How Technology Is Transforming Health Care

Digital innovations make it possible for consumers to use portable devices to access their medical information, monitor their vital signs and carry out a wide range of tasks.

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In some health care systems, patients can now directly download their laboratory reports and medical records, which they were never allowed to do in the past. Any consumer with adequate funds can have his or her genome scanned or even wholly sequenced.

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But just having these technological capabilities will not catapult medicine forward. The gridlock of the medical community, government and the life science industry will not facilitate change or a willingness to embrace and adopt innovation. The U.S. government has been preoccupied with health care "reform," but this refers to improving access and insurance coverage and has little or nothing to do with innovation. Medicine is currently set up to be maximally imprecise. Private practice physicians render "by the yard" and are rewarded for doing more procedures. Medical care is largely shaped by guidelines, indexed to a population rather than an individual. And the evidence from clinical research is derived from populations that do not translate to the real world of persons. The life science industry has no motivation to design drugs or devices that are only effective, however strikingly, for a small, well-defined population segment. At the same time, the regulatory agencies are entirely risk-averse and, as a result, are suppressing remarkably innovative, and even frugal, opportunities to change medicine. The end result is that most of our screening tests and treatments are overused and applied to the wrong individuals, promoting vast waste. And virtually nothing is being done to accelerate true prevention of disease.

In fact, consumers must provide the impetus for new medicine – a new medicine that is no longer paternalistic, since the doctor does not necessarily know best anymore. The American Medical Association has lobbied the government hard for consumers not to have direct access to their genomic data, asserting that this must be mediated through physicians.

We know that 90 percent of physicians are uncomfortable and largely unwilling to make decisions based on their patients' genomic information. But it is your DNA, your cellphone and your right to have all of your medical data and information. With a medical profession particularly incapable of making a transition to practicing individualized medicine, despite a new array of powerful tools, isn't it time for consumers to drive this capability?

A revolution in technology that is based on the primacy of individuals mandates a revolution by consumers in order for new medicine to take hold. We desperately need medicine to be Schumpetered, to be radically transformed. We need the digital world to invade the medical cocoon and to exploit the newfound and exciting technological capabilities of digitizing human beings.

Excerpted from "The Creative Destruction of Medicine" by Eric Topol (Basic Books, 2012)



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