- Copertina rigida: 364 pagine
- Editore: Basic Books (22 gennaio 2015)
- Lingua: Inglese
- ISBN-10: 0465054749
- ISBN-13: 978-0465054749
- Peso di spedizione: 703 g
- Posizione nella classifica Bestseller di Amazon:
The Patient Will See You Now: The Future of Medicine Is in Your Hands (Inglese) Copertina rigida – 22 gen 2015
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The mantra defining the future of medicine, according to physician and author Eric Topol, is 'Nothing about me without me.' And in his new work, The Patient Will See You Now, that mantra animates a vision of medicine that, in everyday practice, is radically democratized and digitized, made accessible and dialogic through the use of handheld devices, open-access records, iDocs, physician avatars and more.”The Plain Dealer
Dr. Topol's overriding thesis is that the old days of doctor knows best' are as good as gone. No longer will doctors control medical data, treatment or profits. Instead, thanks to the newest science, humanity will finally achieve truly democratic health care.”New York Times
[Dr. Topol's] vision is compelling, combining an empowering view of technology with the recognition that medicine requires something more. The best physicians heal even when they can't cure, Dr. Topol notes, and there will never be algorithms, supercomputers, avatars or robots to pull that off.'”Wall Street Journal
Cardiologist Topol argues for taking down the boundaries separating the medical and digital worlds, boldly exploring how patients can shape the medicine of the future.”Publishers Weekly
"It's your blood, your DNA, and your money; shouldn't the images, records, and data belong to you, too? Dr. Topol's deeply researched, powerfully presented arguments will ruffle feathers in the medical establishmentbut he maintains that the new era of smartphones, apps, and tiny sensors is putting the patient in charge for the first time. And he's right."
David Pogue, founder of Yahoo Tech and host of PBS' Nova”
"Dr. Eric Topol is uniquely positioned to map out a new era of democratized medicinea time when each individual will not only have immediate access to all of their own medical data, but even generate much of it and play a principal role in their healthcare.”
Sanjay Gupta, M.D., Chief Medical Correspondent for CNN
"We are seeing a sea-change in medicine, a time when the old paradigms no longer apply. As a physician and a scientist, Eric Topol has been both contributor and commentator to this revolution and therefore, one of the few people who can weave together and explain the stunning advances in seemingly unrelated fields. His personal voice, his ability to explain the most complex developments in science in a simple and engaging manner, and the clarity of his vision of the future make this compelling reading. I couldn't put this book down and I learned so much. It has changed my perspective of what is to come."
Abraham Verghese, author of Cutting for Stone
Topol expertly builds upon his earlier path-finding work and explores how smartphone adoption, big data, new digital monitors of medically relevant information streams, ubiquitous computing, and larger networks are all combining to revolutionize health care far beyond what most now expectwith the exciting promise of lower costs and higher quality simultaneously. Coming from a world-class physician with a unique perspective on the rapidly changing nature of medicine, Topol's prescription for patient empowerment is a must read.”
Al Gore, former Vice President of the United States
[Topol is] one of medicine's most innovative thinkers about the digital future.... [A] valuable contribution to a fascinating subject. Despite his digital predilections, Topol is a humane and sympathetic observer of the plight of patients in our highly dysfunctional health care system. We can only hope mobile devices will help them better navigate (or scroll) their way through this perilous terrain.”New York Times Book Review
Dr. Eric Topol [is] one of the nation's leading thinkers on the future of medicine.”Newt Gingrich, Newsmax
[E]xtraordinarily thought-provoking and even provocative.... [T]he world [Topol] envisions is already exceedingly close to being realized; the writing on the wall is clear, unambiguous and unmistakable. This would be a great book to read sitting in a waiting room or during a stay at the hospital.”Bowling Green Daily News
The Patient Will See You Now is full of innovative thinking.... This book is full of technical wizardry and intriguing questions about the natureand the futureof diagnosing, monitoring and healing.”
Perri Klass, Washington Post
The most extraordinary time for health care lies ahead. Dr. Topol presents a highly innovative vision and model for how, in an era of big data for each individual, medicine can be democratized.”
Mitt Romney, former Governor of Massachusetts
Dr. Eric Topol is a pioneer of the medicine of the future and the future is now! Read this book and empower yourself for total well-being.”
