Topol Sees Health Tech as a Means to Human Empowerment

The Holter monitor has always looked a bit silly—a tangle of cords and electrodes all attached to a recorder that’s larger than many smartphones. In many ways, it’s the antithesis of the modern wireless, digital world. And yet, the Holter monitor remains in wide use.

In other words, according to Eric Topol, MD, the healthcare industry has a lot of catching up to do.

The world is moving into the “fourth industrial revolution”—an era of artificial intelligence, robotics, and big data, Topol said, “But unfortunately, medicine is still stuck in the beginning of the third industrial revolution, somewhere around 1960, because we have not really used the digital infrastructure that we can and will.”

Topol, a cardiologist, author, and director of the Scripps Translational Science Institute, was the keynote speaker Monday morning at the Healthcare Financial Management Association’s 2016 National Institute in Las Vegas. He used much of his talk to prove that the healthcare industry is in fact catching up. He demonstrated a slew of gadgets that can easily replace high-cost tests and doctor visits, such as a credit card-sized finger pad that can perform an accurate echocardiogram, or a cellphone-attached imaging device that replaces the stethoscope with high-quality imaging of the heart, or any other organ.

“Why would you listen to ‘lub-dub’ (a heartbeat via stethoscope) anymore? Why?” Topol asked. “This (smartphone imaging device) should be part of the physical exam—it isn’t—for reasons you can envision that are of course financially related, for the most part.”

However, Topol said healthcare will have to adapt to the new economy. The new devices and technology are coming down in price very quickly. The echocardiogram device can be purchased for $69, he said. A Band-Aid sized sensor that costs $1 to manufacture can perform detailed sleep analysis, replacing a service that can cost thousands of dollars and which brings in millions of dollars in revenue to healthcare organizations.

Importantly, those low price tags will also enable patients—not just healthcare organizations—to buy their own diagnostic equipment and perform their own tests. Soon, Topol said, patients will use technology to constantly monitor their health using a variety of metrics, thereby generating a massive amount of data.

All that data will lead to privacy concerns and fights over who owns the data. Topol believes patients should own their own health data, a stance echoed by President Barack Obama.

“This is a civil right that has not been enabled, has not been granted. It’s my data, I’m generating it… why don’t I own it?” Topol said. “Give me my data.”

To date, New Hampshire is the only state that definitely gives patients ownership of their health data.

For physicians and healthcare organizations, all of this change will mean many healthcare tests and check-ups can be performed from a distance.

“Physical, face-to-face office visits are going to become the minority of interactions, because they don’t work,” he said.

It also means a “democratization of diagnosis and monitoring,” whereby patients will be empowered to become full partners in their healthcare, in a way that wasn’t previously possible.

“The future is about a person taking much more charge (of her healthcare),” he said.

Topol is clearly an early adopter, embracing technologies many physicians are still leery of. Many apps and devices lack approval from the Food and Drug Administration, and many healthcare professionals worry about their accuracy. However, Topol said there’s no turning back. The devices will get better and better, and patient demand will only increase.

But despite his embrace of technology, Topol doesn’t see this new era as all about devices and software. Technology might enable the new era, but Topol said the ultimate purpose of all this is to empower people.

“Humans are under-rated. Doctors have thought for years that people can’t handle the truth; if they got their data they would just go cuckoo,” Topol said. “It doesn’t turn out to be. Every study shows otherwise.”