Episode 18: Dr Eric Topol

How ‘high-definition medicine,’ tailored to each of us, could revolutionise the way we manage illness

#HealthHackers Ep 18 with digital health pioneer Dr Eric Topol

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In this episode, Dr Topol explains:

how a “virtual coach” on your phone or smart speaker could one day prevent heart attacks, seizures and strokes
the future blood test that may be able to detect cancer before it has a chance to grow
the app that would process your macronutrients every time you take a picture of your meal
how we’ll be doing our own blood tests in years to come
why obesity is not just down to eating too much
how treatment for T2 diabetes is “a mess” today
why screening everybody for a condition is “stupid” and “wasteful”
how your DNA and gut microbiome assessment could decide your medical treatment
the purpose of gathering biological data about each of us from the moment we are born
why he’s writing a review for the NHS
how the NHS is leading the rest of the world in incorporating new technologies
what could become the biggest barrier to implementing cutting-edge health tech
plus, his candid view of the NHS system compared to America’s paid-for structure

Preventing illness with ‘high-definition medicine’

Heart attacks, strokes and seizures will all be preventable when we each have “virtual coaches” that know every layer of our biology, according to one of America’s top physicians.

Dr Eric Topol is a cardiologist, geneticist and director at the Scripps Translational Science Institute (a test ground for pioneering medical sensors, wearables & other new tech).

In HealthHackers ep 18, Dr Topol, who’s published two bestselling books on the future of medicine, told me how ‘high-definition medicine,’ tailored to each of us, will revolutionise the way we manage illness.

The term refers to understanding each human being at an unprecedented level, factoring “every layer of biology; DNA, RNA (ribonucleic acid), proteins, metabolites [and] our microbiome” and monitoring this kind of information from the moment we are born.

“If we can… use all of that data to define a human being’s medical essence, I believe we can do a much better job at keeping people healthy in the years ahead,” he told me.

Or, a machine could learn what’s best for us using that same collection of data.

“We are going to be able to eventually prevent… seizures, asthma attacks, heart attacks, strokes because of virtual coaching,” he explained, whether it be via smart-speakers in the home, an avatar or your smartphone.

There could be life-changing technology in the pipeline for cancer detection too.

“There is a chance in the future, by monitoring people, let’s say, who are at high risk once a year or every 6 months with a tube of blood, we’d be able to pick up cancer well before it grew.”

It blows the idea of one-size-fits-all treatment and screening straight out of the water.

“We shouldn’t just do screening on all people for a condition because that’s just really stupid and wasteful.

“It induces lots of false positives and harm,” Dr Topol said.

Collecting biological and physiological data about each of us throughout our lifetime would mean physicians could then match our specific health problem to the best medication, based on our unique DNA, gut health, and other potential factors.

It’s hoped such precision targeting would help prevent a lot of illness, improve recovery and save money.

“Diabetes is a mess today,” he told me.

“For type 2 diabetes, the common form, there’s fifteen classes of drug and nobody knows how to use them.

“There’s no method to the madness.”

And as for the obesity epidemic, Dr Topol says a person’s weight problem is not just simply down to eating too much.

“It turns out some peoples’ obesity is related to genetic issues, they have genome alterations.

“Other people, it could be their gut microbiome and in the future we’ll have ways to manipulate the microbiome”.

The individualised medicine that Dr Topol describes is also meant to empower people.

“You’ll be doing your own lab tests with your smartphone for routine blood tests,” he said.

HD medicine won’t be welcomed by everyone though.

Dr Topol acknowledges the reality is some people don’t want to be coached by technology or monitored from birth using sensors and scanners.

The leading expert’s influence has now hit the UK as he prepares to write a review for the NHS on how staff can deliver a more digital future - one which staff can use artificial intelligence, robotics and genomics.

“No country has taken this seriously as to planning the future of healthcare and the workforce implication as the NHS.

“It deserves a lot of high regard.”

He also told me he’s disappointed (to put it mildly) that the US doesn’t have a similar state-funded healthcare service that treats every citizen, like the NHS.

“It’s just unexplainable. Dreadful is too nice a word to use”

If you’re reading this and starting to wonder if your doctors might soon be replaced by robots - don’t worry.

“What I’m trying to push for really hard is to get back the gift of time so that when patients and doctors, clinicians come together they’ll actually have a lot more valued time to communicate,” said Dr Topol.

Time, is something he appears to have very little of himself.

His NHS review is due in 2019 along with his third book and he continues to see patients while also working on his future medicine research, but he likes it this way.

“I get bored very easily so this is how I thrive.

“I just feel very lucky”.

Follow Dr Topol on Twitter.