You're listening to midday edition on KPBS. I Maureen Cavanaugh. The promise of digital medicine used to be that he would make going for tests and doctors visits easier. Now with technological advances and an explosion in accessibility it may mean that need for most hospital tests and doctors visits may be eliminated. It may also mean that patients will gain unprecedented control over their health care. That's the premise behind the new book by Dr. Eric Topol. Topol is a cartel adjust and professor of genomics. He's also the director of the Scripps translational science Institute in La Jolla. The Topol's latest book is called the patient will see you now: the future of medicine is in your hands. The Topol to come to the show. ________________________________________ Thank you Maureen. It's great to be with you ________________________________________ The title of your book is obviously a play on the typical announcement that the doctor will see you now. Do you see the doctor-patient roles changing that drastically? ________________________________________ Radically changing. And that is because of the power of information. We do not have a way for people to get the information directly but that will change so much with smart phones mobile devices and people generating their own data and going to their own devices. Previously it was going to the doctor and the doctor had total control what order last text and not you can do your own lab test for your phone. Everything is being flipped and this is a bottoms up medicine. A great in version. ________________________________________ You mentioned using apps and on-site -- online testing that is. To make diagnoses. How exactly are we able to do any of that now? And what do you see in the near future? ________________________________________ As a cardiologist at scripts I've been amazed at how so many of my patients I give them an app and the elector cartogram sent from the phone. They put a couple fingers and the other cardiogram and have an algorithm to make the diagnosis. They don't have to go to the ER or an urgent department. For the most part these are very reassuring when a person is feeling their heart racing or missing beats they can it's actually okay. This is the beginning of algorithms and machine-based diagnoses. It also is available for diagnosing a child infection through an attachment on smart phone. You don't have to go to the Peterson it's available for a scheme skin rash or lesion you can take a picture and a text would come back within a few seconds. We're moving to this computer-based assisted consumer diagnostics therefore many of the routine things can be done by patients themselves and it's the treatment that healing and the wisdom of doctors that is, from entry to that ________________________________________ You in the book “the patient will see you now” you talk about a couple instances on airline flights. You have appear the misfortune of being on airline flights where people seem to have health problems. ________________________________________ I'm worried I induce it. ________________________________________ And you have used these methods as smart phone apps and so forth to diagnose people who are having these hard problems on the flights. You're a doctor so you can interpret this stuff -- this information correctly. What about an average person? They be able to do the same thing? ________________________________________ Anyone on the plane the flight attendant could do the same thing because all you are doing is saying put your fingers on this sensor. Or you are doing things that you have computer assistance that was not had this and what's happening is the smart phone which is so powerful and connected through cloud computing and eventually even to supercomputing is unleashing a whole new form of medicine. ________________________________________ What do we do with the information that we will be getting back? From the comparison diagnose what we're having a heart attack? ________________________________________ It may not be a heart attack but certainly would be a heart rhythm problem. And someday it will be. Not diagnosing but warning you. Not a virtual medical system it will tie you that if you don't do something you're going to have an asthma attack or you will have -- watch out your seizure is coming. Takes a medicine. We are being able to get no human being -- no great doctor could assembly all this data information that's why we need a computer's support. We're headed there and it's very exciting because we can get so much big data -- a Google map of your essence. Continually in real-time streaming to your phone and through cloud computing. This is a whole different world and it could lead to -- we have 12 million serious medical errors here in the US. That's the way it is today. It seems like we do a lot better. ________________________________________ You refer to this being the Gutenberg moment for medicine. What does that mean? ________________________________________ If you trace back to the working hundreds when only a very few people could read the elite and the priest and you look today it's only the doctors who can read and control things. There's a lot of similar to us. It was the printing press that changed the world then. And I believe the smart phone with its open for structure is going to change the world in medicine. And really is it inevitable it just matter of when. ________________________________________ Many people may feel they don't know what to do with all this healthcare information that they may have. And managing it all could be difficult. What do we need to learn? ________________________________________ The first thing is you have to only your information. That is not the way it works today. Hospitals and doctors on the information legally and that has to change. And so one should have all of their information assembled and removing it to it area where you will be generating its whether it's through sensors or a lab test also you can some -- someone a doctor to come to house or just meet and secure video chat and have Dr. consults. These things are changing quickly. The transcript of the doctor visit that you would have archived for your phone so much of this stuff is outside the domain of electronic health records as it is is today. Something each person will have all of their information and rightfully own it. But for today it's a matter of getting hold of it and eventually will have a personal cloud that would be the best way to store all of this information as you go from being born or before birth all the way throughout your life span. ________________________________________ That amazing. I'm speaking with Dr. Eric Topol his let his book is called The Patient Will See you Now: The Future of Medicine is in your Hands . How is the medical profession responding to this attentional revolution? ________________________________________ It's interesting. There are some usually the younger doctors who understand that this is a path is irrevocable. But there are many physicians who don't like this and for many reasons. One of which is the loss of control. Another is the fact that medicine is not a professional that ever existed much latest change. Perhaps one of the biggest issues is the reimbursement. This challenges that. In fact throughout the medical profession over millennia there has never been anything this challenged the medical community like this. ________________________________________ What do you see the role of doctors in the in this future? ________________________________________ I think it's more important than ever and that's why I think that physicians would get it they would say this is nice. I don't have to get bogged down so much with all of the mundane stuff. And by the way it's important to understand -- this is not for all patients. Many people like to have their doctor control everything. Good luck. That's fine. But for those who want this this is a different relationship. It's a partnership and doctors would very much be in the situation shifting many of their actual energy and talent to promoting the healing treating and the human factor this whole bit about their wisdom and experience then guidance as well as compassion and communication. This is what doctors can do really well. They've not had time to there being squeezed by so many different forces. This could actually be a good thing. ________________________________________ Do you see that this would lead to meaning fewer doctors? ________________________________________ There is a prognosis by the medical association that we have this looming profound shortage of hundreds or hundred 30,000 doctors over the next several years. I think that is completely off-base. This is a way to maximize the efficiency of the physicians by offsetting to the patient consumer more responsibility. Which they want the could not get it. There were physically suppressed. This is a way to emancipate consumers for their medical care. ________________________________________ Part of this emancipation as you put it in the book also goes -- is concerned with medical research. And the kind of database that this kind of information might be able to give humankind and researchers -- an amazing amount of information in which possibly to make extraordinary advances. ________________________________________ Right. This is what you're touching on that is an opportunity that is limitless and unprecedented. When you have so much granular information high definition for each individual from a medical standpoint and if you could start to bring all that together in this new information resource or worldwide then you have this phenomenal way to match up a patient with a new diagnosis with all of the people and all their information on treatment and outcomes and baseline features and you can say you are going to match up best with these people and this is going to be the best treatment and this outcome for you. It's like Facebook but a medical side not a social thing. Effective you can get 1.3 billion people in one social community have for do something like that for a medical resource purposes? Without privacy the? ________________________________________ Privacy is the thing that could hold us back. Right now this is unattended it's in a sorry state. People are -- there are these data brokers whenever you search something you are mobile phone information -- this has got to stop for medical because this is such --'s information. There hasn't been anything done yet to protect medical privacy. And if that doesn't happen the security of that data this cannot get legs. ________________________________________ What about the hospitals in the future? ________________________________________ I term that the edifice complex. That is because we have been so so fixated on icons these people things. Frankly we still need hospitals. For intensive care units and emergency rooms and operating rooms and some fancy imaging equipped. But most of the hospital of the future will be not necessary because regular hospital room because all that remote monitoring can be done in the comfort of your home in your own bedroom and a fraction of the cost and much more safely. Obviously and more conveniently. Over time just like years ago there was a big shift from inpatient to outpatient -- we're talking about from inpatient to home. ________________________________________ Last question. Are these changes only for wealthy nations? ________________________________________ I'm glad you asked. The whole section about flattening the earth -- this is the opportunity to get rid of the digital divide. Wherever there is a mobile signal, there's ability to render healthcare like this. By the late we have smart phones coming for $35. We have the ability to give people a service contract which we lot cheaper than many emergency room visits and hospitalizations. This is taking advantage of the hardware and software that is so cheap and so hopefully we will see that we can deliver care irrespective of anyone's economic stage ________________________________________ It's always fascinating to speak with you. I've been speaking with Eric Topol's new book is called The Patient Will See you Now: The Future of Medicine is in your Hands . Thanks so much ________________________________________ I enjoyed the discussion. Thank you.
The promise of digital medicine used to be that it would make going for tests and doctor visits easier. Now, with technological advances and an explosion in accessibility, it may mean the need for most hospital tests and doctor visits may be eliminated. It may also mean that patients will gain unprecedented control over their health care.
That's the premise behind the new book, "The Patient Will See You Now: The Future of Medicine is in Your Hands," by Eric Topol. Topol is a cardiologist, professor of genomics and the director of the Scripps Translational Science Institute in La Jolla.
Topol said he believes that people will be able to store information about their own health in smart phones.
"Some day people will have all their information, and rightfully holding it," Topol told KPBS Midday Edition on Monday. "This really is a bottoms up medicine. It's a great inversion."
Topol said he envisions a day when people will have a "virtual medical assistant" and that the 12 million medical errors that happen a year in the U.S. can be eliminated.
"We can do a lot better," Topol said. "I do believe the smart phone with this digital infrastructure is going to change the world of medicine. One should have all their information assembled."
