Eric Topol, MD, Basic Books. New York. 2015.
In 1966, Marshall McLuhan said, “Every aspect of Western mechanical culture was shaped by print technology, but the modern age is the age of electronic media … electronic media constitutes a boundary between fragmented Gutenberg man (to an) integral man.” Eric Topol, MD, embraces this and thinks the time for this is now. A doctor can see you now via your smartphone screen without an hour waiting, at any time, day or night. The doctor you communicate with will have all of your medical data from your sensors, images, labs and genomic sequence. Every patient will have mega terabytes of data, which will someday accumulate from womb to tomb in your personal cloud, stored and ready to even prevent an illness before it happens. According to Dr. Topol, we are in the middle of the process of democratization of medicine. Democratization means “to make available to all people.” His book covers this timely topic.
Patients are now generating their own data on their own devices. Individuals now can not only measure blood pressure or blood glucose levels but can do electrocardiograms, brain waves, eye pressures, lung functions and mood measures. Personal data goes way beyond these measures, for now we also can have a geographic information system (GIS). The human GIS comprises multiple layers of demographic, physiologic, anatomic, biologic and environmental data. This goes way beyond your personal analytics for Facebook. This is your “dashboard for life!” Your GIS can even include your genome – your DNA sequence of 6 billion letters.
Smart phones that assay or sequence DNA are now in development that may make it possible to select optimum treatment for a variety of diseases. Knowing our GIS can also make it possible for us to avoid unnecessary ionizing radiation tests. Having data should dramatically decrease the cost of health care. Patients can use consumer-directed health information technologies to allow them to better manage their health by themselves or with professionals.
It is not surprising that patients often prefer virtual rather than physical visits. The average return visit to a physician lasts seven minutes and a new consultation averages twelve minutes. The average wait time to get into the exam room is 62 minutes. By the end of 2014, nearly one in six doctor visits was virtual.
The author sees dramatic impact from electronic health care. He projects decreased costs, hospital closures and Massive Open Online Medicine (MOOM). He says, “Medicine is morphing into a data science now that big data, unsupervised algorithms, predictive analytics, machine learning, augmented reality, and neuromorphic computing are coming in.” Many will be surprised to find that the U.S. ranks seventh among the top 20 global economies for internet adoption. We need to be part of the solution rather than the problem because much of the practice of medicine will reboot and bypass the present, deeply engrained, sacrosanct doctor-dependent operations.