Topol: Challenges around data hold up the democratization of medicine

By Jonah Comstock

EricTopolDr. Eric Topol's newest book is called "The Patient Will See You Now." At BIO during his keynote talk, a whirlwind overview of the digital health space, Topol freely acknowledged that he wasn't the first person to riff on that phrase.

"It takes 2.6 weeks to get an appointment with a primary care doctor on average. Since it’s hard to see a doctor is, what’s really interesting in contrast is that everyone else will see you now," he said, pointing to a slide full of recent headlines. "The crowd will see you now, the patient will see you now, Dr. Google will see you now, the robot will see you now, the avatar will see you now. Everyone will see you now. Everyone but the doctor."

Topol was highlighting two different intersecting trends -- a doctor shortage and the availability of a number of different technologies that could stand in for a doctor visit in some circumstance, whether it's telemedicine, a tricorder-like home health scanning device, home and consumer-facing lab technologies, or new services like Pager that send doctors to the user's home in an Uber-like business model.

"There’s five different apps where you can get a doctor to come to your house to do a consult," he said. "One of them’s called Heal and it’s backed by Lionel Ritchie. I wrote to him and said 'Maybe you should have called it ‘All night long’. He said ‘No, it’s all day long too’."

He pointed to Apple ResearchKit and to the number of different digital health pilot efforts by pharma companies in recent years as evidence that sensors and connectivity are already changing the face of medicine. But in some ways, we're not ready for those changes yet, particularly when it comes to how we handle data.

"We’re really long on capturing and hoarding data and we’re really short on processing that data. That’s a real problem," he said. "We have to do much better. A second problem is we live in this hyper-connected world which is great, but it has a big liability we have not yet addressed: privacy and security. This is untenable in the medical world. We have to be able to preserve that."

But perhaps the biggest data problem we're still facing is the question of who owns medical data, Topol said.

"Patients want their data more than researchers or their doctors want to give it to them," he said. "People want their data and they’re not getting it. Who owns the data? Interestingly enough, in the US in 49 out of 50 states the patient doesn’t own their data. Only in New Hampshire does the patient own their data. Everywhere else it's the doctor or hospital. That has to get fixed."

Finally, like other speakers at the event, Topol compared digital health to self-driving cars, a technology that has moved from inconceivable to seemingly inevitable in just the past few years.

"We have now seen the development of autonomous driverless cars," he said. "In fact, they have been deemed safer than human beings driving. Who would have expected that to happen so fast? But we also have the ability to do this in medicine. Because these new tools to digitize human beings also can democratize them. We need to have co-pilots, not passengers, a new relationship in care. We have doctorless patients for a lot of the diagnostics coming, for a lot of the remote monitoring coming. But we need doctors more than ever for the treatment, the oversight of that data, the guidance, the expertise, and the wisdom."