The current shift in the healthcare industry to digitize care unquestionably is the biggest shakeup in the history of medicine, according to cardiologist Eric Topol, a professor of genomics at The Scripps Research Institute in San Diego and author of "The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care." Still, Topol (right) says, the industry has a ways to go before it will be able to shake its "slow moving" reputation; the public, he adds, will be key to driving that change.
"We need to take initiative and ask our physicians why they're using old tools or sending us for outdated tests," Topol, who is slated to give the Tuesday, March 5 keynote address at HIMSS13 in New Orleans, tells FierceHealthIT in an exclusive interview. "We need to tell our doctors that we don't want to be in the dark, getting some cookbook recipe for care of one kind of disease or another."
In part one of this two-part interview, Topol talks about the importance of using digital tools, in addition to giving his take on the progress of genome sequencing.
Be sure to read part two, in which he talks about the future of hospitals, social media and accountability.
FHIT: What do you think it's going to take to ensure that doctors who use newer digital tools are the norm in everyday healthcare, rather than the exception to the rule?
Topol: All these years since 1816, we've had a stethophone; now we have a true stethoscope--a high-resolution, mini-ultrasound device. I carry it in my pocket, and I haven't listened to a heart in over three years. A couple of med schools are giving these stethoscope ultrasound devices out to their medical students on their first day, which is a sign of the times.
Getting the next generation of physicians loaded with these tools is key, but we can't wait that long. It would take decades before we had enough physicians who were up to speed. We've got to convert the unwilling currently practicing physicians in this country now. That's why I wrote my book. I'm appealing to the public to help drive this.
I don't want to wait 20 years before we have enough physicians to repopulate with the state-of-the-art tools.
FHIT: How soon do you think genome testing for patients will become routine?
Topol: We're a little ways from routine. I think you can make a really strong case for using whole genome sequencing for initial cancer diagnoses. You can also make a case for using genome sequencing in people with a serious illness who don't have a diagnosis yet--people who go from one medical center to another on "diagnostic odysseys."
There have only been tens of thousands of people in the world who have had whole genome sequencing. We need millions with various conditions before we know what whole human genome sequences need. We only know of our common variations right now, but most of the important stuff is a low-frequency, rare variance. We know relatively little about that.
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It's still expensive and it's not as accurate as it could be. In the next few years, we should see bigger strides bringing the price well below $1,000, maybe even down to $100 a genome.
FHIT: Where will we see early practical uses of genomics in medicine?
Topol: We don't need amniocentesis anymore, or chorionic villus sampling. You get far better information just by doing a maternal blood test. One tube of blood. Why would you put a woman at risk anymore? There's already a big jump forward.
And with that same tube of blood, you could get a whole genome sequence of a fetus at 8 weeks, long before the 12 week threshold where you might consider termination of pregnancy. That has tremendous implications. Not only getting rid of amniocentesis, but what would be the boundaries for terminating pregnancy; what constitutes a serious malady that you wouldn't want to bring a child into the world. Talk about bioethical considerations.
Editor's note: This interview has been edited for length and clarity.
--> READ PART TWO