Are we ready to creatively destroy medicine?

We recently marked the third anniversary of the passage of the Affordable Care Act by reflecting on the positive changes it has brought about and by mulling over the multifaceted challenges that stymie our efforts to build more accessibility, equity, quality, safety, and cost-effectiveness into one of the most complex healthcare systems in the world.

Reining in healthcare costs, a central element in the reforms we seek, is inextricably linked to eliminating medical errors, reducing waste (i.e., unnecessary diagnostic tests and procedures), and, importantly, keeping Americans healthy and away from the emergency room and inpatient settings.

For physicians on the front lines, it all boils down to our collecting and monitoring key clinical and lifestyle data on each of our patients in order to deliver the right recommendations, diagnostics, and treatments to the right patients at the right times, thereby improving the quality of the care we deliver while lowering costs – not an easy task by any measure!

Although he is not yet a blip on many clinicians’ radar screens, Eric Topol, MD, may be on to something that will be vital to our success as healthcare providers in the very near future.

Well known among some clinicians for his work as a cardiologist, geneticist, researcher, and author/editor of related textbooks, Topol has led the National Institutes of Health-supported Scripps Translational Science Institute since 2006.

Perhaps less well known is that Topol is a digital medicine pioneer who, for the second time in less than 2 years, diagnosed a man with heart distress while the patient was miles away – and miles high! – in a commercial airplane.

A vocal proponent of individualized medicine and a passionate advocate of mobile medical technology, Topol has piqued the media’s interest and the public’s attention – even had an invitation from Comedy Central’s Stephen Colbert — by using small, wireless, digital devices as essential tools for diagnosing and monitoring patients like the one described above.

In his first consumer-oriented book, titled The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, he makes a convincing case for these two seemingly contradictory terms working together in synch to target healthcare to the individual.

Topol points out that existing technology already enables patients to continuously monitor their heart rates/rhythms, blood glucose levels, and sleeping brain waves; a quick Google search reveals a host of other remote physiological monitoring technologies (both wearable and implantable) on the horizon that will track a wide range of cardiopulmonary and neurological signs.

Although cardiac pacemakers have long been integrated into the average physician’s lexicon, the untapped clinical opportunities afforded by novel sensors and wireless digital communication devices (e.g., smartphones, tablets) have not generated much interest or enthusiasm in our ranks.

Topol challenges our patients and us, as physicians, to transition from outmoded diagnostics to highly personalized, digital, wireless biosensors that can track and relay vital physiological and neurological data via Smart Phone in real time.

The potential for diagnosing an imminent heart attack, an adverse diabetes event, or increased risk for cerebral vascular accident before our patients become symptomatic is within reach.

Are we ready to shake up our traditional practice patterns to take fuller advantage of the technological opportunities now at our disposal?

David B. Nash is Founding Dean of the Jefferson School of Population Health at Thomas Jefferson University and blogs at Nash on Health Policy and Focus on Health Policy.

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