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Physicians may be marginalized as mobile tech engages us in healthcare

Lucas Mearian | March 7, 2013
Mobile to usher in era of patient engagement, health conference told.

Through the use of genomic information, personalized medicine will come of age, allowing customized medicines to be used to treat a myriad of illnesses, from cancer to diabetes, Topol said.

"We have a serious problem because they're treating all people the same. This is population medicine personified," he said. "Mammography done for all women over the age of 40 has net harm. Net harm of almost 200 per every 1,000 women screened. Similarly for prostrate PSA, net harm - 200 per every 1,000 screened."

With better wireless monitoring technology, disease can be detected early, eliminating the need for annual screenings -- even physicals, he said. Topol pointed to research being done at The California Institute of Technology where embeddable sensors are "half the size of a grain of sand," yet they can detect irregularities in the heart.

"We have sensors in our cars. Why don't we have them in our body?" Topol said. "Most tasks can be taken on by patients. We don't need doctors so much when we have this innovative technology."

Among several examples of how current drugs have fallen short in treating a large swath of the population, Topol pointed to three of the top arthritis medications: Humira, Remicade, and Enbrel. Of all arthritis patients taking the drugs, only 30% benefit from them, he said.

"That means 70% of $30 billion is waste," Topol said, referring to the money spent on developing and producing the three arthritis medications. Topol suggested results would be far better with "personalized medicine," where genomic information is used.

Topol is no stranger to controversy. In 2005, Cleveland Clinic's then top cardiologist, Topol challenged the safety of the pain reliever Vioxx, even acting as a key witness in lawsuits against Merck & Co., which claimed they concealed the dangers of the drug. The result was the drug being removed from the market.

After leaving the Cleveland Clinic, Topol became a genomics professor at the Scripps Research Institute, where he is now the chief academic officer and is vice-chair of the board of the West Wireless Health Institute.

"We shouldn't be suppressing direct-to-consumer access to genomic information. It's your DNA, you should be entitled to that information," he said.

While Topol's view of the future of healthcare may seen controversial, he's not alone in his opinion. HIMSS board member Scott Holbrook took a similar position, speaking just prior to Topol.

"If we are to transform healthcare information technology, that means we must engage all stakeholders. That means non-IT people," Holbrook said. "We must transform from provider to citizens-centered healthcare. We must bring these consumers into our world."


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