Eric Topol, M.D., chief academic officer of Scripps Health in San Diego, is many things. He is a practicing cardiologist, a geneticist, a researcher, and a bestselling author.

In his 2012 book The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare, Topol argues that the healthcare industry is in the beginning phases of its “creative destruction”—a term coined by economist Joseph Schumpeter to describe the revolutionary process by which innovation replaces old industries with new ones. At the heart of this digital-medical revolution, he asserts, is a fundamental shift in who accesses and “owns” medical data and health information—a transfer of power from doctors to consumers.

Now, Topol has come out with a new book, The Patient Will See You Now: The Future of Medicine is in Your Hands, continuing his theme of consumer empowerment. Just as Gutenberg’s printing press spread literature to the masses for the first time in history, he makes the case that smartphones and other mobile devices in the hands of patients will serve to “democratize medicine” giving them control of their data—which has historically been the domain of physicians.

Health Data Management spoke to Topol about his latest book and the future of medicine.

HDM: What do you mean by the democratization of medicine?

Topol: It means that each individual will have enough data—their own Google Map of their medical essence—to work with. Basically, the smartphone is a powerful tool similar to the way that the printing press was back in the 1400s for democratization.  

HDM: So, then as we move into this new era of medicine, what role is there for doctors?

Topol: Actually, I think it is a very alluring role, although not all doctors might agree at this point in time. Today, doctors do the diagnostics, the monitoring, the treatment—they’re so overwhelmed with stuff that they do. But, in the future, doctors will shift a large part of that effort to just the treatment. Patients are not going to be treating themselves or healing themselves. Doctors will be instrumental there more than ever. Most of the routine diagnostics will be done by patients with their own devices and also with computer support, machine learning, and artificial intelligence.

It’s a very different look and the doctor is now a partner. Patients have more equal footing because they have the power of their own data and information. They get to choose whether they’re going to share it, who they are going to share it with, and when they are going to share it. In effect, they own the data, which they never owned before.

Most consumers do want their data. Every survey suggests that 80 percent want it. Most physicians don’t want to give the data. Seventy percent will not give copies of office notes to patients and almost the same percent won’t even email with patients. So, we have a mismatch of what consumers want and what the dominant proportion of doctors are willing to give and do. At some point, we have to improve upon that. Consumers have the right idea. They should have their data and they ought to own their data. And, some day they will. 

HDM: In your vision of the future, will patients diagnose their own diseases and then get in touch with their doctor?

Topol: For example, with an electrocardiogram, you can do that yourself now with a device and it is FDA approved. I have lots of patients that use it that have a history of heart rhythm problems. A lot of times, when they feel their heart might be fluttering, it is normal. Instead of having to go to the emergency room, they can have it resolved immediately with their fingers, a smartphone and computer software.

HDM: What about hospitals? I was reading in the New York Times review of your book that in the future there will be no more hospitals which will become “expensive, disease-ridden anachronisms.”

Topol: When it comes to regular hospital rooms—not the intensive care units, not operating rooms, not procedure rooms—but the regular hospital room, we don’t need hospitals for that. The patient’s bedroom can take on that role and is far safer without the risk of infections and is far less expensive. All the monitoring can be done in the patient’s bedroom in their own home. Regular hospital rooms are gradually going to be on the wane. It’s not going to happen this year, but gradually. Remote monitoring capabilities are extraordinary and will be the substitute for regular hospital rooms.

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