Cardiologist Eric Topol, M.D., hasn't used a stethoscope in four years. Rather than listening to his patients' hearts, Topol is visualizing them.
"It's a relic," Topol said of the stethoscope, which was invented nearly 200 years ago. "Why would you use that when you could see everything in seconds?"
Eric Topol, M.D., speaks about advances in medical technology. Topol was the keynote speaker during the opening session of the 2014 AAFP Assembly Oct. 22 in Washington.
Topol demonstrated his point to a packed ballroom Oct. 22 during the opening session of the 2014 AAFP Assembly here by unbuttoning his shirt, attaching a device to his smartphone and performing an echocardiogram on himself onstage.
Topol's keynote speech addressed advances in technology and the potential they hold to transform health care for physicians and patients. Director of the Scripps Translational Science Institute in La Jolla, Calif., and chief academic officer for Scripps Health, Topol said that in addition to shelving his stethoscope, he doesn't take patients' pulses any more.
"I use my phone, and it gives me more information," he said, noting that smartphone apps can display not only a pulse but specific rhythms. "Patients can do this themselves."
And they are. But that doesn't mean people won't need physicians any longer.
"I had one patient tell me, 'I'm in atrial fib. Now what do I do?'" he said.
Patients, Topol said, will be able to diagnose themselves in some situations, but they still will need the wisdom, experience and treatment only physicians can provide.
- Eric Topol, M.D., said during the opening session of this year's AAFP Assembly that advances in medical technology have the potential to reduce health care costs and improve care.
- Topol said smartphone apps will allow patients to make their own diagnosis in some cases, but people will still need the guidance and treatment only physicians can provide.
- Other innovations include wearable health monitoring equipment and diagnosis through individualized genomic sequencing.
The new era that Topol envisions -- with cheaper and better health care -- is described in greater detail in his new book, The Patient Will See You Now: The Future of Medicine Is in Your Hands, due out in January.
In a recent study in the Journal of the American College of Cardiology: Cardiovascular Imaging, researchers found that handheld ultrasound was more accurate than physical examination for normal and abnormal cardiac function, and it also saved $63 per patient.
Topol said imagine if some of those handheld ultrasounds were used -- rather than machines that cost hospitals six figures -- for the 125 million ultrasounds performed every year in the United States at a cost of several hundred dollars each.
"Ninety percent of consumers are mad about health care costs," he said. "That has to change."
Some physicians, Topol said, aren't comfortable interpreting ultrasounds. No problem. There's an app for that, too.
In fact, there are apps and devices on the market, or in development, for a myriad of diagnostic issues. Topol said Scripps is developing a heart attack app, which involves placing a sensor in a patient's bloodstream that could predict a heart attack days or weeks before it might occur.
Researchers also are developing smartphone technology that could be used to gauge lung function and even diagnose cancer, which would eliminate the need for costly scans, he said.
But that's just the tip of the iceberg. Topol mentioned several other innovations, such as:
- a glucose monitor that plugs into a smartphone,
- earbuds for Apple products that track blood pressure and heart rate,
- a remote heart failure monitor that a patient can wear,
- an ICU vital signs monitor that fits on a patient's wrist, and
- an app that is highly accurate for diagnosing skin lesions.
There also is a new type of selfie on the way for smartphone users. Topol said technology is being developed that will allow a user to take a photo of an injured hand, leg, etc., upload it, and find out whether the bone in question needs to be set.
Topol said the immediacy of these new technologies also will reduce the number of tests that are performed without appropriate followup. For example, Theranos, a Palo Alto, Calif.-based company, has developed a process that uses a single drop of blood to perform tests, and it does so faster and at lower cost than hospital-based labs, Topol said.
Topol, who is a professor of translational genomics at the Scripps Research Institute, also discussed how improved technology will lead to improved diagnoses through the use of genomic sequencing. Topol shared the story of Lilly Grossman(phenomena.nationalgeographic.com), a teenager with neurologic impairment who lacked a clear diagnosis as a teenager despite more than $1 million in medical costs. Finally, Topol and others at Scripps sequenced Lilly and her parents' complete genomes and identified three mutations in two different genes. Having identified those variants, they were able to improve her condition with medication.
Topol said the coming wave of technology will make it possible to provide better, cheaper care.
"There is an unprecedented opportunity to provide care from womb to tomb," he said.
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