Some of the most enthusiastic feedback from this year’s Liberation event came in response to our world-renowned keynote speaker, Eric Topol, MD. Dr. Topol is recognized as one of the leading innovators in medicine today.
“There is no room for a hospital room in the future. It’s all about the patient’s bedroom.”
Dr. Eric Topol, founder and director of the Scripps Research Translational Institute (SRTI) in La Jolla, California, and executive vice president of Scripps Research and professor of molecular medicine, kicked off Liberation 2019 this past October with these bold assertions about the healthcare of tomorrow. Although Dr. Topol acknowledged that there is a time and place for acute care, he also noted that many people could benefit from remote management and self-care technologies, especially in today’s ultra-connected world.
Dr. Topol made his case by sharing insights from his 2019 book, Deep Medicine: How AI Can Humanize Health Care, as well as from the latest clinical and industry research. He began tackling the big picture issues by highlighting the poor return on investment (ROI) the United States is realizing from out-of-control healthcare spending. But you can’t just identify a problem and not provide a solution, so Dr. Topol discussed some of the bold moves needed to ensure better returns for healthcare dollars. These include Dr. Topol’s distinct areas of expertise—big data and artificial intelligence (AI), which he believes can make a meaningful difference in care delivery. He backed up his statement by sharing a recent study entitled, “Quantum Supremacy Using a Programmable Superconducting Processor,” which shows how new analytics capabilities can analyze data in mere seconds.
Getting Beyond Shallow, Error-laden and Wasteful Medicine
To illustrate his next bold move, Dr. Topol shared a recent national survey by JAMA, which found that 83% of unnecessary procedures lead to patient harm, and these same procedures dramatically increase medical waste. For instance, 41 million electrocardiograms and 47 million ultrasounds are performed in the United States on an outpatient basis each year. These procedures cost $1,000 or even more in many cities. But are all of these procedures even warranted or necessary?
Dr. Topol believes the answer is no, and he thinks he has a better solution right in his pocket. Within his cardiology practice, he uses a six-lead, smartphone-powered ultrasound device. The device’s sensor can be held on a patient’s left leg—during a normal office visit, at no additional cost—to generate astonishing images. Not only could providers potentially replace their stethoscopes (which Dr. Topol calls antiquated and error-laden) with the use of this tool, but it could ultimately help replace the need to send patients to an ultrasound lab. This would, in turn, reduce costs, eliminate hassles and improve engagement. That’s because the provider can literally sit next to the patient and share these images in real-time and in exquisite detail.
Taking a Total Body “Medical Selfie”
Dr. Topol described how he has benefited from this new tech on a personal basis. After suffering from intense abdominal pain, Dr. Topol realized he might be able to use the device to discover what was wrong. After scanning his kidney, he saw signs that it was dilated and went immediately to the emergency room for treatment.
“I told the ER doctor that I had a dilated kidney and asked if he wanted to see photos on my phone,” Dr. Topol told Liberation attendees. “He looked at me like I was an alien. But then he sent me to get a $2,700 CT scan, which simply created identical images to what was on my phone.”
Using More and Better Data to Drive Evidence-based Insights
Of course, deep medicine also starts with deeper insights, especially evidence-based ones that can drive better clinical workflow, diagnoses, and more targeted medications and treatments. Dr. Topol described how a widely prescribed therapy—statins to reduce heart attack and stroke risk—actually work in only a small number of patients and yet millions are prescribed worldwide.
Rethinking this blanket approach means questioning the way our industry looks at data—even when it’s statistically significant and clinically based—and taking into account all of the factors that drive successful treatment. We’re now at an important crossroads in medicine where we can leverage innovations, such as polygenic risk scores, to deliver truly individualized, insight-driven care.
Dr. Topol explained how new capabilities born out of AI and digital health technology can better equip physicians to improve and reduce costs across all types of interactions, while improving patient engagement. These capabilities include genetic testing and risk scores as well as specific AI applications, though the latter has experienced slower adoption because of resistance by some industry traditionalists.
One exception is in the area of ophthalmology, where doctors are using new AI technology for early identification of eye problems among diabetics, to help prevent retinopathy that leads to blindness. While these anomalies can be difficult for the human eye to see, AI-assisted technologies can be “trained” to spot the tiniest variations.
Other obstacles to widespread AI adoption include privacy, security and limited datasets. But Dr. Topol believes that with greater use, we’ll have the necessary data to start implementing the technology across all types of specialties. The result will be a dramatic improvement in efficiencies across care delivery. His bold perspective on this and many other issues inherent to the human experience of healthcare made Liberation 2019 a powerful event to remember.