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122 of 132 people found the following review helpful
4.0 out of 5 stars Informative, but doesn't live up to the potential
For a book that has pages of endorsements from key authors and influential physicians, this book fails to meet the expectations - particularly in defining remarkably new disruptive ideas. Despite an excellent set-up and problem definition, this book ends up reading like a well-organized collection of articles from magazines such as Wired.

The premise of Topol...
Published on February 28, 2012 by Sreeram Ramakrishnan

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92 of 115 people found the following review helpful
2.0 out of 5 stars Dry Literature Review - Not a Narrative
This book was highly recommended to me by a physician colleague and I eagerly downloaded it to my Kindle and began reading. I was greatly disappointed.

With all due respect to the author, a well-known, highly-respected, and apparently very well-connected physician, this book comes across as a dry, comprehensive academic literature review with almost every...
Published on January 14, 2012 by D. W. Miller, Jr.


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122 of 132 people found the following review helpful
4.0 out of 5 stars Informative, but doesn't live up to the potential, February 28, 2012
This review is from: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care (Hardcover)
For a book that has pages of endorsements from key authors and influential physicians, this book fails to meet the expectations - particularly in defining remarkably new disruptive ideas. Despite an excellent set-up and problem definition, this book ends up reading like a well-organized collection of articles from magazines such as Wired.

The premise of Topol is a compelling one - the developments and the relative maturity of mobile devices, PCs, Internet, genome sequencing and social media, provides a potential inflection point in the field of medicine. In the initial chapters that borrows heavily from themes established by Clay Shirky (for example, Cognitive Surplus: How Technology Makes Consumers into Collaborators, and those similar to ones defined in Hamlet's BlackBerry: Building a Good Life in the Digital Age and The Third Screen: Marketing to Your Customers in a World Gone Mobile, Topol abstracts 4 key trends (4 C's) that are setting up the stage for the "Ds" - destructive trends. While the ideas themselves are not new, Topol condenses the ideas from various authors to clearly characterize the innovation potential in medicine. Topol also makes some astute observations on the use of guidelines and the limitations of population-based clinical trials. While this first part alone is worth the book, the rest of the book fails to live up to the excellent framing.

The disappointment mostly stems from a lack of new ideas that could do full justice to the tagline of the book - instead of offering new ideas, for the most part, Topol provides an assessment of well-cited relatively new business models (23andme, patient-like me, Hello health, Vscan, etc) - across a variety of themes in physiology, biology, anatomy, and electronic health records. Mixing anecdotes from his own experience, popular literature (science and general news magazines), and academic papers, Topol is able to provide a credible assessment of the cited business models and use them as a context to define some important questions (but often fails to fully address them).

Topol glosses over issues related to who will pay for these services once they are established - this, perhaps is an important oversight in the book - the lack of discussion on how the value captured by either the patient or provider through these technologies be converted to a sustainable business model. Topol also fails to explain how the higher level of IT infrastructure can be justified in terms of the actual health outcomes that can be attributed to those (in fact, Topol himself argues that increased access to information doesn't necessarily empower patients correctly). At times, he gets carried away describing his observations - for example, he wonders if the increasing use of supplements is a "rebellion against conventional medicine". Topol chooses to ignore analyzing other stakeholders such as pharmacies, nutritionists whose roles and business models have significant disruptive potential from the trends he outlines. While the line between "medicine" and "healthcare delivery" are blurring, a sharper focus on either would've tremendously helped a reader.

Despite these 'issues' and a general lack of provocative new ideas, Topol provides an excellent characterization of the potential of disruptive technologies. One wishes that he would have used his unique experiences and reputation to put forward provocative ideas or perhaps build on the themes by an endorser of this book - The Innovator's Prescription: A Disruptive Solution for Health Care. Despite being an informative read, this book is not very likely to inspire a reader familiar with the trends in this field and the author's reputation as a thought leader. For someone new to this field, this is a remarkably comprehensive introduction to the key trends that could impact healthcare/medicine.
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79 of 87 people found the following review helpful
5.0 out of 5 stars Doctors beware!, January 29, 2012
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This review is from: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care (Hardcover)
Every revolution shows the incumbents in poor light - they look foolish, stubborn and indecisive. Eric Topol shows how breakthrough growth in mobile phones, wireless technologies and genomics, and their convergence is revolutionizing Medicine and Healthcare but the current 'high priests' whether it is doctors or the bureaucracy dont seem to be getting it. Nevertheless the flow seems to be irreversible as informed consumers empower themselves and push for new solutions that will provide better care, cheaper and more effective medicines, and democratize the healthcare system.

Topols' stories about the shortcomings on the current system are scary and he is very tough on the members of his profession. Other players in the ecosystem like the Pharma companies also do not escape his sharp criticism. He will not be making many friends with this book - however it will be tremendously useful to the readers in multiple ways - as an individual on how to plan for your healthcare, as a student on planning your career, as an investor or entrepreneur for understanding opportunities that would create revolutionary wealth!. For people in the healthcare profession this should be a wake up call.

