Eric Topol, M.D., chief academic officer of San Diego’s Scripps Health, has seen the future of medicine—a future based on a fundamental shift in who accesses and owns medical data—or what he calls the “rebooting” of medicine.

“You are your data but more importantly each individual needs to own their data. That’s where we need to be,” Topol told an audience at last week’s AHIMA conference in San Diego. “People deserve the respect that comes from data because the information science that we’re into now and going into much deeper has to be taken on by patients.”

In this new era of digital healthcare, access and ownership of medical data will transition from physicians to consumers thanks to the rapid proliferation of smartphones and mobile health apps, he said. Moore’s Law is accelerating and revolutionizing medicine in unimaginable ways, according to Topol.

“For one-fourth of Americans to adopt a new technology, it took over 40 years for electricity, 30 years for the telephone, 13 years for mobile phones, but only two years for smartphones,” he exclaimed. Topol, author of the bestselling book The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare, argues that the smartphone will be the hub of the future of medicine.

Whether monitoring blood pressure or blood sugar levels or heart rates, smartphones will serve as medical dashboards helping consumers to track their own vital signs and overall health conditions, using that data to see patterns and warning signs of illness, Topol asserts.   

“As a cardiologist, I have most of my patients on an app to get their blood pressures displayed on a screen so they can diagnose and manage their own blood pressure, and also the same exists for glucose,” he said. “One of my favorite apps that’s in common use and can now be bought directly by consumers is the smartphone electrocardiogram. The smartphone ECG is great because people can diagnose their own heart rhythm through computer algorithms. And, when you get an email that says ‘I’m in atrial fibrillation, now what do I do?’ that tells you the world is changing.”

Topol said that Scripps is working with the California Institute of Technology on an embeddable sensor that monitors a patient’s bloodstream to predict the onset of a heart attack, hours, days and even weeks in advance. “We have a genomic signature of cells that should be in the blood and denote that there’s an arterial event that’s incubating,” Topol said. “We have designed a system which hopefully will get into patients someday where we can couple the sensor with the genomic signal and you can have a warning in your phone about having a heart attack.”     

In the future, he made the case that tumor DNA in the blood will be similarly monitored through a smartphone to diagnose cancer. Smartphone-based apps with sensors and analyzers are already available to help detect cancer and thyroid disease, as well as conduct “every routine lab test,” according to Topol. “Hospital labs are in serious trouble, vulnerable,” he said. “In fact, you can make a phone into a remarkably powerful microscope to diagnose pathogens–this is the whole idea of having a ‘pathologist-in-the-pocket’ that’s being advanced now.”

But, Topol hastened to add that it’s not just about “lab-on-a-chip” and routine blood tests. Mobile devices will also serve as platforms for analyzing genotypes and targeted sequencing. In addition, he said x-rays taken with smartphones are going to become the new “selfie” in which consumers with a potential fracture get a diagnosis based on an algorithm to see if they should go to an emergency room.

When it comes to scheduling a doctor’s appointment, smartphones are creating “on-demand” medicine in which consumers will no longer wait weeks to see a primary care physician. Instead, they will do their own check-up and self-diagnosis and follow-up with a doctor on an as needed basis. “The smartphone will see you now. That’s the revolution we’re talking about,” said Topol. “We’re talking about democratizing medicine so that it’s for all people and it’s quick.”

“Are we going to have doctor-less patients? That’s the real question. And, I would say absolutely not,” he concluded. “But, so much of diagnosis and monitoring will be done in the future by the patient with relatively small input from doctors, who will shift in the role of this new partnership in which they will be involved in treatment, healing, communication and guidance. That’s the different way we go forward.”      

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