"I have experienced Dr. Topol's healing touch as my personal physician after a 99% heart blockage, in his capacity as cardiology advisor to Men's Health magazine's 12 million readers, and as the visionary author of The Creative Destruction of Medicine. With The Patient Will See You Now, he's extending his healing powers where they'll do the most good: to the patients themselves. Book an appointment to read it now, and you'll save yourself a lot of copays later."
Peter Moore, editor of Men's Health magazine
Eric Topol's book focuses us on the most important development in health care today: putting the patient at the center of everything. This is the pathway to the most effective and efficient innovation, development and reform of health care practices, products and policies globally.”
Alex Gorsky, CEO of Johnson & Johnson
With an impressively well-researched cache of examples, [Topol] explains the various gadgets attached to smartphones to carry out complex medical examinations that cost pennies, the potential for using the same cheap technology in poor countries where expensive medical equipment cannot be deployed and the potential for the opening up of patient datawhich could then be shared across the world through the Internet to find diagnoses and trends on an unprecedented scale.”Winnipeg Free Press
With its many charts, graphs, and citations, this forward-thinking work will appeal to all educated health-care consumers.”Library Journal
A visionary physician predicts a technology-driven, patient-centered revolution in health care. In this work about the changes afoot in the world of medical care, Topol, in this natural follow-up to his previous book, demonstrates the combination of intelligence and ambition that is apparent in his successful medical career.... Not content to simply critique the current system (though he does so thoroughly and convincingly), the author strides optimistically into the future of health care.... An expertly detailed, precisely documented exploration of the power of information and individualization' in health care.”Kirkus Reviews
[Topol] does a terrific job of laying out the immense potential of smartphones and iMedicine technologies to democratize medicine like never before.... Topol's writing style makes it very accessible for the lay person without any dumbing down' that would be a turnoff to health professionals. This is a must read for anyone that cares about healthcare.... I can't think of a book that does a better job of projecting how the future of medicine will unfold and the critical role individuals will play in their own health (beyond the obvious).”Dave Chase, Forbes.com
It is rare to find a book that addresses quite technical topics so clearly, while interweaving stories about the variety of personalities who are shaping the field . The book is both scholarly, supported by careful footnoting, and encyclopedicnearly every recent development challenging traditional notions of medicine is carefully evaluated.”Health Affairs
[Topol] forecasts and engineers a new chapter in medicine.... [He] foresees a future medical world profoundly bolstered by wireless Internet, where each individual will have all their own medical data and the computing power to process it.'”Booklist
If you want to feel as exhilarated, and maybe even as disoriented, as Marty [McFly, the fictional character in the movie Back to the Future II] did after fast-forwarding to 2015, read Dr. Topol's new book, The Patient Will See You Now.... [Topol] describes a health care world upended by digital technology mostly to the benefit of patients. We wield dominion over this new world through our smart phones.”Susan Dentzer, Robert Wood Johnson Foundation's Culture of Health blog
Eric Topol has written a must-read manifesto for patients who feel helpless. Filled with knowledge and engaging stories, this book shows how you can harness technology to be the master of your medical careor at least, a better partner for your doctor. I want Dr. Topol for my doctor.”
Elisabeth Rosenthal, M.D., The New York Times
"Dr. Topol clearly captures the challenges and major disruptions occurring in medicine today. A revolution in healthcare is finally happening - one that will not only improve outcomes, but the individual patient's experience. This is a book that everyone needs to read. The practice and future of medicine are indeed being turned up side down."
John E. Kelly III, Director of Research at IBM
Dr. Eric Topol has the vision for how smartphones will play a central part in health care in the coming years. Consumers will take on a powerful new role in medicine of the future The Patient Will See You Now reveals to us how that will occur.”
JK Shin, President and CEO of Samsung Electronics
In The Patient Will See You Now, Dr. Eric Topol has helped to define a new era in healthcare when the role of the patient has evolved, empowered by the rapid adoption of digital health technologies. We fully agree with Dr. Topol's vision of the future of healthcare becoming increasingly seamless and giving consumers access to carewhere, when, and at the value point they want.”