I would urge all to read this book.
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37 of 39 people found the following review helpful
5.0 out of 5 stars Health Care's Schumpeter Moment, March 18, 2012
By 
Kathleen Scarbrough (Piqua, Ohio United States) - See all my reviews
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Dr. Eric Topol's book is an excellent review of what the promise of technology holds for the US Healthcare system. His background as a geneticist and a cardiologist as well as a highly regarded research scientist informs this book with the promise of the future, and it is the near future at that. Not something decades away. The advent of the empowered patient (by technology as close as their cell phone) extends the opportunity and methodology for significant reductions in the cost of health care for us all---without a reduction in quality. For instance, cell phones with a "lab on a chip" enabling individuals to substantially reduce the cost and compliance of monitoring one's blood work for glucose, cholesterol, etc. while empowering the patient to be more aware and in control.

His review of genetics was a little dense, but as readers we must all bear in mind how difficult it is to condense such a complex subject into a chapter of one book providing enough information for the lay person to become excited about the possibilities in front of us without speaking totally over our heads. The promise of pharmacogenomics is here today. Enabling an oncologist to test a cancer tumor for genetic markers that indicate which of several chemotherapy drugs would be most efficacious for a particular patient. The "wrinkle" in the system is that insurance company awareness and subsequent payments are running behind the speeding train of "Star Trek" medicine. I do believe we will as a society work this out.

As a health care professional, I highly recommend this book for nurses, physicians, administrators as well as interested lay people. There are so many cost pressures coming with health care reform, it is easy to get caught up in thinking that quality of care is doomed to decline. This book opened my eyes to the possibilities in front of us today and many hopes in front of us within the next 5 years. It truly lifted my spirits to read it.

Thank you Dr. Topol.
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19 of 20 people found the following review helpful
5.0 out of 5 stars Awesome Book On the Future Overhaul of Medicine, March 7, 2012
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This review is from: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care (Hardcover)
Dr. Eric Topol is one of the most famous and accomplished Cardiologists in the world. He does an amazing job at simplifying the complex field of genetics to give us insight on the future of medicine. He stresses the point that only a small percentage of patients may derive significant measurable benefit from a medicine over a 5 to 10 year period. It is likely one's genetic makeup that determines whether a medicine may led to benefit or harm. This book should be required reading for all of us in the field of medicine. It is clearly written with great stories. What a fabulous book by a legendary scientist.
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92 of 115 people found the following review helpful
2.0 out of 5 stars Dry Literature Review - Not a Narrative, January 14, 2012
By 
D. W. Miller, Jr. (Shawnee, Kansas USA) - See all my reviews
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This book was highly recommended to me by a physician colleague and I eagerly downloaded it to my Kindle and began reading. I was greatly disappointed.

With all due respect to the author, a well-known, highly-respected, and apparently very well-connected physician, this book comes across as a dry, comprehensive academic literature review with almost every sentence referenced and descriptive of some study or article from a short list of leading periodicals/newspapers/magazines. It seems the author just did a literature search on a set of topics, summarized each reference in a sentence or two, organized the snippets, and then strung them together into a book. Apparently, the author only reads The Economist, The Wall Street Journal, The New York Times, Science, and Wired. Without all the descriptive bloat specifying each study, where it came from, where it was published, how many participants, ad nauseum, the book would be half as long (and a third of the book is notes/references).

Additionally, where there is narrative in the book, most of the time it had very little to do with the title of the book. The explanation of genetic decoding went on and on and was barely comprehensible with all the specific jargon of the science. The author wanted to illuminate readers about important topics (e.g. treating a population rather than an individual) but it seemed off-topic with this title (and was on-topic in Your Medical Mind by Groopman which addressed that issue well).

It also seemed to me that the author promoted ventures where he played an inside role in the venture or at least was a beta-tester. At times, his description of some ventures (e.g. the hand-held cardiac ultrasound device) seemed promotional.

So, I was looking for more narrative to the point of the title, and less academic referencing and dryness as if this were a published literature review in some peer-reviewed medical journal.
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23 of 27 people found the following review helpful
5.0 out of 5 stars Help Us Destroy Our Broken Medical System, January 22, 2012
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I've had the pleasure of knowing and working with Dr. Topol for some time. What strikes me most powerfully about his thoughts is how much ahead of the curve he is in his analysis. In a sentence his thoughts: 'Medicine right now is completely broken. To fix medicine - bring amazing new technology directly to the consumer who is now responsible for their own health.' To me this seems completely obvious - and Dr. Topol lays out the compelling evident for all to see in this book.

