The stethoscope is history

Pioneer of electronic healthcare, Eric Topol, believes that healthcare is about to experience the biggest revolution in its history. The digital revolution will make healthcare better, easier and cheaper.

Mobile technology has revolutionised our life, but medicine has remained largely untouched by it. Although technology can already be harnessed to produce wireless, personified health information for a low cost, the medical community has been reluctant to change treatment protocols. This is the key argument in the recently published The Destruction of Medicine, by the leading American researcher, cardiologist and electronic healthcare pioneer Eric Topol. The book has gained international attention and sparked many discussions about the future of medicine.

“We will not need as many hospitals and doctors in the future as we need today,” said Topol when he visited Helsinki. “The role of doctors as general sources of information will decline. They will become patients’ advisers and partners instead. People will be able to monitor their health with their smartphones and actively participate in their personal healthcare. And most importantly, this improves the success of treatments.”

What will doctors’ appointments be like in the near future?

“Firstly, I most likely don’t need to go and visit my doctor. I can have an encrypted video call from wherever I am. I probably have sent her my health data collected using my smartphone, such as my blood pressure, blood sugar level or heart rate. I might ask her to advise me on how to keep my blood pressure under control. My real-time blood pressure measurements have revealed that my blood pressure rises every Monday when the new work week begins, and I’d like to know what to do. In other words, my doctor will help me interpret the information I already have about my health.

“You probably don’t need to consult a doctor if your children come down with an ear infection, for example. A smartphone is easily converted into an otoscope. You can send the data to a cloud service and receive a diagnosis and possibly a prescription as a reply. In the simplest cases, a doctor may not be needed for making the diagnosis at all.”

What are the possible healthcare uses of a smartphone?

“They are numerous. I have said that hospitals are no longer the centres of medicine – smartphones are. People can use smartphones to collect real-time data about their pulse, blood sugar level, blood pressure, blood oxygen level and quality of sleep, for example. This data is important in the treatment and prevention of several diseases. Phones can be used to perform a laboratory test or determine intraocular pressure, get an eyeglass prescription, and so on. All this is already possible, as the applications and add-ons exist.”

How will this affect healthcare costs?

“It is difficult to estimate the savings by giving a single figure. It has been estimated that new solutions could reduce healthcare costs by a third or even more. What matters most is that they would make people healthier – at a lower cost than today. The wildest predictions suggest that the self-care would reduce the number of doctors by as much as 80 per cent. I disagree. Patients will still need doctors as consultants and partners, just perhaps not so many as today.”

The stethoscope is the best-known doctors’ tool. You claim it is a relic. Why?

“The stethoscope is a sad example. It was invented nearly two hundred years ago but it still remains the symbol of medical expertise. Its name refers to seeing, but it’s only good for listening. These days, there are far more efficient tools for examining the heart and lungs, such as a small high-resolution ultrasound device which yields much more complex and specific information about the human body.”

How have doctors welcomed the healthcare revolution you preach?

“This has not been as dangerous as I thought. Doctors often oppose new, patient-oriented healthcare because it reduces their authority and the need for doctors and because the change will be such a major one – doctors themselves do not need any changes. Most doctors are however beginning to understand that we will need a healthcare model which allows the patients to participate in their treatments. The patients themselves are demanding it more and more.”

What are the consequences of the digital healthcare revolution for health gaps or for developing countries, for example?

“This will be a giant leap for developing countries. Small, affordable and portable devices and the use of smartphones for healthcare is important in developing countries because many cannot afford large, expensive equipment traditionally used in healthcare. The digitalisation of healthcare will have a major global impact. In industrialised countries, self-care and cost savings make it possible to reduce health gaps – and free up healthcare professionals’ time for demanding tasks and those who really require their help.”

What role does a country like Finland play in the digitalisation of healthcare?

“Finland has the potential to become a forerunner of development: nearly everyone has a smartphone and internet access, and there is a general aim to provide everyone with equal healthcare. It is more difficult to introduce self-care in the US, for example, because doctors are not interested in cost savings – quite the contrary. Studies suggest that up to one in three medical procedures is unnecessary but is performed nonetheless.”