Let’s get digital – Eric Topol
It’s an exciting time for healthcare. Mobile technology, cheaper sequencing, and increasingly sophisticated informatics are opening up a new era of patient power. The tools are all there, so what’s holding us back?
What can you say about Eric Topol that hasn’t already been said? He’s previously been voted ‘Most Influential Physician Executive in the United States’ in a poll conducted by Modern Healthcare, he’s also been named one of GQ’s ‘Rock Stars of Science’, he’s been known as the Dean of Digital Medicine, and even been referred to as ‘God’ by some of our readers. So it was no surprised, that he topped our survey of who you’d most like to see interviewed in Front Line Genomics magazine. If there’s one thing I learned about the man during the course of this interview, it’s that his determination to improve healthcare is showing no signs of letting up.
FLG: You’ve been one of the strongest advocates for genomics in healthcare, and a very active promoter of precision medicine. What’s motivating you?
ET: Oh well, I think as a practising physician for three decades, I’ve been in touch with how imprecise medicine is and how we don’t take into account individuality. We have this new capability that’s been coming online over the recent years. And so to me, these are exciting times in medicine with the ability to have this high definition human being capability that just wasn’t present previously.
FLG: How do you balance the benefit to the individual against the benefit to the population?
ET: We’ve had it all backwards until now, and so whether it’s mass screening for things like mammography or PSA or whether it’s using medications that don’t work in most people- these are very good examples of when you treat people all the same at a population level. On the other hand, if you build from the ground up, it’s kind of like what I would consider, reversed epidemiology. It’s a bit like instead of studying populations from 30,000ft, you’re studying them from granular data of each individual. And you start to understand that the simplistic reductionist notions we’ve had all these years about mass screening or mass drug therapy or mass anything is altogether wrong. I think we can actually build, ultimately, a mammoth knowledge resource that has billions of peoples’ granular data to help improve medical decision making in the future.
So it’s a whole different way to approach the problem. It’s actually defining each individual exclusively and then poolling that data, assuming we can get over the hurdles of privacy and security, and then having such things as a nearest neighbour analysis to say, oh well, this person did exceedingly well with this particular treatment and this outcome and these are your closest neighbours as to your Google medical map, if you will. And it isn’t just genomics, it’s all the different omics, it’s all the different physiologic measurements through censors and anatomical measurement through scans and the environment, the exposome, which we can quantify to a large degree also with sensors.
You can read the full interview with Eric on page 11 here.
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