I am routinely *shocked* by the fact that medicine is actually not on the same page yet. I was recently diagnosed hypo-thyroidal. During a 'conversation' with my PcP I was told 'Do you trust me? (no wait for response) If you do you will take this medicine for the rest of your life.' That's the old world. In the new world - consumers are in control - and they have data and technology on their side to make for an extremely positive impact on human health. If you want to see this new world before it is in place - read up.
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15 of 17 people found the following review helpful
5.0 out of 5 stars Fantastic read! The future is here!, January 18, 2012
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Stop waiting for the future, it's already here. Dr Topol has provided a veritable tour de force on the current state of the convergence of mobile health technologies and genomics. This book is written exactly the way Dr Topol presents; with passion, extraordinary depth of knowledge but above all a deep desire to positively influence the direction of modern medicine. Although I am not a stranger to the topics at hand, he discusses them with incredible perspective as to how these new technologies will forever alter the way we practice medicine. It becomes abundantly clear that our practice of 'Medicine by the yard' is clearly not the strategy that will allow us optimally utilize the devices and technologies discussed.

For the first time in history we are witnessing an explosion of medical data and devices which are out pacing medicines ability to incorporate and utilize it. The mechanisms that currently exist for disease risk prediction, diagnosis, prognosis, treatment and continuous monitoring will soon appear archaic in the wake of not only the technologies of tomorrow but those that exist right now. We currently have in our hands the unique ability to 'Schumpeter' modern medicine as Dr Topol would say; it is incumbent on us as physicians of the future to ensure this happens.

If you are a physician or patient who wants an incredible window into the future of medicine, you will find it here.
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17 of 20 people found the following review helpful
5.0 out of 5 stars Don't forget lab professionals, February 5, 2012
By 
Jake (Beavercreek, Ohio) - See all my reviews
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This review is from: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care (Hardcover)
Very good book that opens numerous questions.
When the discussion leads to how and who will interpret genetic sequencing results (eg pg 120), don't forget that lab professionals have been assisting with this (interpretation) for practitioners and patients for many years. Sure, give a patient a cut section of his/her tumor to look at under a microscope and neither the patient nor his/her primary doctor would likely know what to do with it. We have a growing generation of molecular genetic pathologists and lab professionals (I did not see them referenced in the book)who will work alongside of genetecists and genetic counselors to decode the meaning of genetic sequencing data. Handing a patient a copy of their genetic sequence is in some ways analagous to handing a patient a glass slide section of a tumor. An interpretive report should accompany any data and the genetecists, genetic counselors, primary care practitioners, etc can work with lab professionals to provide a proper interpretation and course of action that is unique to that patient.
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17 of 20 people found the following review helpful
5.0 out of 5 stars just what the doctor ordered, January 20, 2012
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This review is from: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care (Hardcover)
Dr. Topol offers a blueprint for the future of health care. As he keenly elucidates in his book, we are at a critical inflection point. We live in a era in which we can digitize and quantify the health of individuals like never before. Combine this with the current health care crisis and the stage is set for an entirely new way to care for patients. This call-to-arms is not only extremely informative, but very inspiring.
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7 of 7 people found the following review helpful
5.0 out of 5 stars Key Reading for Those Who Deal With Medicine, Patients Especially, December 3, 2012
By 
Anne Mills (New York, NY United States) - See all my reviews
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This review is from: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care (Hardcover)
This book merits five stars for content. I'd have shaved one away, because this was NOT an easy book to read. The topic, however, is so important that we'll leave a full array. In any event, if your life intersects with medicine in a major way, read it.

Dr. Topol is an eminent cardiologist, geneticist, and medical researcher. Here, he argues that the practice of medicine is on the brink of massive structural change. The title attributes this to the digital revolution, but the book is at least as much about the impact of the science of genetics. The combination of these two will produce a medical approach far more closely targetted to the individual, far more precise, and -- ulimately -- far cheaper.

A great deal of what Dr. Topol says is very informative and very convincing. Some of it is so "gee whiz" as to be offputting, and some of it sounds like science fiction. Much of what sounds like science fiction, however, is already in development. And some of it is already moving into current practice -- by patients as well as by doctors.

This is very important reading for those who have heavy contact with the healthcare system. One of Dr. Topol's key points is that as information becomes much more readily available, patients will have to take on more responsibility for their own care -- no one doctor can make all the right decisions in every area, and no one knows a patient like the patient him or herself. There is a lot in this book that's essential knowledge for those with serious conditions (or those who are helping those with serious conditions). The rather horrifying chapter on medical errors stands out, but there is much, much more.

My only problem with the book is that I found it a tough read. That's not so much because it was over-technical. The one instance in which that may be true is the section on the role of genomics in medicine, but that is a hard thing to explain, and not part of the general medical knowledge base -- Dr. Topol notes that at the last report, only 2 out of 150 U.S. medical schools had "more than a brief, cursory curriculum" devoted to genomics beyond simple Mendelian traits. My problem was with the overall approach, which is to throw lots and lots and LOTS of information at the reader, without enough explanation or linking together.

Stylistic issues, however, should not deter readers: there's so much very important stuff in this book that it's worth a bit of a slog. Moreover, the readability problem may be with this (elderly) reviewer. Two generally favorable reviews didn't seem to find it a problem. See the Wall Street Journal review at [...]at [...]

Anyway, read it.
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The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care
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