The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care
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Mobile technology has transformed our lives, and personal genomics is revolutionizing biology. But despite the availability of technologies that can provide wireless, personalized health care at lower cost, the medical community has resisted change. In The Creative Destruction of Medicine, Eric Topol—one of the nation’s top physicians—calls for consumer activism to demand innovation and the democratization of medical care. The Creative Destruction of Medicine is the definitive account of the coming disruption of medicine, written by the field’s leading voice.
from their social networks. Things have so drastically changed from the “Who Wants to Be a Millionaire?” TV show that originated in 1998, which allowed game show participants to call a single trusted friend for information. Now we can instantly access the knowledge base of thousands or tens of thousands of people. The era of crowdsourcing social networks has changed whom we trust. In 2009, Nielsen surveyed 25,000 consumers in over fifty countries and determined that individuals trusted their
Human Life Is Cracked by Scientists,” New York Times, June 27, 2000, partners.nytimes.com/library/national/science/062700sci-genome.html; “Cracking the Code,” Time, July 3, 2000, 404. 4 “Biology’s Big Bang,” Economist, July 16–22, 2007. 5 T. Ley and R. Wilson, “DNA Sequencing of a Cytogenetically Normal Acute Myeloid Leukemia Genome,” Nature 456 (2008):66–72; E. Mardis, “Recurring Mutations Found by Sequencing an Acute Myeloid Leukemia Genome,” New England Journal of Medicine 361 (2009):
well beyond use in seniors and may apply to many individuals who use canes because of uneven gait or other disabilities.27 Personal emergency response systems help seniors call for help if they do get hurt. One told the New York Times, “Without the sensors, I would probably be dead.”28 Other devices with wireless transmission that can be used to support aging in place include video cameras, motion sensors, tagging pills to monitor compliance, sensors on the mattress and doors, and vital-sign
a single nucleotide variant that accounted for a twofold likelihood of a therapeutic response.38 It also explained the disparity between ancestries, and the action of the drug fit precisely with a protein coded by the IL28B gene, also known as interferonλ3, which attacks pathogens. It was striking how small the number of patients was needed to generate this discovery—in one study, in Japan, GWAS assessed only sixty-four responders and seventy-eight nonresponders!39 Genotyping IL28 SNPs could, at
decade. (These metrics include the use of beta-blockers for a heart attack or the administration and discontinuation of preventive antibiotics at the appropriate times to reduce surgical site infections.)36 It’s just that these metrics provide little guidance to consumers. The relatively small list of ways to assess quality, mostly representing checklists of whether something was done or a medicine was given for a particular diagnosis, reflects how difficult these data are to come by and has left