Topol: Population health is fundamentally flawed in its approach

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A one-size-fits-all approach to medicine through population health management is a losing proposition, according to Eric Topol, MD, director of the Scripps Translational Science Institute and chief academic officer of Scripps Health in La Jolla, Calif.

What’s urgently needed is a personalized approach to healthcare that treats individuals, not populations, contends the outspoken professor of genomics and the Gary and Mary West Endowed Chair of Innovative Medicine at the Scripps Research Institute.

“We have the tools now to understand the medical essence of each human being and it’s time we start using them and upgrade care from where it is today, with a tremendous amount of waste, and start practicing individualized, precision medicine,” says Topol.

Topol will speak about “The Future of Precision Medicine” on June 7 as part of the opening session at the AHIP 2017 conference in Austin, Texas.

Inefficiency and waste in medicine is pervasive, he notes. Despite spending $3.4 trillion on healthcare last year, Topol points out that there are still 60 percent false positives in mass screenings such as mammograms and prostate cancer tests, while 12 million or more medical errors are committed annually.

He also cites the fact that more than 3 million people have undiagnosed diseases who are “walking around going from one medical center to another,” not to mention the problem of medical errors and adverse events from medications—which is the fourth leading cause of death. “It’s not working,” Topol exclaims.

Population health might be a popular buzzword in healthcare but he doesn’t think much of the concept. “I’m not into population health,” Topol says. “My direction is the totally antithetical way. We have been doing the population stuff—that is, treating everyone the same at a population level—since the beginning of medicine. We need to start treating each unique individual.”

Topol believes the individual makeup of each person can lead to better prevention, treatment and more effective healthcare. In particular, he is encouraged by analytics, artificial intelligence, genomics, as well as machine learning in generating actionable insights about individuals.

“Artificial intelligence is going to make doctors better, and it’s going to make consumers healthier ultimately. So, that’s an exciting next dimension,” observes Topol.

However, the digital tools to “map” the human body are currently available, according to Topol. But, he adds that it goes far beyond genome sequencing by applying biosensors to the body that measure physiologic metrics providing a wealth of information on patients.

“You have sensors for the physiology of each person. You have sequencing for DNA. And, you have the ability to scan—even with things like smartphones, no less other traditional ways—to understand each person’s anatomy,” concludes Topol. “There are sensors for the environment. You can understand each person’s immune system and microbiome, so that every single layer can be defined of each human being that is medically relevant.”

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