, imaging, sensors and better health information were to converge; and the potential pitfalls of this brave new medical world.”
 
New Scientist
“[A]n eye opening account of why conventional medicine is doomed…. [C]ompelling stuff…. [T]he book provides an excellent summary of the current state of medical genetics and how fast it is progrssing, with examples that may surprise even those working in medicine.”
 
Wall Street Journal
“The Creative Destruction of Medicine—an allusion to economist Joseph Schumpeter’s description of ‘creative destruction’ as an engine of business innovation—is a venture capitalist’s delight, describing dozens of medical technologies that show great promise. The book also provides colorful anecdotes about Dr. Topol’s own sampling of these products, as both a doctor and stand-in patient…. [The book’s] most important contributions are in portraying how medical innovation will coalesce to change clinical practice and what the coming changes mean for today’s policy debates…. In Dr. Topol’s vision, innovation that enables real-time diagnosis and personalized treatments is a certainty, though not because reluctant or ‘sclerotic’ doctors accept it or because Washington wills it into being. A seductive technology that works like a dream and improves lives will set off a consumer clamor, whether the new tool is an iPhone 4S or an implantable blood-sugar meter.”
 
Nature Genetics
“Deriving inspiration from the economist Joseph Schumpeter, Topol proposes nothing less than the ‘creative destruction’ of medicine as it is currently practiced, replacing it with a brave new world in which interconnected technologies dramatically improve patient outcomes…. [T]he book is an enjoyable, high-level review of the current state of the field, intended for a general audience but referenced for those inclined to read more deeply. With its rich discussion of science and technology and companies specific to the last couple of years, this book certainly has contemporary relevance.”
 

BostonGlobe
“Topol does an excellent job of explaining all, and his enthusiasm for the possibilities of what the future holds is infectious. It can only be hoped, as the convergence he so convincingly predicts materializes, that the barriers erected by the gatekeepers of yesterday’s paradigms will be easily dismantled so as not to impede the benefits it promises.”

Forbes
“A must-read that lays out a road map for how new technologies in genomics, information technology, and mobile medicine may completely change the way we treat and prevent illness. It’s highly recommended, because Topol has a unique vantage point: he’s one of the few researchers to have played an important role in the old, mass-market medicine world and the newer, genetically focused one.”

Salon
“Topol demonstrates how the digital revolution can be used to change individual care and prevention, and even the economics of American healthcare. From cell phones that automatically collect medical data, to biosensors, advanced imaging, individualized prescriptions and gene-specific drugs, Topol’s book leads readers through science-fiction-sounding scenarios that may soon be a reality.”
 
Abigail Zuger, M.D., New York Times
“[R]eadable and comprehensive…. [Dr. Topol] dispenses in short order with our current population-based medical strategies. They are wasteful and inexact, he points out, often marginally beneficial to the group and downright harmful to the individual. He presents an array of far better ideas, a few now actually being practiced in rudimentary form.”
 
The Economist
“Eric Topol provides a…look at why medicine is about to be ‘Schumpeterised’ (his word) by digital technology. [This book is] a godsend for those who suffer from Armageddon fatigue. [It] also remind[s] us that technology keeps improving despite economic gloom.”
 
David Ewing Duncan, The Atlantic “In [The Creative Destruction of Medicine]…Topol blasts current-day medicine as being archaic and wasteful, making his case with a compelling blend of statistics, anecdotes, and barbs aimed at health care’s Ancien Régime…. [Topol] does a good job of explaining subtleties to a lay audience—such as why some genetic testing for predicting disease is valid and useful, and why much is not.”

Wall Street Journal
The Creative Destruction of Medicine…offers an illuminating perspective on the coming digitization of health care.”

The LancetThe Creative Destruction of Medicine is … packed full of practical examples of how technology is already changing the way some physicians care for patients and patients can monitor themselves…. [the book is] a must read for patients and doctors alike.”

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.
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Product Details

  • ISBN-13: 9780465025503
  • Publisher: Basic Books
  • Publication date: 1/31/2012
  • Pages: 320
  • Sales rank: 180,530
  • 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.

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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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Customer Reviews

Average Rating 3.5
( 9 )
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  • Anonymous

    Posted December 30, 2012

    Great read from a smart author

    Dr. Topol presents a great argument for the benefit of personal genomics and electronic health records. Far from conspiracy or wild theories against Big Pharma, Topol is a scientist first and gives compelling evidence for genetic testing to revolutionize personal medication and dosing. This may be bit of a tough read for someone without any biology education, but still worth it.

    3 out of 3 people found this review helpful.

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  • 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!!!

    2 out of 2 people found this review helpful.

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  • Posted January 31, 2013

    the digital revolution

    How can a book about the digital revolution not be available in a digital format? I haven't read it yet, so ignore the rating, but one can't post without it.

    0 out of 6 people found this review helpful.

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    Posted December 27, 2012

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