Greg Wasson, CEO of Walgreens
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The first section expands his assertion that paternalistic healthcare systems (personified by FDA, AMA, and traditionalists) is really behind the times and the notion "nothing about me without me" is increasingly becoming not only feasible but also demanded by the patients. Providing a detour explaining the evolution of interpretations of the Hippocrates oath, Topol uses that opportunity to take issue (yet again) with the AMA and the entire practice around guidelines. While arguing for increased access for patient-related information to the patients, Topol clearly acknowledges the difference in information and knowledge gaps and points out that mere access is not sufficient, but it is a critical step in rethinking patient engagement and direct participation. To further expand on these themes, Topol borrows Eisentien's characterization of printing press as a change agent and draws significant parallels with that transformation and smartphones, calling this the "Gutenberg moment". While a healthy skepticism is warranted in the claims of everything from holy wars to Renaissance to modern science and founding of american republic is attributed directly to the printing press, one cannot easily dismiss the "combinatorial intellectual activity" printing facilitated. Topol argues (successfully) further that the technology already exists to enable this remarkable period of creativity in healthcare. Using relatively recent episodes such as FDA v/s 23andme and Angelina Jolie's aggressive preventive measures, Topol provides a very informative and engaging view of how the healthcare system is clearly at an inflection point.
In the second section, Topol focuses primarily on the key enabling technologies that will make his vision of a democratized and personalized healthcare a reality. Moving beyond traditional logging devices, Topol paints a realistic vision of the technologies and the opportunities they are already creating such as from lab-on-a-chip to lab-in-body. Along the way, his insights on the failures of EMR systems (using OpenNotes as a contrast), potential of "pre-womb to tomb" predictive/diagnostic models is well worth the read. In fact, the chapter on the various -omics and their potential role (adapted from his famous paper in Cell) and examples on pre-diabetic and airway diseases in itself is worthy of investing in this book. A reader will also gain significant insights about some trailblazing companies like Theranos, QuantuMDx, etc. The discussion around how 3 of the 5 imaging technologies have already been miniaturized to hand-held devices is a clear indication of the realism embedded in Topol's assertions.
In the third section, Topol objectively analyses the import of these changes (cultural and technological) on how healthcare will be delivered and consumed. These discussions go beyond "disintermediation of doctors" and is a must-read for anyone interested in developing new service models. A few years ago, The Innovator's Prescription: A Disruptive Solution for Health Care, provided a radically new way to rethink service models - Topol's book does the same from the viewpoint of patient and the role of technology.
At times, Topol perhaps extends the patient advocacy too aggressively. For example, on a discussion crucifying Myriad and value of patents, he seem to dismiss the risk taken by private enterprises to generate these insights. While he fully acknowledges that information and knowledge gaps are critical, he uses a few hand-picked examples of how highly motivated individuals were able to be remarkably active with the diagnosis and treatment of their conditions (it is hard to say how generalizable these episodes are). Criticisms on AMA may also not be entirely fair and while there will always be "eminence-based medicine" as Topol characterizes it, there is no doubt that some of it needs to be modulated better with patient-centric approaches.
With the clarity of discussion aided by well-chosen examples and analogies bereft of needless cheer-leading, over 50 pages of notes/references, excellent diagrams accompanying some of the key concepts, Topol's book is well-poised to define the next big discussion on healthcare. With the aggressive growth of wearables and smartphones showing no signs of slowing down, wider acknowledgement of patient participation as key for healthcare outcomes, changing delivery models such as ACOs in the US, some of Topol's vision may become reality sooner than even he seem to hope for. Nevertheless, Topol has succeeded in providing a clear thought framework to assess and harness the role of mobile technology in reshaping healthcare ecosystems.
As a physician, I find this scary and exciting. As a patient, family caregiver, and advocate, I'm thrilled. The Patient Will See You Now takes us on a wonderfully written tour including: the end of paternalism in health care (hooray!), tools that patients and families now have to be partners in their care, and an approachable overview to how genomics is finally bringing us personalized medicine. That last piece is even more important to understand given Obama's recent proposal to sequence 1 million genomes.
Whether you think all of these changes are good or not, Topol's work here is a huge amount of easy-to-understand education, impeccably researched, and a pleasure to read.
First, he is an advocate for quality electronic records and the ability for patients to access their records and contribute to them. I have spent lots of time in working on medical records and have moved from the concept of Lawrence Weed that medical records are designed for communication with health care providers and in his SOAP concept to help all users work in designing plans based on data. Now we want data accessible to patients and even more their ability to order, pay for and get lab data on their own. An electronic medical record should outline the issues or problems a patient has and what assessment and plan for treatment considered. An electronic medical record should be available on the cloud to the patient on a password protected site. Our ability as patients to carry our own data and get data including genomic, are important as we consult with physicians to plan for the best path to wellness.
In his prior book he discussed the use of I Pad kind of small computers to carry texts, charts, illustrations as needed in medical,school. Three-dimensional drawings and dissections can be very important for physicians in training as they learn the subtle relations between anatomical parts. My experience with palm pilots years ago when on "rounds" and I asked a question about the diagnostic criteria for an uncommon spinal disorder. I noted a young fellow off to,the side punching his finger in his lap area, and soon he had the answer: not retrieved from his cortex but from his mini computer which then had lots of lists. Now the ability of physician and student or patient to access information is unbelievable.
Topol talks about smart phones and their use in diagnosis. One is in the smart phone otoscope app. It has use for patients who can send the image of their child's ear drum to a site where it can be evaluated. Months ago my daughter brought our grand daughter to her pediatrician where he not only used the app to show mom and child the ear but uploaded normal pictures to discuss the diagnosis. Perhaps of more importance are the cardiac diagnostic capabilities.
Rhythm strips can be run from your bedroom if you feel your heart rate accelerating. The ecg is read and diagnosed as pathological or requiring assistance with quick computer read outs and transmission of the rhythm strip to your cardiologist for his/her review. Physicians can use an ultrasonic heart sound monitor, first mentioned in Topol's prior book but shown at a conference I attended where Abraham Verghese was a key speaker. He noted that the stethoscope is now archaic and with the use of the electronic device an average auscultater can appear knowledgeable. In my experience as young students round with a teaching cardiologist, the guru will ask all to listen to his patient to hear the murmur and then tell them it is a grade 2 mitral ejection murmur or some other heart sound. All students nod that yes they heard and understand. Most did not. Years ago we had friends who had a neighbor who was scheduled to enter college with a scholarship in swimming. His pediatrician on the pre college physical said he had a murmur and sent him for further testing.
Parents were upset. How could that be, the boy is a strong healthy athlete? His diagnosis was correct, the youth had IHSS a rare narrowing of the exiting heart vessel, one linked to sudden death in otherwise healthy athletes. Most generalists would have missed. With the electronic ultrasonic auscultation device it would have been obvious. Of course older internists insist on the effectiveness of the stethoscope, Verghese describes the stethoscope as a shaman's object, one to inspire the patient with confidence. Why else would physicians running for political office wear one when campaigning if not for the symbolic value. Topol mentions that outstanding senior cardiologists believe that electronic device is nowhere as useful as a stethoscope. Physicians are not Luddites; we do dislike change.
Topol is self assured and not wary of criticism, which he treats lightly and with good humor. He has no trouble standing up for what he believes are sound principles. His discovery of unreported findings of cardiac risk from certain medications changed his career as not only industry but a medical edifice got very upset. More people need to have the courage to explain what medical research means.
As a scientist in genomic studies at the Scripps institute his discussion of the 'omes is full. In his last book the chapters on the genomic aspects of health care were difficult to follow for those of us older folks where genetics ended with beans and flies. This new volume is far easier to follow although the issues are more complex. The NYT had an article on neuroscience studies where the author noted there are so many 'omes that there are now a group of anti-omes.( NYT Magazine, 11Jan,2015' p.29, "Mind Games, by Gareth Cook) It would be easy to join that group of deniers.
Many chapters discuss the use of genomic testing today and what it may be in the future. Important concepts for all of us. The longest is "Angelina Jolie : my choice". Her choice involved not just her ability and right to review the risks of carrying the BRCA gene but the courage to discuss it widely. This allows Topol to suggest that genomic studies might best be in the hands of patients. He also shows how Kim Goodsell was able to research her own genetic disorder and discover changes in an uncommon disease through online study.
Discussion of eminent physicians and the paternalistic” eminence” based discussions and advice as well as the “edifice” based method of dispensing care are equally essential for us to fathom as we move ahead and the costs of medical care rise so quickly as we search together for the best care for all.
I highly recommend this for all thinking people. Most of my peers recall the Nobel prize for the double helix was awarded long after we had completed basic biology. The rate of growth of know,edge and use of current biological science is so fast to be overwhelming. Any who think about health care and are bothered because so much is happening should realize that in a democracy we all need to help our elected officials look into the future and help us arrive at a point where we all are involved and all understand our own health and the care it needs.